ST7\ND. COM. REP. NO. I53S
Honolulu, Hawaii
APR 0 2 2025
RE: S.R. No. 53
S.D. 1
Honorable Ronald D. Kouchi
President of the Senate
Thirty-Third State Legislature
Regular Session of 2025
State of Hawaii
Sir:
Your Committee on Health and Human Services, to which was
referred S.R. No. 53 entitled:
"SENATE,RESOLUTION REQUESTING THE DIRECTOR OF HEALTH TO
CONVENE A PHARMACY BENEFIT MANAGER WORKING GROUP TO DETERMINE
THE BEST POLICIES TO REFORM PHARMACY BENEFIT MANAGER
PRACTICES IN THE STATE TO ENSURE TRANSPARENCY AND FAIRNESS
FOR CONSUMERS TkND IN THE PHARMACEUTICAL SECTOR, LOWER DRUG
COSTS TO PATIENT CONSUMERS, TiND INCREASE ACCESS TO HEALTH
CARE,"
begs leave to report as follows:
The purpose and intent of this measure is to request the
Director of Health to convene a Pharmacy Benefit Manager Working
Group to determine the best policies to reform pharmacy benefit
manager practices in the State to ensure transparency and fairness
for consumers in the pharmaceutical sector, lower drug costs for
patient consumers, and increase access to health care.
Your Committee received testimony in support of this measure
from the State Health Planning and Development Agency, University
of Hawai‘i at Hilo, Hawai‘i Pharmacists Association, Walgreen Co.,
and eight individuals.
Your Committee received comments on this measure from the
Department of Health.
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Your Committee finds that over the past decade, pharmacy
benefit managers (PBMs), the intermediary between pharmacies and
insurance companies, have morphed into large health care
conglomerates that exercise control over every link in the
prescription drug delivery chain, resulting in higher drug costs
for patients and increased profits for the corporate health care
conglomerates that own PBMs. Your Committee further finds that
the three largest PBMs control eighty percent of the United States
prescription drug market, profiting from the use of spread pricing
models, also known as pay-to-play models, where the PBMs profit
from the difference between what they charge health insurers for
drugs and the amount they reimburse the pharmacies, which is often
less than the actual costs for the pharmacies to acquire and
dispense the drugs. Your Committee believes that oversight over
PBMs is critically needed in the State to evaluate current PBM
practices and their effects across the health care spectrum
pertaining to both medication cost and access. This measure's PBM
Working Group, consisting of key stakeholders, represents a
measured strategy for identifying the best options to ensure
fairness, transparency, and access to needed medications for
patients and communities in the State.
Your Committee has amended this measure by:
(1) Requesting the Administrator of the State Health
Planning and Development Agency, rather than the
Director of Health, to convene the Pharmacy Benefit
Manager Working Group;
(2) Requesting the Administrator of the State Health
Planning and Development Agency or the Administrator's
designee, rather than the Director of Health or the
Director's designee, to serve as the chairperson of the
Pharmacy Benefit Manager Working Group;
(3) Amending its title accordingly; and
(4) Making technical, nonsubstantive amendments for the
purposes of clarity and consistency.
Your Committee notes the request of $100,000 to enable the
State Health Planning and Development Agency to contract with a
third party to provide assistance to the Pharmacy Benefit Manager
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Working Group in carrying out its duties requested in this
measure.
As affirmed by the record of votes of the members of your
Committee on Health and Human Services that is attached to this
report, your Committee concurs with the intent and purpose of S.R.
No. 53, as amended herein, and recommends its adoption in the form
attached hereto as S.R. No. 53, S.D. 1.
Respectfully submitted on
behalf of the members of the
Committee on Health and Human
Services,
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 The Senate
Thirty-Third Legislature
State of Hawai‘i
Record of Votes
Committee on Health and Human Services
HHS
Bill / Resolution No.;* Committee Referral: Date:
The Committee is reconsidering its previous decision on this measure.
If so. then the previous decision was to: ___________________________________
The Recommendation is; .
Pass, unamended Pass, with amendments __ Hold __ Recommit
2312 2311 2310 2313
Members Aye Aye (WR) Nay Excused
SAN BUENAVENTURA, Joy A. (C)
AQUINO, Henry J.C. (VC)
HASHIMOTO, Troy N.
KEOHOKALOLE, Jarrett
FEVELLA, Kurt
TOTAL 1
Recommendation;
Adopted __ Not Adopted
Chair’s or Designee’s Signaturq^—__ _____
Distribution: Original Yellow Pink Goldenrod
File with Committee Report Clerk's Office Drafting Agency Committee File Copy
*Only one measure per Record of Votes
Revised: 12/09/24