A coalition of consumer, health groups – including NCL – call for nutrition, ingredient, and allergen labeling on alcoholic beverages

February 27, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

Washington, DC – A coalition of consumer and health groups is urging Treasury Secretary Janet Yellen to ensure that the agency responsible for regulating most alcoholic beverages in the U.S. – the Alcohol and Tobacco Tax and Trade Bureau (TTB) – keeps its commitment to require standardized alcohol labeling on all beer, wine, and distilled spirits products by initiating three promised rulemakings on nutrition, ingredients, and allergen labeling on an accelerated basis.

The appeal comes in the form of a February 27 letter from five leading public interest groups as TTB begins a series of “listening sessions” on labeling and advertising of alcoholic beverages on February 28. Raising concerns that the listening sessions are no more than a delay tactic to maintain the status quo and “slow walk deliberations for months,” the organizations – the Asthma and Allergy Foundation of America (AAFA), Center for Science in the Public Interest (CSPI), Consumer Federation of America (CFA), Food Allergy Research and Education (FARE), and National Consumers League (NCL) – called for TTB to publish the rulemakings by June 2024.

The Treasury Department promised that TTB would issue mandatory alcohol labeling rules in a November 17, 2022 letter in response to a lawsuit filed by CSPI, NCL, and CFA. The Department stated its intention to publish the three rulemakings before the end of 2023.

“We write … to express our dismay and serious concern that TTB has backtracked from its written undertaking of the November 17, 2022 agreement,” the groups wrote to Secretary Yellen. “TTB has, in effect, enabled recalcitrant companies by delaying indefinitely rulemakings on mandatory alcohol labeling while opting for a voluntary rule under which labeling “Serving Facts” or “Alcohol Facts” and ingredients are optional.”

Focusing on the health consequences of delaying action on alcohol labeling, the letter from advocates to Secretary Yellen describes how better alcohol labeling will benefit the 84 percent of U.S. adults who drink alcoholic beverages – 216 million people – and who currently do not have the facts about the alcohol they are consuming to protect their health and safety. Overconsumption of alcohol is a costly public health problem that has become much worse in recent years, as alcohol-related deaths have risen substantially. Among the key concerns, alcohol is involved in about 30 percent of all traffic crash fatalities in the U.S, is a source of empty calories that contributes to obesity, can impact blood sugar control in people with diabetes, and labeling can be a life-or-death matter for people with food allergies. Additionally, excessive drinking increases the risk of liver disease, hypertension, cardiovascular disease, alcohol use disorders, certain cancers and severe injuries.

“The consensus among public health and nutrition experts and consumers themselves, in favor of mandatory and complete alcohol labeling is overwhelming,” said Thomas Gremillion, Director of Food Policy at the Consumer Federation of America. “By reneging on its promise to initiate rulemakings, TTB continues to deny Americans the same helpful and easily accessible labeling information now required for conventional foods, dietary supplements, and nonprescription drugs.”

The letter to Secretary Yellen also stresses that alcohol manufacturers have the capability to put standardized Serving Facts labels on their products, when required. This is the case for products such as some hard ciders, hard seltzers, and wine coolers that are regulated by the Food and Drug Administration, which requires such products to have the same Nutrition Facts panel and ingredients statements on nonalcoholic beverages, from soft drinks to juices.

“To date, TTB has taken the position that requiring standardized nutrient content labeling on alcoholic beverages is too costly and burdensome for beverage alcohol manufacturers,” said Sally Greenberg, CEO of the National Consumers League. “However, the inconvenient truth for the industry is that some of the very same companies whose products do not include a Serving Facts statement if they are regulated by TTB already put complete alcohol labeling on their hard ciders, hard seltzers, wine coolers, and other FDA regulated wines and beers.”

Highlighting that the time has come for mandatory alcohol labeling, the letter makes clear that the agency’s current voluntary labeling rules are not working. Although the rule gives companies the option of putting “Serving Facts” or “Alcohol Facts” and ingredients information on their products, new research from the Center for Science in the Public Interest finds that most manufacturers have opted out of TTB’s voluntary program. Using TTB’s COLA database to examine the labels for 132 of the nation’s top beer and wine brands, CSPI’s study found that only 11 labels of the 65 beer brands examined (17%) and none of the 67 wine brands included ingredients lists while 18 beers (28%) and no wines used the voluntary “Serving Facts” label, and one additional beer brand carried the voluntary “Alcohol Facts” label. CSPI’s review also showed that even when serving information is included on beer and wine labels, there is no standard format for where and how the disclosures appear, making it hard for consumers to find information easily and compare different brands.

