Appeals Court Ruling Allowing Maine to Implement Prescription Drug Law Leads Kaiser Health Policy Report Drug Round Up

A federal appeals court on May 16 lifted an injunction barring Maine from implementing its "pioneering prescription drug law," which allows the state to impose price controls on medications in three years if its negotiations with drug companies do not "lead to steep price reductions," the AP/Nando Times reports. The decision by the 1st U.S. Circuit Court of Appeals allows for the immediate start-up of Maine Rx, according to Attorney General Steven Rowe. Under the program, the state will negotiate for lower prices with drug companies on behalf of 325,000 residents without prescription drug coverage; the law "also allows the state to seek rebates from drug manufacturers and labelers that participate in publicly supported prescription programs," including Medicaid. Last October, a federal judge granted an injunction against Maine Rx at the request of the Pharmaceuticals Research and Manufacturers of America, which argued that the law "unconstitutionally regulates transactions outside Maine's state borders." PhRMA also said Maine Rx conflicts with federal Medicaid law by interfering with the relationship between manufacturers and distributors. The appeals court, however, sided with Maine, finding that negotiating drug rebates was a state matter. Maine Human Services Commissioner Kevin Concannon said, "I am thrilled. And the opinion appears to be very clear on virtually all of the arguments made by PhRMA -- the court of appeals ruled with the state" (Kim, AP/Nando Times, 5/16).

N.J. Law Expands Prescription Drug Coverage
Acting New Jersey Gov. Donald DiFrancesco (R) signed legislation (S 6) on May 15 that allocates $60 million to both expand the state's current prescription drug program for seniors and the disabled and create a new less generous benefit, for those with higher incomes, the AP/Home News Tribune reports. The current Pharmaceutical Assistance to the Aged and Disabled (PAAD) program is open to seniors and disabled residents earning up to $18,587 a year for singles and $22,971 for couples. The $310 million program has about 190,000 participants, who pay a $5 co-payment for prescription drugs. The new law will increase the income eligibility levels for PAAD to $19,238 for singles and $23,589 for couples, starting Jan. 1. The law also creates the "Senior Gold" program, which, beginning June 1, will be open to those with incomes no more than $10,000 above the new limits for PAAD. Under "Senior Gold," participants will pay the first $15 of any prescription, then evenly share the remainder of the cost with the state. The plan offers catastrophic coverage once an individual has paid $2,000 a year in out-of-pocket costs, although each drug purchase after this amount is reached will still require a $15 co-pay (AP/Home News Tribune, 5/16). The PAAD expansion and the "Senior Gold" program will make about an additional 100,000 residents eligible for prescription drug coverage (Cichowski, Bergen Record, 5/16).

W.V. Discount Card Gets New Attention
A West Virginia official "pledged" on May 15 to "revitalize" a state program under which seniors receive a discount card for prescription drugs, the AP/Charleston Gazette reports. "Golden Mountaineer" cards have been around for about two decades, and are issued to all residents over 60. However, according to Ann Stottlemyer, commissioner of the Bureau of Senior Services, the "number of businesses that offer discounts to card holders has dropped" as "[m]any stores now have their own senior citizens discount programs." This summer, Stottlemyer's agency will hire a prescription benefits manager to negotiate discounts for card holders with drug companies and pharmacies. The discounts could range from less than 10% to 45% (AP/Charleston Gazette, 5/16).