Part of the controversial changes being made in prescription drug plans for state and county workers will be postponed until the start of next year.

Trustees of the state Employer-Union Health Benefits Trust Fund, or EUTF, have voted to delay the start of its so-called reference-based pricing from next Tuesday until Jan. 1.

The pricing program calls for the use of lower-cost alternatives in three categories of drugs — cholesterol-lowering statins, anti-heartburn/ulcer drugs known as proton pump inhibitors, and allergy medications known as low or non-sedating antihistamines.

EUTF Administrator James Williams said the board decided to delay the pricing program to make sure other plan changes under way go smoothly.

The EUTF was forced to make adjustments to the prescription drug coverage offered members because of rising costs, and started enacting the changes on July 1. This included mandating the use of a Florida pharmacy for maintenance drugs and requiring use of generic drugs.

Under the reference-based pricing program, patients must switch to the lower-cost drugs or get a doctor's exception to stay with their current prescription.

A third alternative is for patients to pay substantially more to stay with their old drug.

The program has drawn criticism from EUTF members and others.

"All drugs within classes of medications are not the same," said Dr. Martin Rosenthal in an e-mail criticizing the new policy as interfering with proper doctor-patient care.

"For example, some statin drugs are more likely to cause muscle inflammation than others and some statin drugs are not compatible with anticoagulant or antiplatelet therapy."

Williams said the plan takes this problem into account by allowing people to remain on their current drugs by having their physicians submit an exception form.

Other changes made by the trustees to the plans include allowing people to opt out of the mandatory mail-order program when it comes to prescription drugs requiring refrigeration.

Williams said trustees noted the concerns about maintaining temperatures during shipping for prescriptions filled by Inform- edRX's Florida pharmacy. The EUTF will allow people to fill prescriptions for insulin and other temperature-controlled medicines at local pharmacies.

It also approved a plan lowering the price of oral oncology prescriptions.

Williams said the EUTF also voted to extend the pharmacy benefits management contract with InformedRX, a Lisle, Ill.-based company, until June 30, 2011.

He said that brings the expiration of the contract in line with other contracts for insurers, including HMSA and HMA.

WILLIAMS RETIRING AS EUTF CHIEF

James Williams, administrator for the Hawai'i Employer-Union Health Benefits Trust Fund, will retire from the agency at the end of the year.

Williams, who has been with the EUTF since November 2004, said his retirement was unrelated to current turmoil and has more to do with his being in his 60s.

The EUTF, which oversees health benefits for state and county workers, has had to cope with rising health care costs and come under fire recently for changes in its drug prescription plan that saved both employers and members money but included changes that were unfavorable for some people.

"I've enjoyed my tenure here," said Williams. "I've had good people to work with and good boards to work with."