Choice to buy medicine locally awaits gov’s nod

A bill awaiting Gov. Neil Abercrombie’s signature could increase competition among pharmacies and make getting medications easier for some residents.

The Legislature passed the bill to allow residents to go to their local pharmacies for prescriptions. Some plans, including current state and county employee health plans, require drugs to be received by mail.

State Rep. Cindy Evans (D, Kaupulehu-Waimea-Halaula), who introduced the bill, said it is an issue of consumer choice. She said many people, like herself, prefer the face-to-face contact and assurances of having a personal pharmacist.

But critics say the bill will increase costs. The Hawaii Medical Service Association and CVS Caremark Corp. say the mail-order requirement makes prescription drugs more affordable.

"This legislation takes away the ability of plan sponsors to design a cost-effective pharmacy benefit plan that best suits their needs and the needs of their beneficiaries and employees," wrote Lauren Rowley, vice president of government affairs at CVS Caremark Corp., in testimony to lawmakers. (CVS also owns the Longs Drugs chain.)

Mark Oto, director of government relations at HMSA, testified that health plans shouldn’t be denied the flexibility to control costs.

State Insurance Commissioner Gordon Ito also had concerns about the bill. He said the insurance commission doesn’t have jurisdiction to enforce it and is also worried about rising costs.

Some advocates of the measure say there isn’t enough evidence to show that fees will increase.

The issue isn’t just about consumer choice. The bill could help local pharmacies compete with huge corporations like CVS, a multibillion-dollar company based in Rhode Island. Hawaii pharmacists say that their business has suffered as a result of the state’s move to mandatory mail order for maintenance drugs like diabetes or allergy medication a few years ago.

Kimberly Svetin of Molokai Drugs, the only pharmacy on an island of 6,000 people, says the importance of the bill lies in improving patient health.

While mail order is convenient for many people, not everyone has Internet access or a mailbox at home, Svetin said. She says sometimes insulin will sit in the post office, heating up far above the recommended temperature. Kauai pharmacist Lianne Mala­pit said the same thing happens on Kauai.