Translation Law and Pharmacy: Protecting the Consumer’s Right to Understand

The days of a pharmacist being able to prepare a prescription, put directions on the label, and give it to a customer with full confidence are over. Skills that many of us take for granted, such as reading a prescription label, figuring out how many hours apart to take a medication, and how to measure liquid medication properly are severely lacking in the general population.

According to the Journal of the American Medical Association, up to 46 percent of adults cannot understand the information on their prescriptions. The elderly are even more likely to take medications incorrectly. By some estimates, 90% of Medicare patients have been prescribed daily medication. It's no surprise that mistakes are made when a patient is asked to keep track of taking five or more medications daily.

And when the patient doesn't speak English, all bets are off.

According to an immigrant advocacy organization, one Spanish-speaking woman was given a medication for her son. She gave it to him and he began vomiting. Concerned, she sought help, and was told that the medication was supposed to be applied topically.¹

Stories of medical mishaps like these are repeated far too often across the country. In an attempt to remedy the situation, the states of New York and California have taken action.

New York's attorney general recently settled with seven major pharmaceutical chains which were not providing equal access to health information. The pharmacies have agreed to provide a multi-pronged solution which includes telephones that will connect customers with off-site interpreters in 150 languages, as well as written instructions in five of New York's main foreign languages: Spanish, Chinese, Italian, Russian, and French.

The state of California passed Senate Bill 472 in 2007, which states that "This bill would require the [California State Board of Pharmacy in the Department of Consumer Affairs] to promulgate regulations that require, on or before January 1, 2011, a standardized, patient-centered, prescription drug label on all prescription medication dispensed to patients in California."

The Board has recently adopted draft regulations for the standardization and translation of prescription drug labels. As of fall 2009, this draft does not include a requirement for these standardized labels to be translated into the patient's primary language, and instead relies on oral interpretation of the instructions. This is despite a clear statement within SB 472 that says "the needs of patients with limited English"² are to be taken into consideration when designing the new label.

Advocacy organizations in California such as the California Pan-Ethnic Health Network (CPEHN) are opposed to the interpretation-only standard. Marty Martinez, policy director for CPEHN, stated recently, “Both oral interpretation and translated labels are vital for patient care and safety.”³

One could also argue that patients who are not receiving translated labels are not receiving equal access as required by existing state and federal laws. Think of all the times that you have picked up a prescription and refused counseling, or picked up a prescription for someone else! The bottom line: Relying on an English-only label after receiving incomplete instructions passed on by a family member or other third party could result in tragedy.

It is important to note that some national pharmacy chains already have some translation assistance in place—Walgreens, for example, has a robust translation system. Companies such as this are sure to attract and retain new customers based on their willingness to accommodate special populations.

Because it is likely that translated labels will indeed be required in the near future, Avantpage Translations recommends that every pharmaceutical provider begin to examine their own translation practices based on these criteria:

1. Is interpretation access available 24/7 at every location of your pharmacy, in a wide range of global languages?
2. Does each location have the capability to translate pharmacy labels into at least 30 different languages?
3. Are your prescription labels in a universal typed format that is clear and easy to read?

Obviously, these areas are just a place to start when evaluating the effectiveness of your communication, and once guidelines are set for your area, you’ll have a clearer idea of what is required. Avantpage is committed to staying abreast of all changes in policy as it relates to translation and keeping our clients informed. Call us today at 877-ANY-LANG to discuss any of your translation concerns. _____________________________________________________________________________________

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References:

1. Semple, Kirk. “Pharmacies Agree to Provide Prescription Data in Many Languages.” April 22, 2009. The New York Times.
2. California SB 472, Corbett. Prescription drugs: labeling requirements.
3. “Support Translated Prescription Drug Labels.” CPEHN Policy Brief, Nov. 23, 2009