Cleaning Products That Destroy Coronavirus

These Common Household Products 

Can Destroy the Novel Coronavirus

By Perry Santanachote / March 09, 2020 / Consumer Reports

Reposted from my Facebook feed

Consumer Reports shows you how to use them and tells you which products to stay away from

News of stores running out of hand-sanitizing gels and chlorine wipes may have you worried about how to protect your family at home as COVID-19 spreads. But plain old hand soap will go a long way.

“It isn’t possible to disinfect every surface you touch throughout your day,” says Stephen Thomas, M.D., chief of infectious diseases and director of global health at Upstate Medical University in Syracuse. “The planet is covered with bacteria and viruses, and we’re constantly in contact with these surfaces, so hand-washing is still your best defense against COVID-19.”

You need to amp up your typical cleaning routine only if someone in the household exhibits signs and symptoms of a respiratory infection, or if you live in an area with known cases of COVID-19. In that scenario, Thomas says, “Clean high-traffic areas that get touched frequently, such as kitchen counters and bathroom faucets, three times a day with a product that kills viruses.”

The good news is that coronaviruses are some of the easiest types of viruses to kill with the appropriate product, according to the Environmental Protection Agency. “It has an envelope around it that allows it to merge with other cells to infect them,” explains Thomas. “If you disrupt that coating, the virus can’t do its job.”

Even if you can't get your hands on hand sanitizer or Clorox wipes, below are a number of cleaning products you probably have around the house already, and that stores are more likely to have in stock, that are effective in deactivating the novel coronavirus. We also tell you the products that don’t work, and when you can expect retailers to stock back up on cleaning supplies.

Cleaning Products That Destroy Coronavirus

Soap and Water Just the friction from scrubbing with soap and water can break the coronavirus’s protective envelope. “Scrub like you’ve got sticky stuff on the surface and you really need to get it off,” says Richard Sachleben, an organic chemist and member of the American Chemical Society. Discard the towel or leave it in a bowl of soapy water for a while to destroy any virus particles that may have survived. 

Bleach The Centers for Disease Control and Prevention recommends a diluted bleach solution (⅓ cup bleach per 1 gallon of water or 4 teaspoons bleach per 1 quart of water) for virus disinfection. Wear gloves while using bleach, and never mix it with anything except water. (The only exception is when doing laundry with detergent.)

“Bleach works great against viruses,” Sachleben says. Just don’t keep the solution for longer than a few days because bleach will degrade certain plastic containers.

Bleach can also corrode metal over time, so Sachleben recommends that people not get into the habit of cleaning their faucets and stainless steel products with it. Because bleach is harsh for many countertops as well, you should rinse surfaces with water after disinfecting to prevent discoloration or damage to the surface.

Isopropyl Alcohol Alcohol solutions with at least 70 percent alcohol are effective against coronavirus. Do not dilute the alcohol solution. Alcohol is generally safe for all surfaces but can discolor some plastics, Sachleben says.

.  According to the CDC, household (3 percent) hydrogen peroxide is effective in deactivating rhinovirus, the virus that causes the common cold, within 6 to 8 minutes of exposure. Rhinovirus is more difficult to destroy than coronaviruses, so hydrogen peroxide should be able to break down coronavirus in less time. Pour it undiluted into a spray bottle and spray it on the surface to be cleaned, but let it sit on the surface for several minutes.

Hydrogen peroxide is not corrosive, so it’s okay to use it on metal surfaces. But similar to bleach, it can discolor fabrics if you accidentally get in on your clothes. “It’s great for getting into hard-to-reach crevices,” Sachleben says. “You can pour it on the area and you don’t have to wipe it off because it essentially decomposes into oxygen and water.”

What Not to Use Against Coronavirus

Homemade Hand Sanitizer You’re probably seeing all sorts of hand sanitizer recipes floating around your social media and the internet, but Thomas, at Upstate Medical in Syracuse, advises against making your own. “People don’t know the right ratios to use, and the internet won’t give you the right answer,” he warns. “Not only can you hurt yourself, but it could give you a false sense of security.”

Sachleben seconds that advice. “I’m a professional chemist, and I don’t mix my own disinfectant products at home,” he says. “Companies spend a bunch of time and money to pay chemists specifically to formulate hand sanitizers that work and that are safe. If you make it yourself, how can you know if it’s stable or if it works?”

