Trying to keep the status quo in government services in an environment of rising costs and declining revenues may indeed prove to be a “Mission: Impossible” scenario.

The maintenance of pharmacy services to the state’s public workers — a tough task at a time when demands on the health care system are accelerating — falls into that “do more with less” category.
The Employer-Union Health Benefits Trust Fund has drawn down considerable heat over its decision to contain costs by requiring regularly filled “maintenance” prescriptions to be filled by mail order and for beneficiaries to pay the differential if they want to continue taking a drug priced higher than the plan’s recommended alternative.
Indeed, some of the complaints coming in are justifiable. With the changed rule due to take effect at the end of this month, some members of the public-workers health plan reported finding the higher-priced drug available locally for less than the price quoted by the plan’s Mainland-based pharmacy benefit manager, InformedRx. If patients are willing to pay the differential, it should be up to them where to buy it. EUTF officials, rightly, have acknowledged that the requirement to fill such orders by mail should be reconsidered.
Other members have voiced concerns that they won’t be able to get their questions answered by the remote manager as easily as by the corner pharmacist. Officials say InformedRx can field such questions, but ensuring that enough customer service is available should be a criterion when the contract comes up for review.
Overall, however, the EUTF board has acted in the best interest of its members through this move. Without the change, premium costs for all beneficiaries — whether or not they’re on any prescriptions — would have been raised.
Cost containment must be seen as a necessary move if cuts in general health care benefits are to be avoided.
Moreover, members will still have an introductory period for any new drug to fill the prescriptions locally. If the cheaper, preferred drug doesn’t work for them, the doctor can order one that does.
The smart thing for members to do is monitor any shortcomings in the service and alert their union representatives on the EUTF board, to hold InformedRx accountable for promised service. There is also an email address (eutfadmin@hawaii.gov) for feedback.
The quality of service, not its form, should be the bottom line in evaluating this needed cost-cutting move for the future.