by Sharla Glass
From the Editor: At one time labeling by a pharmacy would have seemed nonsensical to me. I only had a few bottles, and I could certainly label them myself. Then things became more complicated: now I have a stack of prescriptions, and little techniques such as looking at the pill size, looking for a unique bottle, or remembering exactly where I keep a certain medication aren’t as reliable. Of course I’ve never had good access to the instructions, so over time I’ve come to learn how important they are. Enjoy this article by Sharla from Envision about the way states are implementing legislation to see that we too have labels we can read:
“We see what’s happening and know it’s just a matter of time before our state has a mandate,” the pharmacy executive said. These encouraging words are because NFB affiliates have been approaching their legislatures and Boards of Pharmacy to say accessible prescription labels are a health equity and health literacy issue which needs to be addressed immediately.
Due to the hard work of many NFB affiliates, we’ve reached the point where the industry is anticipating a shift in public policy nationwide in the near future. Who are these affiliates? What have they done to create this shift in pharmacy thought? How do we push forward to make this prediction a reality?
The first two states to pass accessible prescription labeling laws were Nevada in 2017 and Oregon in 2019. The pandemic didn’t stop Frank Perez at the National Association for the Blind of Puerto Rico from advocating over and over again to achieve a victory in Puerto Rico finally signed by the governor in January 2023.
In 2022 the NFB of Tennessee championed a bill and navigated a unique situation because their state is one of the few that actually owns and runs its own pharmacy services through TennHealth. This meant having to make some amendments to avoid legislation getting caught up in fiscal reports. In the end their law passed directing the Board of Pharmacy to do the work of gathering stakeholders to help determine the rules. That rulemaking process is just beginning.
These were all quickly followed by an amazing collaboration in Washington between the NFB, ACB, and Health Equity Circle to pursue accessible prescription labeling and prescription label language access simultaneously. So many people testified for this bill. Though it died on the House floor, advocates so inspired the legislators and Board of Pharmacy that they committed to rulemaking even without a bill. Rulemaking is officially underway, a rough draft and public comment period already completed. One of the things that I will always remember is the House Health Committee chair’s comment that she was appalled that this was not already something being provided. She and many others assumed that this was already standard practice.
This has further inspired other affiliates who have difficulty getting a bill sponsored to try this alternative route. In January 2023 Camille Tate went before the Florida Board of Pharmacy and gave a presentation. The Board’s first response was that they thought it would cost too much to be implemented and needed to be legislated, but after more questions about ADA and Braille technology, they agreed they would need to do more research and discuss it again at a future meeting. Once again, like in Washington, we found that people assumed that it was already being done or it was impossibly difficult to do, but education is the key to progress!
January also brought Roger Crome and Sheila Wright in front of the Missouri Board of Pharmacy. They gave a wonderful presentation which was followed by comments at length given by Board Member Douglas Lang R.Ph., who, surprisingly, had served as a pharmacy representative on the US Access Board working group that developed the “Best Practices for Making Prescription Drug Container Label Information Accessible to Persons Who are Blind or Visually-Impaired or Who are Elderly” (https://www.access-board.gov/rx.html) in 2013. The board also had another pharmacist with a vision impairment who said she herself could benefit from a large print or audible label. The board felt that knowledge of labeling options and best practices are not widely known, and perhaps a public relations campaign to pharmacists and the public would be a help. They also agreed to work with the legislature on the multiple bills the NFB was able to get introduced this session.
We also are following efforts by the NFB of Hawaii and the NFB of Maryland who both found sponsors and have bills scheduled for committee hearings in the coming weeks. There are many other affiliates that are seeking sponsors or gearing up to approach their Board of Pharmacy including NFB of New York, NFB of Arkansas, and NFB of Michigan.
Links to all the bills mentioned and sample draft language can be found https://www.staysaferx.org/p/blog-page_10.html.www.StaySafeRx.org or you would like help tracking accessible labeling bills in your state, contact Sharla Glass at En-Vision America, 941-702-6602 or [email protected].