Vodka There are widely circulated recipes on the internet using vodka to combat coronavirus. A couple of vodka makers, including Tito’s and Smirnoff, have already come out with statements telling their customers that their 80-proof product does not contain enough ethyl alcohol (40 percent compared with the 70 percent required) to kill the coronavirus.

Distilled White Vinegar Disinfection recommendations using vinegar are popular online, but there is no evidence that they are effective against coronavirus. (Read about the 9 things you should never clean with vinegar.)

When Retailers Expect More Supplies

Wondering when you’ll be able to get your hands on hand sanitizer, Lysol wipes, Clorox sprays, etc., at your local store? CR spoke to major chains, including Costco, CVS, Kroger, Stop & Shop, and Walgreens. They said that they are seeing temporary shortages and are restocking as quickly as their suppliers allow (though CVS says it is not seeing a shortage of disinfectant wipes and sprays). Kroger and Stop & Shop have instituted purchase limits.

But your best bet, says Burt Flickinger, managing director at Strategic Resource Group, a retail and consumer goods consulting firm, is to go to the warehouse stores and large grocery chains.

"They have their own distribution warehouses and constantly replenish their stock," he explains. He adds that Walmart has one of the best distribution chains in the country and is prepared for natural disasters like tornadoes or hurricanes. In other words, their system is already in place, so they don't have to scramble to meet demand.

Flickinger says the best time to shop is 6 a.m. to 8 a.m., because the shelves are typically restocked overnight. He anticipates that supplies from Clorox, 3M, and Procter & Gamble will be replenished the soonest.

—Additional reporting by Mary Farrell

https://www.consumerreports.org/cleaning/common-household-products-that-can-destroy-novel-coronavirus/

Will You See an Actual Doctor the Next Time You Go to the Doctor?

I am sharing this article because it has some good information helping to clarify the roles of medical professionals. 

It’s getting harder to see a doctor, but you can still get quality care 

from a host of other professionals if you know who’s who

Consumer Reports / Hallie Levine / February 1, 2018

It used to be so simple: You made an appointment with a doctor and would almost certainly see an M.D., someone who spent four years in medical school and then had at least three years of additional training, usually in a hospital.

But today you’re likely to encounter a veritable alphabet soup of healthcare degrees: D.O., P.A., N.P., R.N., and N.D., to name a few. Who are all these people? What training do they have? Which one is best for you? And where’s your good old M.D., anyway? (See our guide to healthcare providers, below.)

The truth is, you may not always need a traditional physician—and may have a difficult time finding one. The U.S. is short on doctors, especially those practicing primary care, who typically earn less than specialists. We now have fewer primary care physicians per person than many other developed nations. Canada, for example, has 1.2 per 1,000 people; the U.S., just 0.3.

Because there are fewer primary care doctors, it’s more difficult to get an appointment. The average wait time for a new patient in a big city to see a family-medicine physician, for example, is now 29 days, compared with 19.5 days in 2014, according to physician recruiting firm Merritt Hawkins.

At the same time, doctors today are feeling pressure to work faster. Because of competitive forces in the marketplace, including many hospitals buying up physician practices, doctors are now more likely to work for large networks than for themselves. And those employers often set daily patient quotas—16 to 25 per day is typical—that can limit your time with a doctor.

That time crunch, combined with growing demands to document all their encounters in often cumbersome electronic health records, is taking a toll on doctors.

More than half of primary care doctors report feeling burned out, according to a 2017 Medscape survey. And that could undermine the care they provide, make them less willing to work collaboratively with patients, and drive even more out of the profession.

A Team of Providers

Enter “advanced practice providers.” These are the N.P.s (nurse practitioners) and P.A.s (physician assistants) you may run into at a doctor’s office.

They don’t have as much training as M.D.s but are licensed to do many of the same things. And their ranks are growing fast. The share of physicians with these clinicians on their team has risen from 25 percent in 1999 to more than 60 percent now.

But is seeing one of them as good as seeing a medical doctor? In most cases, yes, says Ateev Mehrotra, M.D., an associate professor of healthcare policy at Harvard Medical School.

His January 2017 study in the journal Medical Care found that practices with more N.P.s and P.A.s had fewer specialist referrals, hospitalizations, and ER visits. And other research has found that when it comes to high blood pressure, diabetes, respiratory infections, and other common problems, there’s little difference in treatment from M.D.s and advanced practice providers.

