The national furor over rising drug prices is moving to the ballot box in California, where voters will decide how the state negotiates for prescription medications.

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The stakes are high: How trendsetting California votes could spill over to other states.

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Despite what each sides says, Stanford University law professor Michelle Mello said the fiscal effects are unclear. That’s mainly because of the secrecy surrounding drug pricing negotiations, putting voters in a tough spot.

“It’s going to come down to a battle of the sound bites,” said Mello, who studies health policy.