“We have the data that demonstrate that Treasury’s voluntary rule has failed to adequately improve transparency in alcohol labeling,” said Dr. Peter G. Lurie, President of the Center for Science in the Public Interest. “Ensuring that the agency ends this ineffective voluntary regime by issuing mandatory labeling rules necessitates national leadership. This is why we are appealing directly to Secretary Yellen to intercede personally to require the agency to commit to publish all three proposed rules by June 2024.”

The 2022 letter whereby TTB undertook to publish standardized alcohol content, calorie, and allergen labeling by the end of 2023 resulted from a lawsuit filed by Center for Science in the Public Interest, Consumer Federation of America, and the National Consumers League on October 3, 2022. The suit charged TTB with failing to act on a citizen petitionsubmitted to the Treasury Department in 2003 to mandate alcohol labeling. CSPI, CFA, and NCL filed the petition along with a coalition of 66 other organizations and eight individuals, including four deans of schools of public health.

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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 nclnet.org.

The 340B drug discount program should be helping patients in need, not boosting pharmacy chain profits

By Sally Greenberg, Chief Executive Officer, National Consumers League

The federal 340B drug discount program is a worthy and critical program. Created by Congress in 1992, it mandates that pharmaceutical manufacturers participating in the Medicaid program must offer prescription medicines at discounted rates to community health centers and safety-net hospitals serving low-income and uninsured patients. Over the years, this program has given vulnerable patients access to the drugs they need and freed up resources for the qualified facilities to offer more health care services to indigent communities.

Over the past decade or so, however, this valuable program has been increasingly corporatized by for profit entities known to increase costs for consumers including middlemen like pharmacy benefit managers and pharmacy chains. Too many of the dollars circulating through the 340B program are benefiting the well-off and for-profit corporations, instead of consumers with significant health and financial needs. News stories have shined a spotlight on big health systems using the program to bolster profits, while hallowing out critical resources in underserved areas. However, more attention needs to be given to the billions of 340B dollars going to major pharmacy chains like CVS, Walgreens, Walmart and Rite-Aid that are not benefiting the patients this program is intended to serve. Increasingly, however, policymakers at the federal and state level are suggesting bailing out these for-profit entities under the guides of “contract pharmacy” legislation.

Here’s the problem: In 2010, the federal government issued guidelines allowing 340B-eligible health providers to contract with for-profit retail pharmacies to dispense medications, with virtually no rules or safeguards. Since that time, the number of pharmacies participating in the 340B program has grown from 789 in 2009 to over 25,000 today. If this meant more access to affordable drugs for consumer, that would be one thing, but this has not been the case. As contract pharmacies have increased, so too has consumer challenges affording their medicines, nearly in parallel. For example:

  • Even though 340B contract pharmacies are receiving drugs at discounted prices, there is no evidence they are passing those savings onto consumers. One analysis from the respected IQVIA firm found that 340B discounts were shared with consumers in only 1.5 percent of eligible pharmacy claims.
  • Although the 340B program is intended to benefit underserved, vulnerable communities with high proportions of poor and uninsured patients, hospitals in the program are contracting with pharmacies that are not, in fact, in areas afflicted with poverty and a scarcity of health care services.
  • The vast majority of 340B contract pharmacy arrangements are with the aforementioned big national chains like CVS and Walgreens, which are enjoying enormous profits as a result of their participation in the drug discount program. Contract pharmacies collected an estimated $13 billion in gross profits in 2018, with a 72% profit margin on 340B drugs (because they are getting those drugs at a steep discount, which they don’t share with consumers). Needless to say, fattening corporate pharmacy profits should not be this program’s mission.

Contract pharmacy abuse of the 340B program has not gone unnoticed by policymakers in Washington. In January 2024, leaders in the U.S. Senate questioned CVS Health and Walgreens as part of as part of an ongoing investigation into how health care entities use and generate revenue from the 340B Drug Pricing Program. The Government Accountability Office (GAO) and the Department of Health and Human Service Office of the Inspector General (OIG), also highlighted issues with the program’s integrity as it relates to contract pharmacy use. 340B is in desperate need of transparency and oversight, not unfettered expansion.

