Prescription Drug Purchasing, Proposition D (November 2013)

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A Prescription Drug Purchasing, Proposition D ballot question is on the November 5, 2013, election ballot for voters in the city of San Francisco, which is in California.

Proposition D would seek to reduce the city's cost of prescription drugs by requiring direct negotiation with drug manufacturers and establishing a policy that the city request state and federal government representatives to sponsor laws that would reduce drug costs to all levels of government with the goal of a 33% reduction.[1]

Text of measure

The question on the ballot:

Proposition D:

Shall it be City policy to use all available opportunities to reduce the City’s cost of prescription drugs and to ask state and federal representatives to sponsor legislation to reduce drug prices paid by the government?[1][2]



  • Yes on Prop D[3]
  • Board President David Chiu
  • Scott Wiener, Supervisor
  • David Campos, Supervisor

Yes on D Music Video - Fair Drug Pricing for San Francisco
  • Eric Mar, Supervisor
  • Malia Cohen, Supervisor
  • Norman Yee, Supervisor
  • Jane Kim, Supervisor
  • Mark Farrell, Supervisor
  • Katy Tang, Supervisor
  • London Breed, Supervisor

Arguments in favor

Proponents of Proposition D argue that drug prices are to high in San Francisco and everywhere. They believe that Proposition D will give legislators the motivation to keep drug prices low through various incentives, regulations and negotiations. Facts cited by the yes on Proposition D include:

  • The average cost of health care for a family of four is over $22,000.
  • This amount is larger for at-risk seniors, bigger families, HIV/AIDS patients and other high-risk individuals throughout the city.
  • San Francisco spends over $23 million per year on city-run medical programs for seniors, working families, women, HIV/AIDS patients and others.

They argue that these costs are too high for both the city government and individuals throughout the city and propose seeking ways to lower the costs of prescriptions drugs at the source.[1]



  • Dr. Terence Faulkner, J.D.
  • State of California Certified Farmer's Market
  • Advisory Board of Committeeman (1999-2005)
  • U.S. Presidents Federal Executive Awards Committeeman of 1988

Arguments against

Opponents of Proposition D, arguing on behalf of drug companies such as Gilead Sciences and Dendreon, point out that without the success of such companies providing them with more than an adequate profit and left over funding for new research. They argue that unless these companies being willing and able to spend hundreds of millions of dollars on highly uncertain drug projects and tests basic drugs that are savings millions of lives today would be unavailable because they would not exist. An example put forward is the 26 point drop that occurred in Dendreon's stock on August 9, 2013, when a cancer drug they were working on ran into problems. Critics of the proposal argue that Proposition D will open the door to regulations and laws that will only hamper progress and could prevent the next science breakthrough, which would be detrimental to scientific progress.[1]

Getting a little imaginative, the anti-Proposition D activists also cite records that say the diseased population of of the Roman Empire and China 2,000 year ago was at around 44 million and 48 million respectively, with nothing doctors could do about it. Around the average life span was at this time was 30 years. While today with breakthroughs in health care science the average life span is more than twice as long, at 80 years. The "no on D" champions say this change is largely due to drug and medical research and say that "attempting to cut back on the money paid to drug research companies is a very dangerous and mistake crusade.[1]


Summaries provided on the voter pamphlet by the Ballot Simplification Committee

The way it is now

The City and County of San Francisco (City) purchases prescription drugs for health services provided by the City. The City provides inpatient health services at San Francisco General Hospital and Laguna Honda Hospital. It also provides outpatient health services at City hospitals and clinics and institutional health services in the San Francisco jail.

The City spends more than $23 million per year on prescription drugs.

To ensure the City receives the lowest possible price on prescription drugs, City law authorizes San Francisco’s Public Health Department to use outside companies to negotiate prices.

  • For inpatient medications and medications for jail inmates, the City uses a company that negotiates drug prices with drug manufacturers.
  • For outpatient medications, the City participates in a federal program that offers a significant discount on prescription drugs. To ensure that it remains eligible for this program, the City uses a federally selected company to negotiate prices and purchase outpatient prescription drugs.[1][2]

The proposal

Proposition D would make it City policy to use all available opportunities to reduce the City’s cost of prescription drugs. It would also establish as policy that the City continue to negotiate directly with drug manufacturers to reduce its cost for medications. Proposition D would also establish as policy that the City ask its state and federal government representatives to sponsor legislation to reduce by one-third the drug prices paid by all levels of government.

A “YES” Vote Means: If you vote “yes,” you want to make it City policy to use all available opportunities to reduce the City’s cost of prescription drugs and you want the City to ask state and federal representatives to sponsor legislation to reduce drug prices paid by government.

A “NO” Vote Means: If you vote “no,” you do not want to adopt this policy.[1][2]

Controller's statement

City Controller Ben Rosenfield said, in his statement of fiscal impact, that Proposition D would not affect the cost of government.[1]

See also

External links

Suggest a link


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 San Francisco Voter Pamphlet and Sample Ballot for November 5, 2013 election
  2. 2.0 2.1 2.2 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributed to the original source.
  3. Yes on D campaign website