NCL strongly supports FDA’s proposal to ban menthol

August 3, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC – The National Consumers League filed comments today with the Food and Drug Administration (FDA) in support of the agency’s proposal to ban menthol products.

“We commend the FDA’s actions, though we believe the ban on menthol cigarettes in the United States should have been implemented years ago,” said Sally Greenberg, Executive Director of NCL. “Nevertheless, this ban on menthol will save hundreds of thousands of lives and will have especially important positive benefits for African Americans because tobacco companies have relentlessly marketed menthol cigarettes to African Americans for decades.”

NCL recently recorded a podcast with the African American Tobacco Control Leadership Council, the country’s leading public health education and advocacy organization taking on Big Tobacco to save Black lives. The podcast can be found here: https://nclnet.org/menthol-cigarettes-going-up-in-smoke/

NCL also noted that the United States is an outlier among nations of the world in its proposal to ban menthol just now. The EU implemented a ban for its 28 member countries in 2020.

“Menthol enhances the addictive effects of nicotine in the brain,” said Greenberg. “The tobacco industry knew this and yet continued to market the product to Americans, especially targeting African Americans. Menthol is associated with progression to regular cigarette smoking in youth and young adults.”

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL applauds the FDA for renewing its focus on infant formula

July 14, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC— The National Consumers League (NCL) applauds the Food and Drug Administration (FDA) for taking strong steps to assure consumers that infant formula coming from overseas has been properly inspected and is free from contaminants or adulterants and therefore safe for infants.

“Consumers should have confidence that the infant formula that is being imported to the U.S. … involved a thorough review of the information provided by the companies, including details about the product’s nutritional adequacy and safety, microbiological testing results, labeling information, and importantly, details about the manufacturing facility’s food safety production practices and inspection history,” according to a press statement posted on FDA.gov.

Over the past few months NCL, the nation’s oldest consumer advocacy organization, has issued several statements on the infant formula shortage. The shortage was caused primarily by the unconscionable and unsanitary practices at Abbott’s Michigan infant formula facility when it failed to follow safety protocols, falsified documents to the FDA, and then shipped contaminated formula resulting in babies contracting foodborne illnesses and as many as nine infant deaths, according to FDA documents. Abbott’s reckless actions – coupled with the FDA’s slow response to the outbreak – finally lead to both parties issuing a recall of the faulty formula and ultimately triggered a nationwide shortage of powdered infant formula.

As FDA renews its focus on infant formula, NCL applauds the agency’s determined outreach to keep parents informed about how to read food labels from products made abroad. These labels use metric measurements that consumers in the United States may not easily comprehend. Most importantly, FDA has ramped up inspections of the products to ensure good and safe manufacturing processes.

Below are several statements on the infant formula crisis issued by NCL in the past few months, one of which includes our June 16 testimony before a Senate Judiciary Subcommittee.

https://nclnet.org/ncl-applauds-fda-response-formula-shortage/

https://nclnet.org/senate-testimony-consolidation-harms-consumers/

https://nclnet.org/baby-formula-shortage/

 

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

A New Patient-Centered Action Agenda calls for people with obesity to have the same rights and access to care as people with other chronic diseases

July 7, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC— The National Consumers League (NCL) today released A New Patient-Centered Obesity Action Agenda: Changing the Trajectory of Obesity Through Patient Empowerment, Health Professional Intervention and Supportive Government Policies, a new report with a blueprint to change how Americans think about obesity, empower people with obesity to get the best care, and afford those with obesity the same access to care as adults with other serious chronic diseases.

Issued as a call to action, the report was prepared in consultation with a panel of leading obesity specialists as a roadmap for overcoming one of the difficult challenges affecting US adults now living with obesity: despite significant advances in the understanding and treatment of obesity, only 10 percent of people with obesity get help from medical professionals,[1] meaning the disease remains largely undiagnosed and undertreated. Accordingly, only 30 million[2] of the estimated 108 million adults living with obesity[3] have been diagnosed with the disease and only around 2 percent of those eligible for anti-obesity medications have been prescribed these drugs.[4]

