Brand-name drug prices
rise for state employees

Retirees may also pay more
under HMSA's prescription plan

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By Helen Altonn
haltonn@starbulletin.com

About 69,000 state employees and retirees with Hawaii Medical Service Association drug benefits this month began paying more for brand-name drugs.

A three-tier drug plan initiated for those HMSA members July 1 encourages them to ask for less-expensive generic or preferred medicines.

The average co-payments are $5 for generic drugs, $15 for preferred products and $20 for all other brands, said HMSA Senior Vice President Cliff Cisco.

HMSA put the same plan into effect four years ago for about 130,000 employees with drug benefits as part of their group health plans.

It's an incentive to use generic or preferred prescription drugs rather than premium, nonpreferred medicines for which there is an equivalent product, Cisco said.

The state didn't buy the three-tier package then, but decided this past year to implement it, he said.

That will double or triple members' co-payments for preferred-brand drugs. But Cisco pointed out that many state retirees have full coverage drug plans, meaning the state pays their premiums.

He said a lot of material went out to affected HMSA members in May and June but they may not realize the benefits have changed until they go to their pharmacy to get a prescription filled.

"We encourage members to discuss their drug options with their physician and determine what's best for them," he said. "It's a clinical decision if you find the product you've been using has a high co-payment."

In cases where preferred drugs in some categories aren't effective for patients, Cisco said the physician can work with HMSA to make an exception for the individual.

Hawaii, as a small community, can't have much impact on the pharmaceutical industry and spiraling drug costs, Cisco said.

But increased co-payments help to make HMSA members more aware of the high costs and discuss options with their physicians, he said.