America’s hands-off regulatory stance on prescription drug pricing allows pharmaceutical companies to raise costs, resulting in the most expensive medications worldwide. California ballot measure Proposition 61 intended to cap cost inflation by matching state prices with those negotiated by the U.S. Department of Veterans Affairs (VA). The measure, which failed on Nov. 8, could have created a national precedent for lowering prescription drugs costs.

About The Bill

Sponsored largely by the AIDS Healthcare Foundation, the Proposition 61 initiative would have lowered drug prices for patients in California. The measure, also known as the California Drug Price Relief Act, would set prices through the VA’s negotiation system and limit the reach of pharmaceutical monopolies.

Proposition 61


If passed, the bill would have:

  • Prohibited state agencies from buying any prescription drug from a drug manufacturer at any price over the lowest price paid for the same drug by VA, except as may be required by federal law.
  • Applied to any program where the state agency is the ultimate payer for a prescription drug, even if the state agency does not itself buy the drug.
  • Exempted purchases of prescription drugs under managed care programs funded through Medi-Cal.

Proponents and opponents of the measure funneled millions into campaign efforts, which led to one of the most expensive initiatives to date. According to Ballotpedia, total fundraising efforts from both sides came to $128.1 million.

Each campaign spent a large chunk of money to move their respective agendas forward, though drug companies spent the majority at $109 million to block the measure. 

Yes on 61: Pharmaceutical Profits

Source: Yes On 61

The “Yes on 61” campaign focused on pharmaceutical greed, asserting that corporate drugmakers are ripping off American patients. The campaign created “wanted” posters to call attention to CEO salaries and legal settlements, in addition to video advertisements accusing corporations of consumer exploitation.  

According to the site Yes on 61, the VA pays “20-24% less on average for drugs than other government agencies, and 40% less than even Medicare.”

Video ads featured big-name CEOs, like Johnson & Johnson’s Alex Gorsky, publicizing his $23.8 million salary and a number of legal disputes related to the company’s off-label marketing and safety negligence.

No on 61: The Status Quo

The No On 61 campaign feared a negative impact from disrupting the current price regulation system. The opposing campaign predicted the initiative would lead to higher drug prices for veterans and seniors, as well as decreased access to medications.

The anti-prop argument suggested that the measure would ultimately affect veteran discounts. The opposing side was also comprised of legislators, medical organizations and doctors.

Continued Support

Though the proposition was defeated 54-46, legislators and organizations will continue fighting to lower the cost of drug prices.

Connect with an advocate to share your story about healthcare costs in the United States.