Hawaii Struggles to Keep Its Prescrption Assistance Program Alive

First started in 2002, Hawaii’s drug assistance program, called Rx Plus, is designed to help low- to middle-income Hawaii residents get help with their prescription medication costs. Rather that using the Patient Assistance Programs, the state actually negotiates lower drug acquisition costs and passes those savings on to consumers.

The program is called Hawaii Rx Plus. It is a free discount program for residents who earn too much money to qualify for Medicaid and either do not have insurance or have prescription drug needs not fully covered by their insurance.

The problem with the program is that the government is not actively pursuing the deals as set forth in the legislation.  The wording actually stated that they “may” negotiate, which left it open to avoiding the talks all together. The result has been that rates haven’t been as low as they could be.

State House and Senate Democrats, over Gov. Linda Lingle’s veto, amended the law this year to require the administration to negotiate by simply changing the word “may” to “shall.” The new law also requires the state to tell doctors about the differences in drug costs between manufacturers that offer rebates to the state and those that do not.

They are in a place now where they are ready to go to bat for their patients, but with an enrollment of just 112,000 people (all of whom make less than 3.5 times the poverty level), they need to start enrolling new patients rapidly to have the buying power that they need to get even better deals.

“The success of the program depends on the number of people we can enroll quickly,” Lillian Koller, director of the state Department of Human Services, said at the time. “As enrollment grows, we will be able to leverage our purchasing power with drug manufacturers and achieve greater discounts for our participants.”

Unfortunately, Hawaiians have not gotten the level of benefit that was expected from this program when it was created. They have faced opposition from lawmakers and manufacturers, and advocates have been left feeling frustrated on many levels. Hawaii should be proud of their efforts to provide prescription assistance to those in need, and we can only hope that they are able to soon provide the support that they had planned for.