The consequences of undertreatment affect virtually every aspect of the healthcare system. Obesity not only has a negative impact on almost every aspect of health and well-being, but it worsens the outcomes of over 230 obesity-related chronic diseases, from type 2 diabetes and heart disease to some forms of cancer.[5] Accordingly, obesity is responsible for an approximately 300,000 premature deaths each year[6] deaths and costs the U.S. economy an estimated $1.72 trillion annually in direct and indirect costs.[7]

“Although obesity is one of today’s most visible public health problems, it is often ignored and discounted as a serious disease, resulting in a health crisis that has only worsened with time,” said
Sally Greenberg, NCL’s Executive Director. “This report focuses attention on the numerous public perception, provider and policy-related factors that preclude Americans with overweight and obesity from getting effective treatment and must be addressed if obesity outcomes are to improve in the US.”

To change the trajectory of the obesity epidemic, the report calls for a national mobilization to overcome the “human” factors– incorrect beliefs about the cause and treatment of obesity, prejudice towards people due to their size, lack of training for health providers, access barriers, and outdated government policies – that continue to prevent Americans from seeking and obtaining obesity care. Towards this end, NCL’s patient-centered action agenda identifies nine priorities for action:

  1. Redefine Obesity for the American Public as a Treatable Chronic Disease

Although the American Medical Association classifies obesity as a chronic disease requiring treatment, three-quarters of Americans believe obesity results from a lack of willpower. Thus, redefining obesity as a treatable chronic condition will provide a new context for health providers and patients to have a positive discussion about weight, leading to more people getting diagnosed and treated.

  1. Adopt Patient-First Language for Obesity

Unlike other chronic diseases where health professionals use people-first language that puts a person before a diagnosis, practitioners routinely use terms to describe obesity that can be off-putting and demoralizing. To change this situation, the National Consumers supports the agenda of the People-First Initiative launched by the Obesity Action Coalition, which advocates for widespread adoption of people-first language by practitioners in all healthcare settings.

  1. Make Combatting Weight Stigma a National Priority

Studies show that 40 percent of healthcare professionals –physicians, nurses, dietitians, psychologists and medical students – admit to having negative reactions based on a person’s size.[8]Addressing this pervasive problem requires a unified national initiative that makes the impact of weight stigma “real” for clinicians and the public and disseminates the latest information to health providers on strategies to reduce weight stigma.

  1. Elevate the Need for Physician Training in Obesity

A recent study of 40 US medical schools finds that 30 percent of these institutions provide little or no education in nutrition and obesity interventions while one third of schools reported no obesity education programs in place.[9] These findings underscore the urgency for US medical schools to change their priorities and develop curricula that comprehensively addresses the disease of obesity.

  1. Establish Excess Weight as a Vital Sign

Besides body temperature, blood pressure, heart rate and respiration, health providers routinely measure height and weight at each visit. Thus, if healthcare professionals were to calculate and provide patients with their Body Mass Index (BMI) at the time of the office visit, practitioners could have a tool to discuss excess weight when patients are most receptive to discussing their health status.  It is recognized that BMI is a crude measure and not the sole predictor of obesity but when combined with patient-friendly information that explains the level of weight and options for treatment, this interaction could initiate a positive, respectful conversation about obesity care.

  1. Provide the Tools for a Doctor-Patient Dialogue on Excess Weight

A major reason primary care providers (PCPs) are reluctant to provide obesity counseling is the lack of informational tools to have conversations with patients about their weight status and care options. Therefore, a unified effort to make available to PCPs evidence-based, patient-friendly content on obesity will facilitate a better dialogue between clinicians and patients and promote shared decision-making.

  1. Establish Coverage of Obesity as a Standard Benefit Across Insurers and Health Plans

Although employers and insurers are starting to cover treatment options for obesity in employee benefit packages, too many people continue to be denied coverage or face access barriers, such as step therapy and prior authorization, that delay treatment. Improving obesity outcomes therefore requires supporting legislative efforts, like the “Safe Step Act” that would require group health plans to provide an exception process for step-therapy protocols. It also necessitates collaboration among payers, providers, policymakers, and advocates to establish a standard, affordable benefit for the prevention and treatment of obesity that applies across plan types and payers.

