Neighbor‑island pharmacies warn SB 2283 mail‑order expansion could harm local access

Sen. San Buenaventura convened testimony on SB 2283, a bill aimed at expanding mail‑order access to prescription medications. Proponents, including the Hawaii Medical Service Association, said broader mail‑order options can improve adherence for long‑term therapies and reduce avoidable hospitalizations.

Walden, speaking for HMSA, said mail order is “a proven strategy to lower cost and improve health outcomes” and that automatic refill processes for maintenance medications reduce gaps in therapy. Pharmaceutical trade groups and insurers filed written support and stood on that testimony during the hearing.

Independent and neighbor‑island pharmacists disputed that picture. Kimberly (Molokai Drugs) told the committee that most Molokai residents must pick up mail at one of five post offices with very limited hours and that, for temperature‑sensitive drugs such as insulin, shipments left over weekends can experience prolonged heat exposure. “If you do not pick up your mail order prescriptions by Friday noon… insulin on ice may be stored in a non‑air conditioned facility for 69 hours,” she said, raising concerns about product safety and patient harm.

Derek, owner of 5 Minute Pharmacy, and Corey Sanders of the Hawaii Pharmacists Association testified that mail‑order policies have forced independent stores to close in rural areas and that many patients rely on in‑person counseling, delivery and continuity of care from local pharmacies. Sanders argued that research since 2013 shows mail order is not always cheaper and that reduced local touch points can worsen management of chronic disease.

The chair moved on without questions; the item was later deferred for further work at decision making. The record shows broad support from insurers and statewide groups but sustained, specific opposition from independent and neighbor‑island pharmacies that cited logistics, safety, and economic impacts for small providers.