A Big Win For California Patients And Consumers – “Refill Reminders” A “Go” – National Consumers League

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sg.jpgCalifornia’s Office of Health Information Integrity (CalOHII) just delivered a big victory for patients and consumers by expressly recognizing that sponsored medication adherence programs for a currently prescribed drug (commonly called “refill reminders”) do not require patient authorization in California. In publishing its long-awaited State Health Information Policy Manual, CalOHII takes a step to harmonize the state’s Confidentiality of Medical Information Act (CMIA) with the federal medical privacy laws and regulations (a.k.a., the HIPAA Privacy Rule).

For years now, due in part to privacy concerns, confusion has persisted within the healthcare community about the types of refill reminder programs that can legally run in California. In fact, California is the only state in the U.S. where pharmacies do not, to any meaningful degree, operate sponsored refill reminder programs. California consumers deserve the benefit of refill reminders that provide helpful information to patients about their prescription drugs. Patient access to this information is now guaranteed.

CalOHII’s publication of its Manual makes clear that California adopts the same approach that the U.S. Department of Health and Human Services (HHS) took in its 2013 final rulemaking and “Refill Reminder Guidance.” Under that HHS Guidance, pharmacies are able to provide their patients with sponsored refill reminders. NCL applauds CalOHII for clarifying that the CMIA should be interpreted consistently with the HIPAA Privacy Rule. With that clarification, NCL is hopeful that California pharmacies and their sponsors will jumpstart sponsored refill reminder programs. 

NCL is a longstanding supporter of refill reminder programs. NCL leads  “Script Your Future,” a public education campaign designed to raise awareness of the importance of taking medication as prescribed. Poor medication adherence is a major, and significantly under-appreciated, health problem. Studies establish that nearly three-out-of-four Americans do not take their medications as directed, which costs the healthcare system nearly $300 billion per year and results in almost 125,000 unnecessary deaths per year. To help combat this problem, most pharmacies, health plans, and doctors provide a broad range of patient-directed communications regarding prescription drug therapies, including communications that encourage patients to stay on prescribed therapy. The sponsored refill reminder programs endorsed by CalOHII in its Manual are a key part of these efforts in California.  

 As a founding member of the Best Privacy Practices Coalition, NCL is also a strong believer in the protection of medical privacy. However, medical privacy does not exist in a vacuum. NCL is pleased that CalOHII has arrived at a great middle ground that balances the need for information with privacy concerns of patients. This balance is a win for Californians.

Promoting health or products? A look into the Facts Up Front program

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factsupfront.pngDue to the work of the Facts Up Front campaign, today’s food products are marked with labels that advertise their nutrition facts. You have most likely seen them as the small snapshot of information on the front corners of products like cereal and bread. While this is a promising health campaign, consumers should be wary because these labels can often be misleading.

Facts Up Front was primarily developed by leaders in the food industry to help grocery shoppers like you and me easily identify nutritious food, when we may not have the time to read an entire Nutrition Facts panel.

Consumers seeking nutritional information should take a closer look at nutrition labels, as sometimes the food industry has been remiss in keeping honesty at the forefront of their labeling and marketing of products. Several years ago, one labeling campaign called “Smart Choices,” promoted sugar-laden, highly processed products as healthy options. Programs like Smart Choices, which had lenient criteria for what was considered “healthy,” lacked credibility and soon disappeared. Walter C. Willett, chairman of the nutrition department of the Harvard School of Public Health, said that the less healthy products that were given the Smart Choices’ seal of approval were in fact, “horrible choices.” As consumer advocates, we would like to see the food industry put the health of consumers at the heart of their new and improved labeling system.

Currently, Facts Up Front labels are only used by food companies that choose to display nutrition facts on the front of their packaging, which also raises some red flags. Michael Jacobson, the executive director of the Center for Science in the Public Interest, stated that Facts Up Front’s “voluntary nature means you may not see it on junk foods. And even if you did, it wouldn’t successfully highlight the food’s unhealthfulness.” There is no breakdown of the label information until you search online for Facts Up Front or a nutrition information website. The Facts Up Front labels show only the amount of calories, saturated fat, sodium, and sugar per serving on product packaging. The campaign may only display information about up to two nutrients or vitamins on front-of-packaging labels if the products meet FDA standards of a “good source,” which applies to foods that have 10 to 19 percent of the recommended daily value of a specific nutrient. The fact is, it is difficult for consumers to use these labels intuitively to make a “healthy decision,” which is what the campaign aims to accomplish.