  1. End Outdated Medicare Rules That Exclude Coverage for Necessary Obesity Care

Today, the many millions of Americans enrolled in the Medicare program are denied safe and effective obesity treatment due to outdated Medicare Part D rules that exclude coverage for FDA-approved obesity drugs and Medicare Part B policies that places undue restrictions on intensive behavioral therapy by allowing only primary care providers to deliver IBT and severely restricting the physical locations where this care can occur. Congress has the power to change this situation, which is why NCL has joined with the obesity, public health and nutrition communities is pressing for swift passage of the Treat and Reduce Obesity Act (TROA). The proposed legislation would expand Medicare coverage to allow access to IBT from a diverse range of healthcare providers while ending the exclusion for new anti-obesity medications that are improving the standard of care for adult Americans with obesity.

  1. Create a Patients’ Bill of Rights for People with Obesity

For too long, people with obesity have been stigmatized, discriminated against, and have faced significant hurdles and burdensome requirements to receive care. Changing this situation will require giving people with obesity the knowledge, skills and confidence to be advocates for their best obesity care. Therefore, NCL’s patient-centered obesity action agenda calls for the creation of a Patients’ Bill of Rights for People with Obesity based on the recognition that obesity is a treatable disease and everyone with obesity deserves the same level of attention and care as those with other chronic conditions.

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About the Report

To prepare the report, NCL partnered with the Obesity Care Advocacy Network (OCAN) to host a roundtable discussion in December 2021where public health specialists, leading professional societies, the minority health field and the obesity policy community assessed the state of the science on obesity today, the scope and cost of the disease in the US and the major barriers impeding quality obesity care with special attention to the “human” obstacles that keep people with obesity from seeking or obtaining treatment. Additionally, NCL conducted a literature review to gather additional insights, especially regarding how to change how people with obesity see themselves, so they become empowered to advocate for their care as patients with a chronic disease. Based on this assessment, NCL drafted the report, which was vetted by experts participating in the roundtable, and developed the policy recommendations included in the Patient-Centered Obesity Action Agenda.

 

About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

 

[1] Stokes A, et al. Prevalence and Determinants of Engagement with Obesity Care in the United States. Obesity. Vol. 26, Issue 5; May 2018, 814-818

[2] PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

[3] Hales CM,, et al. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. Centers for Disease Control and Prevention. NCHS Data Brief. No. 360. February 2020.

[4] PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

[5] Obesity Care Advocacy Network. Fact Sheet: Obesity Care Beyond Weight Loss

[6] Allison DB, et al. Annual deaths attributable to obesity in the United States JAMA 1999Oct 27 282(16)1530–8.

[7] Milken Institute (October 2018), “America’s Obesity Crisis: The Health and Economic Costs of Excess Weight.”

[8] Fruh SM, et al. Obesity Stigma and Bias. J Nurse Pract. 2016 Jul-Aug; 12(7): 425–432.

[9] Butch WS, et al. Low priority of obesity education leads to lack of medical student’ preparedness to effectively treat patients with obesity; results from the U.S. medical school obesity education benchmark study. BMC Med Educ 20, 23 (2020)

Menthol cigarettes are going up in smoke

Sally Greenberg sits down with members of the African American Tobacco Control Leadership Council, the country’s leading public health education and advocacy organization taking on Big Tobacco to save Black lives…

The National Consumers League commends the FDA’s decision to ban JUUL e-cigarettes

June 27, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC— NCL applauds the FDA’s decision to ban JUUL e-cigarettes and believes that this is a significant first step towards curtailing the ongoing vaping epidemic. After a blistering and aggressive social media campaign in 2017, JUUL emerged at the forefront of the e-cigarette industry. Targeted advertisement towards youth and the production of fruit flavored nicotine pods highlighted the company’s flagrant disregard for public health and safety. JUUL is a central contributor to the rising rates of nicotine addiction in youth, according to the FDA. The FDA did its job in banning the company’s further advertising and sale of vaping products.

A large increase in the use of e-cigarettes among youth has occurred in recent years. Research indicates that vaping among high school students rose from 2.4 percent in 2019 to 26.5 percent in 2020 – a 1000 percent increase. Eight out of ten teenagers use flavored products and an estimated 59 percent of high school and 54 percent of middle school students who vape prefer JUUL as their brand of choice. As a consumer watchdog, NCL finds JUUL’s deliberate youth-targeted marketing and lack of health transparency shocking. This has led to our children purchasing their products without fully understanding the risk vaping poses to their health.