Yet that is exactly what is happening in some U.S. states. This matter is taking on a greater urgency now as several states are contemplating legislation that doubles down on the problem instead of fixing it. Consumers would be shocked to learn their state representatives are ushering through changes that would further solidify the profitable role these large corporate contract pharmacies are playing in the abused 340B program. Policymakers at the state and federal level need to address a fundamental question – where do 340B savings go? And when the answer is to corporate pharmacy giants – not patients – it’s time to reconsider ill-conceived policies giving contract pharmacies even more access to 340B drug discounts.

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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 nclnet.org.

PBM reforms needed now in order to expand access to lower cost biosimilars that would benefit all Americans

February 22, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

Washington, DC – The National Consumers League (NCL) recently submitted a letter to the U.S. House and Senate leadership expressing our collective support for Pharmacy Benefit Managers (PBM) reforms to improve consumer and patient access to biosimilars. Given the ongoing surge in prescription drug costs, expanding access to lower cost biosimilars represents a bipartisan solution that would benefit all Americans.

“We are hopeful PBM reforms will be included in a final March healthcare package,” said NCL CEO Sally Greenberg.

The letter can be found here.

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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 nclnet.org.

Consumer struggles with Native American healthcare

By Sam Sears, Health Policy Associate, National Consumers League

My name is Sam Sears, and I am the new Health Policy Associate working at the National Consumers League. I am excited to be working with Robin, Sally, and the rest of the staff at NCL. Consumer issues regarding health care, specifically access and confidence, are wide-reaching and I am thrilled to be able to lend my growing expertise and experience to support the cause and NCL.

I always thought I would end up in healthcare, but my younger self had always envisioned my work with a much more narrowed focus. Academically, my background is in policy and gender studies, where I focused on equal protections for women and queer, specifically related to intimate partner violence and protections and reproductive justice. After graduation, I worked as a barista while also taking placements through a temp agency here in DC, focusing on nonprofits and advocacy organizations. It was, in part, due to the temp placements that I found myself working on broader health policy issues such as the 340B Drug Pricing program and health care access for individuals.

Before joining NCL, I worked at the National Council of Urban Indian Health (NCUIH) for two years, where I was able to learn quite a bit about the healthcare delivery system for Native Americans and the barriers to access that they often face. While NCUIH’s focus is centered on ensuring that Native Americans living in urban settings have access to quality, accessible, and culturally competent health services, much of the work is done collaboratively with other advocates and organizations working within the space. Because of this, my work at NCUIH often was encompassing issues facing the larger community.

Upon joining NCL, I realized that a prominent problem for Native Americans is a much larger area of concern for all Americans and their healthcare – the pervasive and misleading Medicare Advantage plan advertisements seen on television. In fact, in a letter to Centers for Medicaid and Medicare Services (CMS) and Dr. Brooks-LaSure, the CMS Tribal Technical Advisory Group, a group of 17 representatives comprised of elected Tribal leaders or appointed representatives and representatives of national Indian organizations headquartered in DC, highlighted how Medicare Advantage (MA) plans have been “aggressive and invasive when marketing their plans”.

A Kaiser Family Foundation report on the 1,200 unique ads, mostly for MA plans, aired during the enrollment window found that 27% led beneficiaries into thinking they were being recruited for traditional Medicare plans. For Native Americans, this aggressive marketing has led people to enroll in plans that do not include local Indian Health Service providers, meaning they lose coverage and no longer able to go to the doctors they trust to care for them in a culturally competent manner. This confusion is not limited to just Native Americans, as Dr. Brooks-LaSure has stated previously.

It’s important to note that CMS has been addressing the misinformation and confusion from these ads. In April of 2023, the agency released a final rule regarding Medicare Advantage marketing and communications, amongst other Medicare part plans and related topics. Specifically, CMS must now pre-approve all television MA plan advertisements that will air during the open enrollment period, minimizing the opportunity for misinformation and predatory practices within the ads. CMS has also significantly increased its ability to investigate complaints about misleading agents and advertisements. This regulation, while large and with rolling applicability dates, will apply to the 2024 contract year for MA plan marketing and communication, meaning that the open and re-enrollment period at the tail end of the 2024 calendar year will be drastically different.