The quick, simple informational element of this campaign requires more intensive public nutrition education, because it is clear that misleading nutrition marketing can, and does, occur. Facts Up Front can use the help of health marketing research, such as the Institute of Medicine’s 2011 study on front-of-package labels, and should continue to work with advocates to ensure labels provide the most honest, easy-to-use, and factual information to consumers. In the meantime, consumers should “trust, but verify” all nutrition labeling on food products.

King v. Burwell ruling will keep consumers insured (and healthy!)

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Health_Care_Law.jpgThe King v. Burwell ruling in favor of the Affordable Care Act (ACA) has allowed for approximately eight million consumers to keep their insurance coverage. In the King case, petitioners challenged the clause of the Affordable Care Act that stated subsidies are available to people who use an exchange “established by the State” to purchase insurance. 

Consumers living in the 34 states without state marketplaces are able to benefit from the subsidies because the Internal Revenue Service allowed people to receive assistance if they purchased a plan on the federally-run marketplace. The plaintiffs argued that subsidies by law are only given to people living in states with their own health insurance marketplaces. The ruling allows consumers in states where the marketplace is run by the federal government to keep their subsidy and insurance.

The National Consumers League (NCL) applauds the Supreme Court for upholding the ACA subsidies for consumers using the federal marketplace. The Supreme Court decision helps prevent a rise in premiums for all consumers using the health care exchange. The subsidies are a key provision of the law and they are an important part of keeping consumers insured and healthy. This decision provides hope that the ACA will face fewer political and legal obstacles in the future and can continue to provide health insurance to consumers. Despite the naysayers, the numbers speak volumes. Since the ACA’s enactment, more than 16 million Americans have been able to afford quality health insurance they did not have before.

If you do not already have health insurance, you can enroll in person, over the phone, by mail, online at Healthcare.gov, or on your state exchange’s site during the open enrollment period. 

Talk before you take: The importance of doctor-patient communication before starting a new medication – National Consumers League

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92_kamay.jpgWe’ve all been there. Sitting alone in a cold doctor’s office, listening to a re-run of the Dr. Oz show while waiting for your doctor to come back in the room with a diagnosis and prescription in hand. You can’t wait to leave and get back on the path to wellness. And who could blame you? No one likes to wait—especially when you don’t feel healthy. The doctor comes back, hands you your prescription, and gives you a brief overview about what the medication is and the appropriate dosage. But, what happens next is critical. Do you hop off that cold, uncomfortable patient bed and go on your merry way, or do you ask questions? Specifically, questions pertaining to the risks associated with this prescription medication.

While in recent years, the communication gap between healthcare providers and patients has been met with a fair share of commentary, critique, scholarly review and analysis, we are slowly making progress, thanks in part to numerous campaigns and educational initiatives. Recently, the National Council on Patient Information and Education (NCPIE), a non-profit organization, launched a campaign to help bridge the communication gap with Talk Before You Take.

Launched earlier this year, Talk Before You Take highlights the importance of communicating with your healthcare provider about the benefits and risks of prescribed medications before a prescription is written and filled. The specific aims of the Talk Before You Take are to:

  • Understand medication side effects
  • Avoid adverse drug reactions
  • Improve adherence to medicine regimen(s)
  • Live healthier lives

Here are four tips to help guide your conversation with your healthcare provider about prescription medicines:

  • 1. Talk to your healthcare provider and ask questions about the benefits and potential risks of prescription medicines you take.
  • 2. Tell your healthcare provider about all of the medicines you are taking—including over-the-counter medicines, vitamins, and dietary supplements.
  • 3. Tell your healthcare provider about any allergies or sensitivities that you may have.
  • 4. Read and follow the medicine label and directions.

And remember, even if you get home and realize that you still have questions about your prescription medications; it’s not too late. Don’t hesitate to pick up the phone and call your healthcare provider. Because when it comes to your health, there are no silly questions.

Guest blog: A new venture for collaborative solutions – National Consumers League

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lee_lynch.jpgThis guest post was originally published at Reservoir Communications Group’s blog.

What do you get when you put representatives from more than 30 of the nation’s leading patient-focused health organizations, companies and government agencies in a room, amidst a sea of sometimes-competing priorities that are specific to each of those organizations? Cacophony? Stalemate? Not at all, at least not during the National Consumers League’s (NCL) inaugural Health Advisory Council meeting.

