Prescription Drug Purchasing, Proposition D (November 2013)

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

Proposition D sought 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]

Election results

Below are the results as of 10:19 pm, with 409 of 409 precincts reporting.

San Francisco Prop D
Approveda Yes 72,978 80.08%
These results are from the San Francisco elections office.

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This ballot measure article has preliminary election results. Certified election results will be added as soon as they are made available by the state or county election office. The following totals are as of percent of precincts reporting.

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
  • The San Francisco Democratic Party[4]

Arguments in favor

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

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

They argued that these costs were too high for both the city government and individuals throughout the city and proposed 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, pointed out that without the success of such companies providing them with more than an adequate profit and left over funding for new research, many diseases would remain impervious to treatment. They argued that unless these companies were 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 was 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 argued that Proposition D would open the door to regulations and laws that would only hamper progress and could prevent the next science or medical breakthrough.[1]

The anti-Proposition D activists also cited historical documents about the diseased population of the Roman Empire and China 2,000 year ago, recording the number of people with diseases at around 44 million and 48 million respectively. The documents cited also claimed that doctors could do nothing about it. Opponents also point out that the average life span at this time was about 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 said this change is largely due to drug and medical research and that "attempting to cut back on the money paid to drug research companies is a very dangerous and mistaken 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]

Path to the ballot

See also: Laws governing local ballot measures in California

According to law, to qualify an initiative for the November 5, 2013 ballot, petitioners had to collect 9,702 valid signatures, which is equal to 5% of the total number of people who voted for Mayor in 2011. The "Fair Drug Pricing" campaign, pushed by the AIDS Healthcare Foundation, collected more than enough signatures as confirmed by a random check by the Department of Elections.[4]

See also

External links

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