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

Beginning in 2022, Maryland’s new Prescription Drug Affordability board 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 initially applied to all insurance plans in the state but was later revised 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,  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.

“Hypothetically this board would determine whether the state should establish a process for setting upward payment limits for prescription drug products,” he said. “It’s like a consumer protection board that you might see in the insurance commission office, but we’d have oversight on drug costs.”

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 “affordability challenges.”

Payment caps wouldn’t 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’d be appalled if it went from $5 a gallon to $50 for milk.”

The only explanation from the pharmacy was that the drug’s 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.

“It’s frightening. I need this to live,” she said. “I know I’m not the only transplant patient. There’s a lot of us.”

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

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

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

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