In a slap to the pharmaceutical industry and a rebuke to Congress, the Maine Legislature on Tuesday became the first in the country to approve a bill that would clamp sweeping price controls on medications sold in the state.

The "Act to Establish Fairer Prescription Drug Prices" would immediately establish a pricing board to set suggested lower prices. If the prices did not fall, then as of Oct. 1, 2001, the board would mandate that all drugs sold in Maine could cost no more than they would in Canada.The bill must still go to Gov. Angus S. King Jr., who has remained neutral on it, but it passed by veto-proof margins in both chambers Tuesday -- 23-9 in the Senate, 102-47 in the House. It is expected to face legal challenges, in particular on the grounds that it hinders interstate commerce, but the state attorney general has testified that he believes the bill can withstand them, in part because the commerce clause in the U.S. Constitution allows an exception for states protecting the basic health and safety of their citizens.

"This makes Maine the first state to say, 'Americans shouldn't be subsidizing low prices for prescription drugs around the world,' " state Sen. Chellie Pingree, the Senate's Democratic majority leader and the bill's primary sponsor. "The pharmaceutical industry worked extra hard against this bill, but they had no argument and this is a huge national issue."

The rising cost of medications is particularly an issue in border states like Maine, where residents can cross into Canada, which has national health insurance, and reap the benefits of the discount the Canadian government negotiates with drug companies, saving as much as 60 percent or 70 percent on certain drugs.

The Vermont state senate recently passed a similar bill with "fair pricing of prescription drugs" in its title, though it has yet to be voted on in the state House of Representatives. The New England states have also formed a coalition to try to present a united front on drug prices, whether through local price controls or pooling their residents to demand mass discounts. The legislative leaders in the coalition argue that virtually every other country negotiates a low price for their drugs with the industry, so Americans end up footing the bill for all the research that benefits everyone.

"It sounds like they're claiming this is a win for the Legislature, but I think it's a detrimental blow to patients in Maine who need access to medicine," said Gabrielle Williams, a spokeswoman for Pharmaceutical Research and Manufacturers of America, the Washington-based trade association. "It could have significant impacts on access to certain medications in Maine."

Delays in setting prices could bring delays in access to new drugs, she said. Also, price controls remove the financial incentive for research and development to create new miracle drugs, she added.

And some fear that manufacturers would refuse to sell drugs in Maine.