As I stated earlier, many of the issues that I had worked on while with NCUIH are also applicable to the broader population and community who struggle with access to healthcare. So, I am excited to be able to continue to work on these consumer issues with NCL. And I am eager to see how NCL could support and expand on the work I’ve been able to touch on through my other positions.

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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 nclnet.org.

Americans now have an Obesity Bill of Rights

January 31, 2024

Media contact: Nancy Glick, 202-320-5579, nancyg@nclnet.org; Simona Combi, 571-527-3982, simona.combi@ncoa.org

Washington, DC – Because obesity – the most prevalent and costly chronic disease in the United States –remains largely undiagnosed and untreated a decade after the American Medical Association (AMA) classified it as a serious disease requiring comprehensive care,[1] the National Consumers League (NCL) and National Council on Aging (NCOA) today introduced the nation’s first Obesity Bill of Rights and launched a grassroots movement – Right2ObesityCare – to advance changes in federal, state, and employer policies that will ensure these rights are incorporated into medical practice.

Developed in consultation with leading obesity specialists and endorsed by nearly 40 national obesity and chronic disease organizations, the Obesity Bill of Rights establishes eight essential rights, so people with obesity will be screened, diagnosed, counseled, and treated according to medical guidelines and no longer face widespread weight bias and ageism within the health care system or exclusionary coverage policies by insurers and government agencies.

“Our goal with the Obesity Bill of Rights is to define quality obesity care as the right of all adults and empower those with the disease to ask questions and demand treatment without discrimination or bias regardless of their size or weight” said Sally Greenberg, Chief Executive Officer of the National Consumers League. “For too long, adults with obesity have encountered a health care system that is working against them. They have been stigmatized, discriminated against, not treated with respect by their health providers, and have faced significant hurdles and burdensome requirements to receive obesity care.”

As described by Patricia Nece, J.D., Immediate Past Chair of the Obesity Action Coalition, “For my entire life, I’ve been a target of ridicule simply because of my weight. People rarely take time to look beyond my weight to see me.”

Currently, only 30 million[2] of the estimated 108 million adults living with obesity[3] have been diagnosed with the condition, and only about 2% of those eligible for anti-obesity medications have been prescribed these treatments.[4] The consequence of untreated obesity for the nation is worsening outcomes for over 230 obesity-related chronic diseases,[5] approximately 400,000 premature deaths a year,[6] and an estimated $1.72 trillion in direct and indirect costs to the U.S. economy.[7]

Defining Quality Obesity Care for All
The Obesity Bill of Rights establishes and promotes eight essential rights to drive transformational change and define the core requirements for people with obesity to receive person-centered, quality care:

  1. The Right to Accurate, Clear, Trusted, and Accessible Information on obesity as a treatable chronic disease
  2. The Right to Respect by all members of the integrated care team when screening, counseling, and providing treatment
  3. The Right to Make Treatment Decisions about one’s health goals and obesity care in consultation with the individual’s health providers
  4. The Right to Treatment from Qualified Health Providers including counseling and ongoing care from health providers with expertise in obesity care
  5. The Right to Person-Centered Care that is personalized, respects the individual’s cultural beliefs, meets their specific health goals, and considers the person’s whole health and not just their weight status
  6. The Right to Accessible Obesity Treatment from Health Systems, so those with severe obesity receive care in settings that allow for privacy, using size and weight-accessible equipment and diagnostic scans
  7. The Right for Older Adults to Receive Quality Obesity Care that comprises a respectful, comprehensive care approach consistent with their personalized medical needs
  8. The Right to Coverage for Treatment with access to the full range of treatment options for the person’s disease as prescribed by the individual’s health provider

“Collectively, these rights will ensure that adults with obesity have trusted, accurate information about their disease, respectful and nondiscriminatory care from medical professionals, and insurance that provides access to all treatments deemed appropriate by their health providers,” said Ramsey Alwin, NCOA President and CEO. “In town halls across the country, older adults told us they often feel invisible when seeking obesity care. The Obesity Bill of Rights recognizes and aims to address their unique challenges.”

Putting the Bill of Rights into practice

With the goal of reversing the trajectory of the nation’s obesity epidemic, NCL and NCOA will spearhead Right2ObesityCare, a new grassroots movement to engage people with obesity, their caregivers, health professionals, community leaders, employers, and a network of obesity and chronic disease organizations to drive adoption of the Obesity Bill of Rights in clinical settings.

