WASHINGTON — For almost three years, legislators from Florida to Hawaii have watched the high-stakes legal battle between the state of Maine and the pharmaceutical industry with more than passing interest.
So they reacted to Monday's U.S. Supreme Court ruling, which revived a Maine program to reduce prescription drug prices for the uninsured, as if David had seriously wounded, if not slain, Goliath.
"This is a tremendous blow to the [pharmaceutical] industry," said Peter E. Shumlin, a former state senator in Vermont who founded a multistate coalition on drug prices.
"It's not just the state of Maine that's the problem," Shumlin said. "It's that every legislator in every state -- regardless of political party -- in his right mind will do this."
He was referring to the Maine Rx program, which threatens to punish drug companies that don't give uninsured state residents the same low prices offered to patients in the federal-state Medicaid program for the poor. Companies that decline to offer the discount would have their products taken off the state's list of approved drugs.
While Monday's court ruling probably will encourage many states to follow Maine's lead, it does not guarantee that their programs -- or Maine's -- will survive the inevitable legal challenges from the pharmaceutical industry. Maine Rx, established in 2000, has yet to be carried out.
States will also have to reckon with the Bush administration, which Monday restated its view that Maine had gone "too far" in using the leverage of its Medicaid program to force drug companies to lower prices for non-Medicaid patients.
"Today's decision validated [our] central position," said Campbell Gardett, a spokesman for the Department of Health and Human Services.
State programs such as Maine's will need the approval of HHS, he said, and Secretary Tommy G. Thompson would be unlikely to approve Maine Rx in its current form.
Any program that requires a state to authorize drugs on a case-by-case basis if they are not on a list of preferred medications "is going to slow down drugs to [Medicaid] patients," Gardett said, echoing an argument of the drug industry.
The Pharmaceutical Research and Manufacturers of America, which sued to block Maine Rx, said Monday that the program "effectively [denies] patients the specific medicine they need based on cost."
