Hawaii Struggles to Keep Its Prescription 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 than using the Patient Assistance Programs, the state actually negotiates lower drug acquisition costs and passes those savings on to consumers.

Hawaii Rx Plus

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 altogether. The result has been that rates haven’t been as low as they could be.

State House and Senate Democrats

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 its 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.

Ask about free samples: Many doctors have extra supplies of medications in their offices and are willing to help outpatients in need.

  • Buy in bulk: Many pharmacies give discounts if you buy a three-month supply of drugs at once versus a 30-day supply.
  • Split your pills: Ask your doctor about cutting your pills in half. Pill-splitting allows you to get two months’ worth of medicine for the price of one, but not all pills can be split. Splitting devices are available in most pharmacies, or for those hard to split pills see www.precisionpillsplitters.com.
  • Shop online: Using online or mail-order pharmacies is another way to cut costs – often 25 percent or more. A top resource for finding U.S.-based pharmacies offering the lowest prices is www.destinationrx.com – click on “Price Compare.” (Tip: Make sure the online pharmacy you’re buying from has the “VIPPS” seal of approval – see www.vipps.info). Seniors enrolled in a Medicare prescription drug plan also need to make sure the online pharmacy they’re buying from is included in their network. Otherwise, the purchase may not count toward their deductible.

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