Using the online hub www.right2obesitycare.org to mobilize stakeholders, Right2ObesityCare will focus on national and state policy efforts, including developing a set of national “obesity goals” for full implementation of the Obesity Bill of Rights by December 31, 2029. Plans include hosting regional town halls, workshops, and advocacy forums across the country; scheduling meetings with federal and state legislators and regulators; and arming interested citizens and advocacy leaders with materials and tools to advocate for implementation of the Obesity Bill of Rights in their communities and workplaces. NCL and NCOA also will pursue development of a model law that stakeholders can use to incorporate the Obesity Bill of Rights into state law.

“The Obesity Bill of Rights brings us a step closer to creating a society where all individuals are treated with respect and without discrimination or bias regardless of their size or weight. Establishing eight essential rights for people living with obesity strengthens efforts to end such blame, shame and discrimination and give individuals who want and need it, access to safe and effective options to improve their health,” added Joe Nadglowski, President and CEO of the Obesity Action Coalition.

Advocacy on implementing the Obesity Bill of Rights also gives policymakers new impetus to pass legislation that will remove the regulatory and insurance obstacles that keep many people with obesity from getting the care prescribed by their health providers.

According to Rep. Brad Wenstrup, DPM (R-OH), “By tackling obesity head on, we can better prevent numerous additional diseases like type 2 diabetes, high blood pressure, and heart disease. My bill, the Treat and Reduce Obesity Act (TROA), expands Medicare beneficiaries’ access to treatment options to include FDA-approved medications, clinical psychologists, registered dieticians, and nutrition professionals. Not only would this legislation help Americans live healthier and longer lives, but it can also save taxpayer dollars over the long run.”

Added Rep. Gwen Moore (D-WI), “Obesity is a chronic condition – not a personal or moral failing. We need to ensure our health care system treats it as a disease, so that Americans with obesity can access holistic, high-quality care that meets the full spectrum of their needs. I am proud to be a co-lead of the Treat and Reduce Obesity Act, which puts us on a path toward effectively treating obesity, helping create healthier outcomes for Americans and supporting enhanced quality of life for Medicare beneficiaries who need comprehensive care.”

Development of the Obesity Bill of Rights

A year in development, the Obesity Bill of Rights is the product of extensive research combined with four town hall meetings hosted in senior centers and churches in California, Delaware, Mississippi, and Oklahoma between June and August 2023. At these town halls, more than 250 older adults, community leaders, and local clinicians described a health care system that is inhospitable to delivering quality obesity care, and physicians described having limited time for counseling, not enough training in obesity management, and inadequate coverage and reimbursement for obesity care.

After turning this knowledge and the lived experiences of older adults into a first draft, NCL and NCOA hosted a roundtable at The Obesity Society annual meeting in October 2023 where leading obesity experts reviewed the preliminary document and made recommendations. NCL and NCOA then sought feedback from specialists in minority health, aging, and rural health, as well as health professionals and other stakeholders who provided additional guidance. The final step was to circulate the updated Obesity Bill of Rights to a wide group of stakeholder organizations, resulting in initial endorsements from 36 obesity, public health, and chronic disease organizations and medical societies.

Nearly 40 consumer, aging, and public health organizations endorse the Obesity Bill of Rights

To date, the following organizations have endorsed the first-ever Obesity Bill of Rights: 1) the Academy of Nutrition and Dietetics; 2) Alliance for Aging Research; 3) Alliance for Women’s Health & Prevention; 4) American College of Occupational and Environmental Medicine; 5) American Medical Women’s Association; 6) American Nurses Association; 7) American Society on Aging;  8) American Society for Nutrition; 9) Association of Black Cardiologists; 10) Association of Diabetes Care & Education Specialists; 11) Bias180; 12) Black Women’s Health Imperative; 13) Choose Healthy Life; 14) ConscienHealth; 15) Council on Black Health; 16) Defeat Malnutrition Today; 17)  Gerontological Society of America; 18) Global Liver Institute; 19) Health Equity Coalition for Chronic Disease; 20) HealthyWomen; 21) Lupus Foundation of America; 22) MANA; 23) National Asian Pacific Center on Aging; 24) National Black Nurses Association; 25) National Hispanic Council on Aging; 26) National Hispanic Health Foundation; 27) National Kidney Foundation; 28) Noom, Inc.; 29) Nurses Obesity Network; 30) Obesity Action Coalition; 31) Obesity Medicine Society;  32) Patients Rising;  33) Partnership to Advance Cardiovascular Health; 34) Preventive Cardiovascular Nurses Association; 35) The Obesity Society; and 36) WeightWatchers.

