Monday’s Supreme Court decision that has been interpreted as the go-ahead for Maine Rx must be an exceptionally bitter pill for the pharmaceutical industry to swallow. Especially since it was the industry itself that asked the bench to rule.

It is not wrong to suggest it is beyond time the drug companies got a taste of their own medicine: financial constriction.

Of course, the constrictions now faced by low-income families that require life saving prescription drugs are harmful. The constrictions the pharmaceutical industry may face by more fairly pricing its products will be a mere annoyance that cuts into corporate advertising, perks and bonuses.

Maine Rx permits the state to require prior authorization before prescriptions are dispensed to some government-insured patients and to negotiate for fair and reasonably priced prescription drugs for the uninsured. The former is already permitted under the Medicaid Act; the latter is plain fairness since the uninsured subsidize charity and insured patient care.

Maine Rx is not a certainty, though, so we can’t let up pressure to bring forth this program.

The Supreme Court did not rule Maine Rx is solid legislation. It ruled that the program does not violate the Commerce Clause of the Constitution and it lifted a federal court injunction that prohibited implementation of the program, which leaves the Pharmaceutical Research and Manufacturers of America free to pursue its original lawsuit against the state filed in U.S. District Court and continue its argument that Maine Rx could harm Medicaid patients.

PhRMA’s sole and flimsy remaining argument is that the program “could” harm Medicaid patients by requiring prior authorization. Specifically, that requiring doctors to get authorization before writing prescriptions does not “serve the interests of the Medicaid program,” even though federal law permits this process.

The more obvious argument is that prior authorization precisely does serve the interests of the Medicaid program by establishing a means of monitoring costs to make smart spending decisions.

Medicaid is an expensive program and getting more expensive every year. We offer prescription coverage, even though not legally required to do so, and we offer very comprehensive health care coverage. At some point, as we struggle to pay our bills, Maine may be forced to limit coverage. That, certainly, is a greater threat to Medicaid patients than additional paperwork for prescription authorization.

PhRMA’s argument that Maine Rx “could” harm patients is empty. The promise of 25 to 40 percent discounts on prescription drugs for uninsured patients that Maine Rx offers is not. It is welcome relief for those who are now cutting pills in half or sacrificing food for medicine, and it may keep some Mainers from dropping into poverty and turning to Medicaid coverage altogether. That, certainly, serves the interests of Medicaid.

When Health and Human Services Secretary Tommy Thompson visited Maine last year, he said he believed Maine Rx was a good program and deserved a chance to work, perhaps as a pilot for other states interested in adopting similar strategies.

We urge the secretary, who has the authority to grant Maine immediate approval to implement Maine Rx, to stay true to his word and buck the Bush administration’s clear disapproval of the discount prescription program. Patients are sick and tired of waiting for relief.
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