Rep. John Mizuno wants to clamp down on expensive prescription drug costs, and he鈥檚 taking his cue from recent legislation passed in Maryland.

Beginning in 2022, will be able to limit what county and state governments pay for prescription drugs offered by government employee insurance plans.

The measure was the first of its kind in the nation, and to apply only to drugs purchased by health plans that cover Maryland county and state government employees.

Rep John Mizuno cesspool meeting held at the Capitol.
Rep. John Mizuno wants Hawaii to explore placing caps on prescription drug pricing. Cory Lum/Civil Beat

Mizuno, chairman of the House health committee,聽 wants Hawaii to consider doing something similar and plans to introduce a bill in January that paves the way for a Hawaii drug affordability board.

鈥淗ypothetically this board would determine whether the state should establish a process for setting upward payment limits for prescription drug products,鈥 he said. 鈥淚t鈥檚 like a consumer protection board that you might see in the insurance commission office, but we鈥檇 have oversight on drug costs.鈥

Mizuno envisions the prescription drug affordability board to be housed under the Hawaii Department of Health. It also would include the directors of health, commerce and consumer affairs, and med-QUEST among others. Members of the board would serve without compensation.

Going forward, the board would evaluate medicines or treatments that could pose 鈥渁ffordability challenges.鈥

Payment caps wouldn鈥檛 apply to drug products that are considered to be in shortage by the federal Food and Drug Administration, Mizuno said. The board would develop criteria for upper payment limits and consider the cost of prescription drug administration, and delivery.

In Maryland, the criteria applies to new brand name prescription drugs that cost more than $30,000 a year or over the course of treatment, existing medications that increase by $3,000 or more per year or over course of treatment and generic medications that increase in price by double or more.

Julie Ann Pritchett, a Honolulu native who now lives in Hilo, takes an immunosuppressive drug three times daily to survive with her new liver. Her transplant was the only recourse after a liver cancer diagnosis.

About one year into treatment, her co-payment for a three-month supply of pills jumped from $24 to $211.

“I said, ‘What, the medication became gold all of a sudden?'” she recalled. “You鈥檇 be appalled if it went from $5 a gallon to $50 for milk.”

The only explanation from the pharmacy was that the drug鈥檚 manufacturer increased the drug’s price ten-fold, and her co-payment rose along with it.

When she tried an alternative anti-rejection drug treatment, she broke out in a rash. So her doctor decreased her dosage from four pills a day to three to help her cut costs.

鈥淚t鈥檚 frightening. I need this to live,鈥 she said. 鈥淚 know I鈥檓 not the only transplant patient. There鈥檚 a lot of us.鈥

Mizuno recognized that such a measure will be met with opposition, particularly by pharmaceutical companies.

鈥淧rescription drugs are just too expensive so you need to have a mechanism to control costs, but it will be very controversial,鈥 he said.

In Maryland, the board will need to get approval from a legislative panel to set future payment caps. The board has .

Support Independent, Unbiased News

Civil Beat is a nonprofit, reader-supported newsroom based in 贬补飞补颈驶颈. When you give, your donation is combined with gifts from thousands of your fellow readers, and together you help power the strongest team of investigative journalists in the state.

 

About the Author