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About NCL

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. The organization’s 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.

About NCOA

The National Council on Aging is the national voice for every person’s right to age well. We believe that how we age should not be determined by gender, color, sexuality, income, or ZIP code. Working with thousands of national and local partners, we provide resources, tools, best practices, and advocacy to ensure every person can age with health and financial security. Founded in 1950, we are the oldest national organization focused on older adults. Learn more at www.ncoa.org.

 

[1] Obesity Medicine Association. June 19, 2013. “AMA House of Delegates Adopts Policy to Recognize Obesity as a Disease. Accessible at https://obesitymedicine.org/blog/ama-adopts-policy-recognize-obesity-disease/:

[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] Hurt Rt, et al. Obesity epidemic: overview, pathophysiology, and the intensive care unit conundrum. J Parenter Enteral Nutr. 2011 Sep;35(5 Suppl):45-135

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

PBMs claim new programs will save consumers money. Let’s take a closer look.

By Robin Strongin, Senior Director of Health Policy

Consumers have known for quite some time now that the prescription drug pricing system is essentially a black box. Dealings among drug manufacturers, health insurers and pharmacy benefit managers (PBMs) establish which drugs insurance will cover and make accessible to consumers. What’s more, the prices that consumers pay for those medicines vary wildly – often leading to high out-of-pocket costs for us all.

Two of the three major PBM companies that are in the middle of this drug pricing web recently announced that they are establishing new programs (CVS’s CostVantage and Express Scripts’ ClearNetwork) that set transparent formulas for drugs with a pre-set markup and a flat fee for the PBMs. On paper, this sounds like a great idea.

But consumers would be wise to take these claims with a healthy grain of proverbial salt. We know PBMs continue to find new ways to put themselves over patients (more on that here) and we must demand answers to the issues the PBMs are still skirting. For example:

  • Will these new programs actually make prescription drugs more affordable and reduce out-of-pocket costs at the pharmacy counter? Notably, both Express Scripts and CVS Health have acknowledged that employers and plan sponsors may not save any money from this move. There is no sign either that consumers will be able to get the drugs they need for a fair price.
  • While the companies boast increased transparency, they still have not shared – nor said they will share – how much they are paying to acquire the drugs that will be dispensed to patients. PBM clients have long sought this information, but it appears that data will still be hidden in the black box.
  • In the case of CVS Health, the changes the company announced will only be effective at CVS-owned pharmacies. It will not affect how CVS will reimburse millions of prescriptions at the local and independent pharmacies it doesn’t own. A cynic might say this is just another mechanism by CVS to drive more patients to its own pharmacies.

Most notably, nothing CVS Health and Express Scripts have announced will change one of the pervasive anti-consumer elements of the drug pricing system. In their dealings with drugmakers, they can still cut deals that will determine which medicines get preferential placement. This means PBMs could continue to push consumers toward higher-priced drugs and limit access to more affordable generics and biosimilars.

It’s no coincidence that Congress is getting closer to passing PBM reform legislation that would mandate transparency, force the PBMs to pass their negotiated savings from drugmakers to consumers and remove the incentives for PBMs to push consumers to higher-priced drugs. One might say that these moves by CVS and Express Scripts are cosmetic attempts to ward off legislation by touting their own self-reforms.

But, as with so much that goes on in the drug pricing game, these “reforms” may not be what they seem. We need Congress to step in for consumers to help ensure we’re no longer facing a big disadvantage at the pharmacy counter.

Learn more about the PBM problem at nclnet.org/pbms.

NCL comments regarding Proposed Rule: Medication Guides: Patient Medication Information Docket No. FDA-2019-N-5959

November 21, 2023

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

The National Consumers League recently submitted comments regarding the Proposed Rule, Medication Guides: Patient Medication Information, that we believe will greatly improve the information patients receive with their prescription medicines.

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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 nclnet.org.

