Four axes from current statute and agency guidance. Teal bar = substitution/assistance/access in place; amber = permissive or absent.
| Generic substitution mandate | Permissive |
| State Pharmaceutical Assistance Program | No broad SPAP |
| 90-day fills permitted | Allowed |
| PMP mandatory prescriber query | Required by statute |
Hawaii permits but does not mandate generic substitution. Under HRS § 328-92, a pharmacist may substitute a less expensive equivalent drug product unless the prescriber has indicated "dispense as written" or otherwise prohibited substitution. The substitute must be FDA AB-rated. Patient consent is required.
Med-QUEST (Hawaii Medicaid) maintains the Hawaii Medicaid Preferred Drug List. Most members are enrolled in QUEST Integration managed-care plans (HMSA, Kaiser Permanente, AlohaCare, UnitedHealthcare Community Plan, Wellcare), which follow the unified PDL. Non-preferred drugs require prior authorization initiated by the prescriber.
Preferred Drug List: View current PDL
Prior authorization contact: Med-QUEST Pharmacy: 1-808-692-8094
Hawaii does not operate a Medicare-recognized SPAP. Low-income Hawaii residents use Medicare Part D Extra Help (LIS), Med-QUEST (Hawaii Medicaid) (if eligible), manufacturer Patient Assistance Programs, and Hawaii SHIP (Sage PLUS) for Medicare enrollment counseling.
Eligibility: No state SPAP. Hawaii SHIP (Sage PLUS) helps with Medicare enrollment.
Hawaii permits 90-day fills of non-controlled chronic medications at retail and mail-order pharmacies. Out-of-state pharmacies must hold a Hawaii Nonresident Pharmacy license from the Board of Pharmacy. Federal CSA refill limits apply to controlled substances.
Hawaii operates the Hawaii Prescription Drug Monitoring Program (HI PDMP), under HRS § 329-101. Prescribers must check the PMP before issuing certain controlled-substance prescriptions. Dispensers must report Schedule II-V dispensing within one business day.
PMP portal: Hawaii Prescription Drug Monitoring Program (HI PDMP)
Hawaii hosts a substantial 340B network including The Queen's Health System, Kaiser Foundation Hospital, FQHCs across Oahu/Big Island/Maui/Kauai, and Ryan White clinics.
Find a 340B clinic in Hawaii: HRSA OPAIS database (HI filter)
Our sister site OmniRx maintains a federal-side patient assistance program directory covering manufacturer PAPs, foundation copay assistance, GoodRx-style discount cards, and 340B locators applicable nationwide.
Once the law side is clear, the next question is which pharmacy actually has the cheapest fill. Use the RxGrab Pharmacy Finder to compare CostPlus Drugs, Costco, Walmart, Amazon Pharmacy, and other discount pharmacies on your specific medication, and read our generic vs brand explainer for the bioequivalence rules behind every substitution.
Yes unless your prescriber wrote "dispense as written." Under HRS § 328-92 substitution is permissive.
No. Use federal Extra Help, Med-QUEST Medicaid if eligible, and manufacturer Patient Assistance Programs. Sage PLUS helps with Medicare Part D enrollment.
Med-QUEST is Hawaii's Medicaid program, operated as fully managed-care via QUEST Integration. All plans use the unified Hawaii Medicaid PDL.
Yes for certain controlled-substance prescriptions under HRS § 329-101.