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In the latest skirmish over prescription drug pricing, consumer activists filed a lawsuit against Ohio officials for ordering a review of signatures collected for a ballot measure designed to lower the cost of medicines.

The proposed measure, known as the Ohio Drug Price Relief Act, would require the state to pay no more for medicines than the US Department of Veterans Affairs. Currently, the VA gets a 24 percent discount off average manufacturer prices. A similar measure recently qualified for the ballot in California, despite opposition from the pharmaceutical industry.

The lawsuit was filed two days after Ohio Secretary of State John Husted demanded election officials conduct another review of more than 171,000 signatures. He took that step after attorneys for the Pharmaceutical Research & Manufacturers of America, the industry trade group, wrote a letter to Husted to question the validity of many of the signatures that had been submitted.

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The activists and their supporters, who claimed they gathered nearly twice the number of signatures needed, are concerned that the review will jeopardize the ability to have the measure placed on the ballot in time for the November election.

“This is an arbitrary decision to satisfy a special interest,” said Gen Kenslea, a spokesman for the AIDS Healthcare Foundation, an advocacy group that also runs patient clinics and worked with the activists to gather the signatures.  “And now, the clock is running and we may end up having less time.” Once signatures are verified, the state legislature has four months to act on the measure.

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“It seems to me that PhRMA is doing everything it can to keep the drug-pricing measure off the ballot in Ohio. The last thing PhRMA wants is attention being paid to such a ballot measure in the state during an election year, especially a presidential election,” he continued. AHF, by the way, spearheaded the ballot initiative in California, where several drug makers contributed about $34 million to fight the effort.

The lead plaintiff in the lawsuit, Tracy Jones, is a former executive director of the AIDS Taskforce of Greater Cleveland, which is an affiliate of AHF. Her attorney referred us to AHF. We also asked PhRMA for comment and will update you accordingly.

While the lawsuit focuses on the technical procedures used to gather signatures for ballot initiatives, the larger dispute is really about the heated controversy over the cost of medicines. Over the past few years, drugs for such hard-to-treat illnesses as cancer and hepatitis C have caused a firestorm, especially among public and private payers that worry about overextended budgets.

At the same time, the pharmaceutical industry has been criticized for taking continual price hikes, while some drug makers have been chastised for buying medicines and quickly jacking up prices to unforeseen heights — sometimes, by hundreds or even thousands of percentage points. Turing Pharmaceuticals, which Martin Shkreli ran before being arrested, and Valeant Pharmaceuticals are notorious examples.

Nonetheless, the pharmaceutical industry remains strongly opposed to any initiative that would impose price caps or encourage negotiations over prices. Although presidential candidates Hillary Clinton and Bernie Sanders favor allowing Medicare to negotiate for at least some medicines, the notion is not expected to gain much traction, despite growing consumer anger.

Drug makers are not taking any chances. In California, for instance, a spokeswoman for the industry campaign to defeat the ballot initiative recently called the proposal “misleading and flawed.”

She also argued the measure will increase the prices of prescription drugs sold to veterans and many California consumers, and reduce choices of medicines available. At the same time, she maintained the measure will cost taxpayers “millions more in state bureaucracy and lawsuits because it will be virtually impossible to implement.”

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