Pharmacies in Hawaii will now be able to set up remote vending units to deliver prescription medicines to low income residents in rural areas following a vote by the state's legislature last week, according to the Kauai Garden Island News.
While the measure (Senate Bill 2459) passed unanimously, it faced criticism from a number of parties including some pharmacists.
In March, Catherine Shimabukuro, manager of Kalaheo Pharmacy, testified that she believed that the units failed to meet standards set by the National Association of Boards of Pharmacy.
At the time, Ms. Shimabukuro called the goal of the legislation "noble" albeit "misguided in its approach" to finding a means to care for the uninsured in Hawaii.
"There are many other avenues that can address this need and all are viable and doable without rewriting the laws that govern the practice of pharmacy," she said.
Ms. Shimabukuro argued that there are plenty of pharmacists in Hawaii giving residents of the state easy access to care no matter where they live. Based on the access issue, she maintained, vending units were not needed.
State Rep. Roland Sagum maintained that access was about more than where a pharmacy or vending unit was located.
"The pricing of these [prescription] drugs is much cheaper than they can get at a pharmacy," he told the Garden Island News. "It's for our people who are poor and the indigent."
Ho‘ola Lahui, a federally qualified health center, previously distributed drugs through remote units until the state's pharmacy board ruled a pharmacist must be present to dispense medicines from a kiosk. As a result of the ruling in April 2007, Ho‘ola Lahui stopped using remote units to dispense drugs.
With the passage of S.B. 2459, Ho‘ola Lahui can, once again, begin using remote vendors to fill prescriptions.
Brian Carter, the pharmacist in charge at Lihu‘e Professional Pharmacy, said Ho‘ola Lahui was motivated by profits and not customer concerns in pushing for the legislation.
"Ho‘ola Lahui has received money from the federal government to provide aid to the poor and needy people of Hawaii," he said. "What Ho‘ola is doing is using the money that they have received, in good faith, to profit for themselves and put the pharmacies that have served this community for the past 50 years out of business."
Hawaii's Pharmacy Board was among the groups who supported the adoption of the new law. During the public statement process, Dr. Elwin Goo, the board's chairman, testified on the bill's behalf.
"The board supports the practice of remote dispensing and believes it is a technology that should be afforded to all pharmacies so that all residents of this state can be afforded easier access to prescription medications to meet their health care needs," he said. "The board understands and sympathizes with the concerns of the legislature of the financial impact on the small independent pharmacies; however, this bill is not about financial gain or the prosperity of a business, but of the safe dispensing of prescription medications."
Supporters say that the dispensing kiosks are not like the typical vending unit used to dispense beverages or snack products. Consumers communicate with pharmacy techs using a two-way video and sound system.
"It's very controlled, Sen. Hooser told the Garden Island News. "Only certain medications are allowed to be dispensed and an off-site pharmacist does the record keeping."
Discussion Questions: Considering the shortage of pharmacists and the number of consumers in rural areas and elsewhere without convenient access to drugstores, do you expect to see more companies in the business of dispensing prescriptions push for remote vending units? Do the apparent savings suggest to you that Rx vending units will become more widely used in the future?