Hawaii Passes Rx Vending Bill

May 07, 2008

By George Anderson

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?

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6 Comments on "Hawaii Passes Rx Vending Bill"

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Jerry Gelsomino
14 years 19 days ago

Doesn’t the thought of unmonitored vending machines that deliver drugs sound like a sure blueprint for abuse? When you think about the possibilities; criminals breaking in and stealing the prescriptions to either abuse the drug or turn around and try to scalp it, patients who may depend on a kiosk delivered prescription and not be able to get it because the machine is broken or the drug is out of supply, taking the wrong drug for the wrong ailment…then who is responsible?

This is a bad idea for the poor and the rich.

M. Jericho Banks PhD
M. Jericho Banks PhD
14 years 19 days ago

Depending on whose statement you trust, the premise of this topic, “Considering the shortage of pharmacists,” may be incorrect. After all, Ms. Shimabukuro “argued that there are plenty of pharmacists in Hawaii.” And therein lies the issue: Who to believe among a gaggle of self-promoting politicians and political appointees asserting opposite points of view in a teeny, politically-inbred state? This is not about who gets their ‘scrips, but about who gets their spiff.

Al McClain
Al McClain
14 years 19 days ago

Where I could see this working is for common drugs that are needed in a hurry, so mail order is not a good option. Sure, this business will grow but it will be a tiny niche.

Mark Lilien
14 years 19 days ago

Many folks don’t need pharmacists or MDs. They know what medications they need. Paying MDs to repeatedly sign their names to prescriptions is often a huge waste, doubling the waste of requiring pharmacists. In many countries, pharmacy customers need only ask for the drugs they need, without needless prescriptions signed by anyone. And regardless of what pharmacist lobbyists say, lots of pharmacist activity is mindless repetition not characterized by the need for any thought at all. If Americans are really concerned about drug abuse, then why not require all bartenders to get pharmacist licenses? Alcohol is stronger, and subject to more abuse, than most prescription drugs.

David Livingston
14 years 19 days ago

Low income people in Hawaii? I did not realize that. I can’t afford to live in Hawaii. I can barely afford to visit there. As for Rx vending machines, why not just use the US Mail the same way us mainlanders do when a drug store is not convenient?

Amy Dutton
Amy Dutton
14 years 19 days ago

I live in a small community (900) in Iowa. Fortunately, I have the means and reason to get to the metro area daily where I can get my scrips filled. However, there are many, not only in my community but in the far more remote areas of Iowa, that are not only low income, but far from pharmacies.

While mail order pharmaceuticals are great for maintenance drugs covered under insurance plans, there are many that cannot go that route.

I hope to see this vending option or another remote dispensing method–what about a pharm-mobile (like the book mobile of old) that visits rural communities once or twice a week with a pharmacist on board to help close the gap?


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