Pharmacy Frustrations

Molokai Drugs seeks exemption from new drug plan. 

Opinion by Kimberly Svetin

On behalf of Molokai Drugs, we would like to thank the community for their support—hundreds of letters, phone calls, e-mails, petitions—on behalf of asking the Board of Trustees of the Hawaii Employer-Union Health Benefits Trust Fund (EUTF) for an exemption in the mandatory mail order program for the islands of Molokai (including Kalaupapa, Kalalau County) and Lanai. We know that you have many choices and truly appreciate your support over the past 74 years.

Since the July 15, 2009 Board of Trustees meeting, we have been approached by a number of residents and wanted to give an update to our community on what has been happening. At the meeting, we (Molokai Drugs) were told by the Board of Trustees to work on a solution with informedRx, an SXC company (NASDAQ: SXCI) based in Lisle, Illinois. We were sent a pharmacy working agreement in writing on August 5, 2009 by our contact at informedRx and are reviewing this document. The topic of the exemption was tabled until the next Board of Trustees meeting, which will be held on August 26, 2009.

We at Molokai Drugs fully believe our patient care model is the preferred option for delivering high quality pharmacy services to our community's residents. We provide the integration of accurate medication dispensing, patient education/counseling and physician feedback/reporting, improving the overall quality of care as well as the patient experience. This system of care and communication has been built on a relationship between the member, physician and pharmacist, a trust that has been developed over many years; this relationship is one of the special reasons we all call Molokai our home.

In this eye-opening process, we have learned how important it is to take control of our personal and family's health, whether we are an EUTF member or not. The hundreds of EUTF active employees, beneficiaries and non-Medicare eligible retirees on our island really need to read and re-read the EUTF PPO Prescription Drug Plan “Overview of Plan Changes” Effective July 1, 2009 (the 27-page booklet mailed to each member in June 2009). The mandatory mail order is just one small part of the changes.

Please note that effective July 1, 2009, there were many changes to the EUTF prescription benefit. These changes were to “contain program costs while ensuring that EUTF participants continue to receive maximum benefits” (“Overview of Plan Changes,” page 17). These changes include a generic drug incentive program; the removal of formulary grandfathering; utilization management guidelines; a maintenance mail order program; reference-based pricing; Ascend SpecialtyRx; and a specialty drug tier.

Although mail service reduces out-of-pocket costs over three prescriptions, a member's immediate out-of pocket cost will be at least twice that of what it was before the plan change. This will cause a particular hardship for our patients who pay month-to-month for the medicines. Also, there are patients who do not have credit or debit cards and may find it difficult to pay.

We believe the “one-size-fits-all” EUTF plan coordinated by informedRx does not work for all of our customers on Molokai and Lanai. We felt it was our responsibility to advocate our patient care model over what was being imposed by the EUTF. However, for the record, Molokai Drugs is prepared to work with the EUTF and informedRx to establish a pharmacy program for Lanai and Molokai EUTF members affected by the mandatory mail order program. We look forward to further discussion of how we can make this happen with minimal disruption to our EUTF members and to our island's prescribing dentists and physicians.

As always, please stop by and see our registered pharmacists—David Mikami, Jon Mikami, Kelly Go—with your concerns and questions. We hope to inform our community about the EUTF Board of Trustees decision as soon as we are notified. No matter the result, we will continue to serve our island and continue to assist all those affected with the EUTF and other drug plan changes to ensure the optimal in patient care outcomes for our community.

Kimberly Svetin is President of Molokai Drugs, Inc. She also sent this letter to Governor Linda Lingle, Senator Kalani English, Representative Mele Carroll and Maui Council Chairman Danny Mateo.