States' Rx for Drug Costs.

• Author: Cauchi, Richard

With skyrocketing costs of prescription drugs creating real hardships for the elderly and the uninsured, some states acted quickly to expand access.

If it wouldn't have been for the cost of the drugs, I wouldn't have had to go back to work," says 67-year-old Paulette Beaudoin. She spends $469 per month on daily medications, ranging from Celebrex for arthritis to Ambien for insomnia. A popular ulcer drug, Prilosec, costs her another $110 a month. Some months ago, she had to spend another $145 for a temporary illness. She has gone back to a three-day-a-week job in Biddeford, Maine, to pay these bills.

With no drug coverage plan, Florida retiree Elaine Kett scrimps each month to pay for her Prilosec ($114.99 a month), Pulmicort for her lungs ($117) and 10 other prescription drugs she requires. The total runs to a little more than $10,000 a year. "I'm a widow on a fixed income, and this is killing me because my income is just a bit more than double the cost of these drugs," she says.

"I was paying astronomical amounts for eye medications, And I couldn't afford them after a while. I'm very independent, but, really, it was ridiculous," says Barbara Henry, a 69-year-old former teacher in Maine.

These cases mirror the policy debate in America today. Public programs spend almost $20 billion on prescription drugs, yet millions of people lack required medicines.

Maine found one answer: Its newly expanded Low Cost Drugs for the Elderly Program came to the rescue in late 1999 and now pays 80 percent of the price of drugs such as those Henry and Beaudoin need.

The state gained international attention last May when the Legislature enacted the nation's first law that includes price controls on prescription drugs. The bill also created a new "Maine Rx" program that allows any resident without prescription coverage, who enrolls, to purchase drugs at a discount based on the Medicaid rate. That program, which could cover up to one-fourth of the state's population, begins this month.

The law, however, has been challenged in federal court by the pharmaceutical industry. "Everybody's trying to figure out a way to do this," says Maine House Minority Leader Joseph Bruno, a Republican who runs a chain of 10 pharmacies in the state. "If it's a problem in Maine, it's a problem everywhere."

A federal judge issued a preliminary injunction Oct. 26 that prevents Maine from enforcing parts of its new prescription drug law until a hearing is conducted on its constitutionality. In his ruling, Justice D. Brock Hornby was sympathetic to what Maine is trying to do. "The Maine Legislature has sound reasons for wanting to assist its uninsured citizens who must cope with astronomical prescription drug prices," Hornby said. "But in our country, under our Constitution, states cannot legislate outside their...