I had the pleasure of being a part of this meeting last week and while I have worked with nearly all of these organizations — individually and through coalitions – at one time or another, it is somewhat of a rare thing to engage with all of them during a coming together that may lead to solutions to seemingly insurmountable issues.

NCL has a history of NOT shying away from tough issues. Whether the issue is protecting the rights of child workers, improving treatment adherence, tackling consumer fraud, or improving consumer literacy, I’ve always thought their motto should read, Bring It On.

Through NCL’s new Health Advisory Council, they are looking to leading consumer, patient, health care professional, industry and government voices to help them determine what major health-focused issues need to be better addressed and could be addressed collaboratively.

The Health Advisory Council is very much at the beginning, but at the start, members and participants advised that the following were major issue areas that aligned with their own organizations’ interests:

  1. Medications — both Rx and OTC — were top of mind:  Adherence, management and general safe use of medications, as well as safe use of antibiotics
  2. Coverage policies and impact on access to care and medications was also an area for collaborative opportunity
  3. Defining and optimizing the respective roles of health care providers especially those of nurses and pharmacists —was a shared area of interest
  4. Improving both patient and HCP communication skills was also of common interest

As a communicator, I found it interesting how virtually every one of these top issue areas has communications at the center. Whichever topics NCL and its Health Advisory Council members choose to collaboratively pursue  — whether it be safe use of medications, enhancing access to care and treatment for diverse populations or people suffering from chronic conditions, fully recognizing the potential role nurses and pharmacists could play to improve value across the system, or tackling the need to improve communications between patients and HCPs in order to raise the overall level of coordinated care — communications, if successfully applied, will be a major part of the solution.

Some of the problems discussed seem larger than life. But many of the organizations in the room have a history of trying to tackle that which seems impossible:

A number of state-based organizations — such as the North Carolina Alliance for Healthy Communities and Ohio Pharmacists Association and researchers from Duke University and the University of Minnesota — are also involved and can help ensure that any possible approach is also localized in nature.

It’s too early to tell in which direction the NCL Health Advisory Council will head, but nothing ventured, nothing gained. More to come as the Council shares perspectives and concerns with one another and advises the NCL on what areas are worth pursuing — and solving — on behalf of America’s consumers.

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Lee Lynch is founding principal at Lynch Advocacy Solutions, LLC and strategic counselor at Reservoir Communications Group. Her experience extends across advocacy, public relations, public affairs, issues management, marketing, and journalism. For more than a decade, Lee led the Edelman Alliances group – a dedicated team she founded that engaged hundreds of influencers and third-party organizations to find unique ways to collaboratively link organizations, corporations and governments to achieve mutual goals. 

Watered-down lemon juice making advocates sour – National Consumers League

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In a formal complaint to the Food and Drug Administration this month, NCL is urging the federal agency to stop the sale of four brands of “100%” lemon juice that were recently tested and found to be heavily diluted with water. NCL tested four products, each of which turned out to contain only a small amount of real lemon juice! 

  • “NaturaLemon 100% Lemon Juice from concentrate – Natural Strength” contains only about 35 percent lemon juice.
  • “Lira 100% Lemon Juice from concentrate” contains only about 25 percent lemon juice.
  • “Lemon Time Lemon Juice from concentrate” contains about only 15 percent lemon juice. The product states on its front label, “Contains 100% Lemon Juice with added ingredients.”
  • “Pampa Lemon Juice from concentrate” contains only about 10 percent lemon juice. The product states “Made with 100% Juice.”  The label also includes the statement “Natural Strength.”

Consumer advocates believe that these producers water down their products to lower production costs and increases profits. In the case of lemon juice, recent weather conditions have led to variability in the supply of fresh lemons —and lemons being harder to get has given unscrupulous producers incentive to dilute their products with water and add citric acid and sugars to compensate for flavor.

The label of NaturaLemon illustrates just how bad the problem is. The label indicates that the bottle contains the juice of 30 lemons! However, doing the math, the bottle is likely made with only the juice from 10 lemons. The incentive to cheat is obvious.

NCL has long been an advocate of truthful and honest labeling. Consumers who buy these brands think that they are getting 100 percent lemon juice, but in reality they are not getting what they have paid for. We hope that FDA or state officials will take action to ensure that these brands either clean up their act or are no longer sold in stores. Click here to read NCL’s complaint to FDA and view the laboratory tests we sponsored.