The FDA’s assessment of the data JUUL provided for their application to sell their products was that it was “insufficient and conflicting”. The agency also expressed concern about the potential toxicological risks of JUUL products. The adverse effects of e-cigarette usage are known. The immediate side effects include, but are not limited to, shortness of breath, headaches, dizziness, and coughing. Long-term, the vaporization of e-cigarette juice pushes ultrafine particles deep into the lungs. This can lead to damaged lung tissue, respiratory issues, reproductive complications, and harm adolescent neurodevelopment.

It is clear that the vaping epidemic jeopardizes consumers’ health and must be addressed. According to the CDC, tobacco product use is the leading cause of preventable disease, disability, and death in the United States. As an organization dedicated to advocating for consumer health and safety, NCL believes that the FDA’s JUUL ban will help mitigate this public health crisis, but for the sake of our children, regulatory agencies and policy-makers must continue to push forward in addressing this issue.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL denounces today’s SCOTUS ruling overturning Roe v. Wade

June 24, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC— Almost 50 years since the Supreme Court ruling in 1973, Roe v. Wade, which guaranteed a woman’s constitutional right to an abortion, the protections provided by Roe were overturned today by the Supreme Court of the United States (SCOTUS). The ruling is a devastating blow to women, girls, and their families who have long fought for equal access to reproductive health services – health services which includes access to safe abortion, says the National Consumers League (NCL).

“Many women will suffer and will suffer unnecessarily from this egregious ruling by SCOTUS,” says Sally Greenberg, Executive Director of NCL. “This decision is an attack on poor women or low-income woman, who represent 75% of abortion patients,” according to the Guttmacher Institute, a research group that supports abortion rights.

The final opinion is strikingly similar to the draft that was leaked in May of this year and authored by Justice Samuel Alito. In the opinion, Alito writes, “It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.”

In the wake of this June 24 ruling, 26 states are expected to ban all or nearly all abortions.

Justice Clarence Thomas, in his concurring opinion overturning Roe v. Wade, laid out a vision that fomented fears about what other rights could disappear: the same rationale that the Supreme Court used to declare there was no right to abortion, he said, should also be used to overturn cases establishing rights to contraception, same-sex consensual relations and same-sex marriage.

In their joint dissent, the three liberal justices of the court, argued that the ruling will affect “countless life decisions.” They also noted that, “It says that from the very moment of fertilization, a woman has no rights to speak of.”

“NCL applauds responses from many employers, including JPMorgan Chase, which is clarifying its health care benefits in the wake of the Supreme Court overturning Roe v. Wade on Friday, saying that abortion has long been a covered service for the bank and starting in July will be included under the company’s health care travel benefit,” says Greenberg. “We applaud Levi Strauss & Co — the 169-year-old jean company — stands strongly against restricting access to abortion and said it will continue to protect employees — making sure they have access to the care they need regardless of where they live.

NCL also thanks officials in many states and the District of Columbia that have pledged to provide abortion access and safe havens including New Hampshire, Michigan, New York governors along with New York Attorney General Letitia James and DC Mayor Muriel Bowser.

In his address to the nation today, President Joe Biden expressed his disappointment over the SCOTUS ruling: “This is a sad day for the country in my view, but it doesn’t mean the fight is over.” He also added that his administration will use all its appropriate lawful powers and that “Congress must act.” He went on to say, “with your vote, you can act.”

NCL believes that women’s reproductive rights is fundamental and must be protected; this radical decision by the Supreme Court is vastly out of step with American public opinion and a disastrous for women’s rights and freedoms.  We will continue to advocate for federal, state and local protections for women across the country, in keeping with NCL’s long history of championing the rights of women and children, especially those among us who are most vulnerable.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL provided oral testimony to the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices in support of new pneumococcal vaccine recommendations for adults 65 years of age and older

June 22, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC— On June 22, 2022, NCL’s Health Policy Associate Milena Berhane provided oral testimony to the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices in support of new pneumococcal vaccine recommendations for adults 65 years of age and older. NCL comments appear below.