Congressional briefing: The path forward for a safe cannabis marketplace

By Robin Strongin, Senior Director of Health Policy

Cannabis Consumer Watch recently hosted a briefing on Capitol Hill to educate policymakers and staff on the public health risks that exist in the current cannabis marketplace, and to offer policy solutions that would help protect consumer safety and encourage innovation for patients. The briefing was moderated by the Collaborative for Cannabinoid Science and Safety’s Libby Baney, and the panel of experts included:

Robin Stronger, Senior Director of Health Policy, National Consumers League, who explained NCL’s biggest concerns about the current cannabis marketplace. She pointed out, “Out of over 140 CD products studied by the FDA, more than half were mislabeled and nearly 40 of those products had more than 120% of the CBD level listed. Several had pesticides and even toxic mold – we just don’t know what consumers are buying. And consumers aren’t aware of the risks.”

Dale Sutherland, President & Founder, CODE 3, who shared that during his time with DC Metropolitan Police Department, they saw, “how bad distribution efforts can be – product manufacturing and transportation conditions that aren’t heavily regulated present several unique health risks.”

Sue Thau, Public Policy Consultant, CADCA highlighted the negative effects cannabis products have on children in particular, explaining, “Poison control calls related to cannabis digestion are increasing each year – and that’s just the data that we do have – there isn’t an efficient way to track all the issues parents and families face.” She provided examples of THC products that use packaging similar to popular children’s snacks or are in packaging that appeals to kids.

From consumer health to law enforcement, to concerns around youth consumption, the unique backgrounds of the panel made for a robust conversation that included multiple perspectives on the cannabis issue. To learn more about the concerns highlighted during the discussion, visit our Cannabis 101 page here.

 

NCL statement on PBMs and new GAO report

September 18, 2023

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

WASHINGTON, DC – The National Consumers League (NCL) today released a statement following a recently released U.S. Government Accountability Office (“GAO”) report on Medicare Part D rebates.

The following statement is attributable to NCL Chief Executive Officer, Sally Greenberg:

“Investigation after investigation, report after report, and study after study prove that pharmacy benefit managers (“PBMs’) do not provide benefits to consumers. To the contrary, we believe PBMs, who are middlemen, drain billions of dollars that should be going into the pockets of patients and consumers and help them defray their healthcare costs. The evidence mounts that PBMs, which once had a noble purpose, have lost their way and become profit centers unto themselves, adding costs to our drug supply system at the expense of patients. This latest report by GAO underscores that our nation’s seniors – often our most vulnerable patients who rely most on medications – pay the highest price for PBM practices.

“In just one year, GAO found that the PBMs collected almost $50 billion in rebates from prescription drug manufacturers under the Medicare Part D program alone. These savings should go directly to Medicare beneficiaries, but for the nearly 80 of the highest rebated drugs analyzed, GAO found that seniors paid more than $20 billion, while their plan sponsors — often vertically integrated with PBMs — paid only $5.3 billion. PBMs are able to enrich themselves because they control access to prescription drugs, block competition, conduct business in the shadows, and pocket discounts meant for patients. PBMs simply driving up out-of-pocket costs for Medicare beneficiaries to the tune of millions of dollars.

“Congress has an opportunity to enact meaningful PBM reforms to prevent such behavior. We urge our leaders in Congress to closely examine the findings of the GAO report, and put a stop to the practices of PBMs to profit off of vulnerable patients. In doing so, our elected representatives will put money back in the pockets of patients and help them to better afford the medications they need.”

Learn more about NCL’s work to address the PBM problem at nclnet.org/pbms.

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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 nclnet.org.

National Consumers League response to the Request for Information regarding FDA regulation of CBD

August 25, 2023

Media contact: National Consumers League – Katie Brown, katie@nclnet.org, 202-823-8442

Washington, D.C. – On August 17, the National Consumers League responded to the Request for Information regarding FDA-Regulation of CBD.

In 2019, in response to the proliferation of unreviewed and untested CBD products, NCL identified the need for greater education among consumers about CBD and better enforcement of regulations in the CBD marketplace. NCL created Consumers for Safe CBD to address the need, champion the rights of consumers, and call on government and industry to do better – to ensure safety and promote a pathway for new products through clinically tested scientific research. Since then, action has been taken on the state and federal levels to increase access to cannabinoids beyond CBD. In response, NCL expanded our educational campaign and established Cannabis Consumer Watch.” 

The full letter can be found here.

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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 nclnet.org.