Voters in Ohio decided not to approve an initiative on Tuesday that was aimed at reducing the cost of prescription drugs in the state. The measure would have capped the price of prescription drugs purchased by the state government, including Medicaid.

The measure drew strong resistance from drug makers, which spent more than $49 million to try to kill it, and the industry is not accustomed to losing political fights. Last year, it successfully killed a measure in California that was similar to the one in Ohio, but only after spending more than $100 million to do so.