Thank you, Dr. Lee. My name is Milena Berhane, and today I am representing the National Consumers League. Since NCL’s founding in 1899 by social reformer Florence Kelley, we have advocated for the critical role immunizations play in the preservation and improvement of public health. We extend our gratitude to this Committee for the opportunity to present public comments.

According to the National Foundation for Infectious Diseases (NFID), pneumococcal disease is a leading cause of serious illness throughout the world. In the US, nearly 50,000 people die each year from pneumonia. The death rate is even higher in those age 65 years and older. Vaccination is a critical public health measure for preventing disease, hospitalizations, and death, so it is critical that access to the pneumococcal vaccine is expanded.

We are concerned about the lack of clarity surrounding the current ACIP recommendations regarding the pneumococcal vaccine, for adults ages 65 years of age and older. It is critical that the recommendations for this age groups are clear, so that patients and providers are better able to understand who should receive which vaccine, and when. The pneumococcal vaccine will continue to be a safe and effective measure in protecting Americans from disease, and it is imperative that older adults are able to receive them.

Having clear recommendations for adults 65 years of age and older is also critical in addressing health equity issues, especially among older Black and Latinx populations that already face issues in lacking access to health care. Pneumococcal vaccine uptake needs to increase in these populations so that currently existing health disparities are not further exacerbated. Therefore, in order to promote health equity among all older adults and increase vaccination rates, it is critical that clear recommendations are provided for this age group.

The National Consumers League recognizes the extreme importance of immunizations in protecting the health and safety of all Americans, and will continue its efforts to increase vaccine confidence and uptake across lifespan. We look forward to the upcoming recommendations by this committee regarding the pneumococcal vaccine for older adults.

Thank you.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL backs the Pregnant Workers Fairness Act to curtail workplace discrimination

June 21, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, DC— The National Consumers League (NCL) believes it is imperative that the Pregnant Workers Fairness Act (H.R. 1065), introduced by Representative Jerrold Nadler (NY-10), is enacted by Congress. In the uphill battle for equity in the workplace, NCL views H.R. 1065 as essential to protecting pregnant workers against unjustly losing their jobs and ensuring they receive pregnancy and post-partum accommodations to stay healthy.

Despite the steady decline of births in the United States since 2016, the number of federal pregnancy discrimination cases filed has steadily risen 67% from 2016-2020; and lawsuits are projected to set a new annual record this year. Workers lose approximately two thirds of the cases filed due to gaps in the current legal framework. H.R. 1065 will close loopholes in the Pregnancy Discrimination Act which requires pregnant workers to demonstrate that other workers are benefiting from comparatively similar accommodations before gaining approval from their employe

Women of color are more likely to work in physically demanding jobs, which also places the baby at  increased risk for preterm birth, low-birth weight, preeclampsia, birth defects, and more. While these health problems can be severe, long-term, and even deadly, studies illustrate how low-cost and basic accommodations for pregnant and postpartum workers can significantly reduce their risk. These include providing access to a chair to decrease time spent standing and basic accommodations for breastfeeding parents, such as a private space and additional break time to pump.

NCL strongly supports H.R. 1065. It will ask employers to provide reasonable accommodations for workers affected by medical conditions relating to pregnancy and childbirth. This will not only reduce health-related risks, but also improve workers’ economic security by safeguarding their jobs, income, health insurance, their baby’s health and more. Furthermore, by directly targeting discriminatory employment practices, H.R. 1065 represents a strong step in addressing sexism and racism in the workplace.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

How did my medicine get here? Behind the scenes of the healthcare supply chain

Many of us take for granted that our medicines are available at the pharmacy whenever needed…

NCL Director of Health Policy testifies at Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights on how consolidation in the marketplace harms consumers

June 16, 2022

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, (202) 207-2832

Washington, D.C. – On Wednesday, June 15, 2022, the National Consumers League’s Director of Health Policy Jeanette Contreras provided oral testimony to the Senate Judiciary Subcommittee on Competition Policy, Antitrust, and Consumer Rights on how consolidation in the marketplace harms consumers.

In her testimony, Ms. Contreras discussed the importance of consumers having choices for safe goods and services at a fair price, a core principle of NCL’s advocacy work. Touching on several issues impacting consumers in the U.S. – such as the infant formula shortage, consolidation of the airline industry, primary ticketing market for live events, and the unfair business practices of pharmacy benefit managers (PBMs) – Ms. Contreras reiterated the need for competition in the marketplace and enacting stronger antitrust laws, all of which help protect U.S. consumers.

