To Translate or Not? A Look at Pharmacy Labels and Language

In California, there is a debate over the translation of medicine labels. Currently, 44 percent of Californians speak a language other than English at home. Most medicine labels in California are printed in English, which places patients who do not understand written English in danger of taking their medications incorrectly. (NPR) This can be very dangerous and can cause serious harm.

Currently, California’s Board of Pharmacy’s website includes translations of basic instructions (such as “take one pill at bedtime”) in Chinese, Korean, Russian, Spanish, and Vietnamese. (Board) According to members of the California Board of Pharmacy and the California Pharmacist’s Association, however, these translations are not regularly used. (NPR) Perhaps this is a contributing factor to the California Board of Pharmacy’s reluctance to spend time and money translating medicine labels.

In August, California’s Board of Pharmacy discussed new regulations that would require all pharmacies to provide translated labels on prescription drug bottles. New York approved a similar rule last year. (NY) Though it would seem that such a rule would have only positive effects, some stakeholders have serious concerns. (Pharmacy)

One concern is that pharmacists who don’t speak multiple languages could face liability. If there is a mistake in a translation that pharmacists are unable to catch, pharmacists may be dis-incentivized from using translated labels. (AARP) Another concern is that the potential for translation errors could also lead to a need for higher malpractice insurance, which would eventually lead to higher costs for consumers. NPR.

California’s Board of Pharmacy raised a concern over the size of prescription drug bottles. (NPR) Translated labels would require larger bottles of pills, which patients do not like. This would lead to patients pouring their medication in a bag or putting their pills in a pocket and dumping the bottle. (NPR) Dumping a prescription medication bottle in the trash can have a whole host of problems. For example, patients may realize they actually do want the instructions on their bottle and can’t get it back, or someone could fill the bottle with another pill and sell that for quick cash.

The risk to limited English-speakers of improperly taking medicine, translation supporters argue, is greater than any liability that could result from translating labels. (KevinMD) Sarah de Guia, director of Government Affairs for the California Pan Ethnic Health Network, argues that because of expanded insurance coverage through the Affordable Care Act, the government would want to have more rather than fewer instructions available to the public. (NPR)

Considering other perspectives, such as those of patients, doctors, and insurance companies, it seems that having translations of medicine labels is in the best interests of everyone. While pharmacists may be worried about liability, if their patients do not ever have directions that they understand, then they are just as likely, or even more so, to use their medications incorrectly as they would be with a problematic translation. Having translations of medicine labels could actually lower the risk of liability that pharmacists face, rather than raising it because the chances of a patient using their medication incorrectly is lessened.

What are possible solutions? (1) Labels could be folded around bottles, keeping bottles the same size. (2) Pharmacists could print out the translated labels and hand those to the patient separately or place the printouts in a bag or folder. (3) The California Board of Pharmacy could expand the translations available on their website to more than basic instructions and include more languages. This would need to be complemented with some sort of advertising strategy that encourages more use of their website. (4) The technology industry, researchers, physicians, pharmacists, and policymakers could collaborate to develop initiatives that best address the language barriers that contribute to disparities in healthcare. (Pediatrics)

While translating labels may cost more money and require more work for the California Board of Pharmacy, it is likely that these costs will be saved in the long run if patients are using their medications safely and properly. There will always be risks and potential for something to go wrong, and the fear of badly translated labels is a legitimate one. Nevertheless, the current concerns appear to outweigh the concerns of badly translated labels.



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