H.B. 18 Summary

• Establishes maximum wholesale prices for the 250 most costly prescription drugs in Hawaii, pegged to Canadian drug prices from Ontario, Quebec, British Columbia, and Alberta formularies.

• Prohibits state entities, health plans, and participating ERISA plans from purchasing referenced drugs above the established maximum prices; also prohibits pharmacies from purchasing these drugs above the maximum rates.

• Requires the Insurance Commissioner to annually compile the list of referenced drugs by August 1st and calculate expected savings, with savings to be passed directly to consumers through reduced costs.

• Prohibits drug manufacturers and distributors from withdrawing referenced drugs from Hawaii markets to avoid price limitations; requires 180-day notice for non-price-related withdrawals and mandates good-faith negotiation at or below referenced rates.

• Imposes penalties of $500,000 or the annual savings amount (whichever is greater) for violations of withdrawal/negotiation provisions, and $1,000 per transaction for price-related violations; takes effect July 1, 2021.