Her testimony appears below.

June 15, 2022

Good afternoon Chairwoman Klobuchar, Ranking Member Lee, and members of the Subcommittee. My name is Jeanette Contreras. I am the Director of Health Policy at the National Consumers League. I appreciate the opportunity to testify remotely today- due to COVID.

Founded in 1899, NCL is America’s oldest consumer advocacy organization. A core principle of our advocacy is that the marketplace should encourage competition to guarantee that consumers have choices for safe goods and services at a fair price. Monopolies harm competition, leaving consumers with fewer options at higher prices. Monopolistic practices are especially harmful when they occur in the health care arena, where they can exacerbate health disparities.

We share the concerns of new parents regarding the recent shortage of infant formula. Our hearts go out to those parents who have lost babies or whose infants suffered devastating health consequences from contaminated formula. At NCL, we believe all goods and services sold to consumers should be safe and meet all legal requirements- including regulatory guidelines set forth by the FDA.

NCL applauds the FDA and the Administration for adopting a multifaceted approach to increase the supply of infant formula, including temporarily allowing foreign manufacturers to sell their products in the U.S. Additionally, we believe invoking the Defense Production Act to prioritize getting needed inputs to infant formula manufacturers was sound policy. These measures are helping to solve the immediate logistical problem of getting formula onto store shelves across the country.

While addressing the immediate formula shortage is most urgent, we are also troubled that it took the FDA almost four months to act on a whistleblower complaint sent to the agency. This complaint should have received immediate attention given the gravity of the allegations against the Abbott facility. We support a full investigation and, if warranted, bringing criminal and civil charges against those who falsified data. NCL also recommends that the U.S. create a single food safety agency and dedicate an office to overseeing the safety and supply of infant formula.

It should concern every American that one manufacturer controls 40% of the U.S. infant formula market. Only three companies — Abbott, Mead Johnson, and Nestle — control 98% of the industry.

Consolidation in the infant formula industry is a major contributor to the current crisis, but it is only one of many cases where market concentration in recent decades has limited competition and harmed consumers.

For example, NCL continues to raise concerns about the consolidation of the airline industry. Due to weak enforcement of existing antitrust laws, from 2005 to 2015, the number of major U.S. airlines declined from nine to four. And today they control more than 80 percent of the domestic U.S. market.

Our antitrust laws have also failed to protect consumers who attend live events. After merging with Ticketmaster in 2010, Live Nation Entertainment controls roughly 80% of the primary ticketing market in the U.S. As anyone who has purchased tickets recently can attest, this has led to an increase in add-fees and the basic price of tickets.

Stronger antitrust enforcement would be especially beneficial for curtailing anti-competitive conduct in the health care industry, where we’ve seen consolidation lead to higher costs for consumers without an increase in quality or access to care. We are pleased that the Biden administration is looking into how hospital prices increase after acquisitions. We are also hopeful that the ongoing review of DOJ & FTC merger enforcement guidelines will result in more action by those agencies.

NCL also applauds the recent FTC decision to open an investigation into the unfair business practices of pharmacy benefit managers or PBMs. NCL works tirelessly to raise awareness of the outsized role that PBMs play in driving up prescription drug prices for consumers. According to a recent report, the three biggest PBMs controlled roughly 77% of all U.S. prescription drug claims in 2020. And a recent Senate Finance Committee report found some PBMs are getting a 70% rebate on insulin, while out-of-pocket costs for this life-saving medication continue to rise.

These cases are just a few examples of how monopolies and anti-competitive practices have become a problem for consumers. To ensure crises like today’s formula shortage do not happen again, market consolidation must be addressed so that the temporary shutdown of a single factory does not result in the collapse of an entire supply chain.

Whether it is baby formula, airline travel, live event tickets, or pharmaceutical sales, the lack of competition is having increasingly negative impacts on consumer welfare and requires urgent action.

Chairwoman Klobuchar, Ranking Member Lee, thank you for holding today’s hearing and inviting NCL to speak about this important issue. I look forward to answering your questions.

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About the National Consumers League (NCL) 

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.