The team approach is also efficient, allowing each clinician to focus on what he or she does best. And it can mean shorter wait times and better patient education, according to a 2016 analysis by the Agency for Healthcare Research and Quality.

In addition to N.P.s and P.A.s, you may also be more likely to encounter other healthcare professionals now.

They include reputable ones, such as doctors of osteopathic medicine (D.O.). Their education is similar to an M.D.’s, with special training in muscle and skeletal issues, and their numbers have been growing.

But you may also encounter some more controversial providers, such as naturopathic doctors, or N.D.s.

This guide explains who’s who, gives advice on how to get the most of your precious time with each of them, and identifies those you should consider steering clear of.

A Guide to Today's Healthcare Professionals

For a routine office visit these days, you might not ever see an M.D. A case of the flu, for example, might be handled by a physician assistant (P.A.), and a regular checkup might be done mainly by a nurse practitioner (N.P.). And that can be just fine: Practices with advanced practice providers have outcomes at least as good as those that rely mainly on M.D.s. But it can be reassuring to know exactly who it is you’re seeing. Here’s a guide to some of the providers and what sets them apart from one another:

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MEDICAL DOCTOR (M.D.)

Training: Earning this degree requires four years of medical school—typically with two years studying biomedical science and basic clinical skill and two more rotating through a broad variety of specialties. Then there’s an additional three to seven years under the supervision of experienced faculty physicians

Strengths: M.D.s (and D.O.s; see below) have the most training of the providers you’ll see. So if you have several conditions or symptoms that don’t easily add up, an M.D. can connect the dots more easily, says David Blumenthal, M.D., president of the Commonwealth Fund, a nonprofit foundation that focuses on health policy.

Limitations: Primary care docs are in short supply, so it might be difficult to find one accepting new patients, and he or she might not be able to spend as much time with you as you like.

CR’s Advice: If you have a complex health condition or one that isn’t responding to treatment, you’re better off seeing an M.D., says Marvin M. Lipman, M.D., CR’s chief medical adviser. But if you’re in good health or your condition is well-controlled, it can be fine to get the bulk of your care from an advanced practice provider.

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DOCTOR OF OSTEOPATHIC MEDICINE (D.O.)

Training: The four years of medical education for D.O.s largely matches M.D. programs but also includes 200 hours in osteopathic manipulative medicine, hands-on techniques designed mainly to treat pain. These doctors participate in many of the same residency programs as M.D.s and can specialize in anything from pediatrics to psychiatry to surgery. One of four U.S. medical students now attends an osteopathic medical school. But don’t confuse D.O.s with osteopathic practitioners who are trained abroad; they’re neither M.D.s nor D.O.s., only perform manipulative treatment, and can’t prescribe medicine.

Strengths: “D.O.s are virtually interchangeable from M.D.s,” says Susan Hingle, M.D., chair of the Board of Regents of the American College of Physicians. They provide a full range of medical care for all types of diseases and health problems, but they may be especially good at treating musculoskeletal conditions such as lower back pain and less likely to prescribe drugs for that problem, according to a 2015 study in the Journal of the American Osteopathic Association.

Limitations: Like M.D.s, they don’t have much time to spend with patients. The average osteopathic visit is actually a couple of minutes shorter than the average visit with an M.D., according to that same 2015 study.

CR’s Advice: A D.O. can serve as your doctor in any case where you might seek an M.D. More than half of them practice family medicine or pediatrics. And by seeing a D.O., you get the benefit of his or her extra training in the musculoskeletal system.

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NURSE PRACTITIONER (N.P.)

Training: Before someone can become an N.P., he or she must be a registered nurse (R.N.), which requires an undergraduate degree in nursing. N.P.s go on to advanced education and clinical training, earning either a master’s or doctorate degree, specializing in an area such as family practice, pediatrics, or women’s health, says Diane Padden, N.P., Ph.D., vice president of professional practice and partnerships at the American Association of Nurse Practitioners.

Strengths: N.P. education and training emphasize patient-centered care, which means that in addition to diagnosing and treating conditions, N.P.s focus on health education and counseling. One study found that patients tend to be more satisfied after a visit with an N.P. and that those visits tend to be longer. In some states, N.P.s can practice independently.

Limitations: Those with diagnostic dilemmas, such as an unexplained fever that has lasted a few weeks, should usually be referred to an M.D. or a D.O.

CR’s advice: It’s fine to choose a nurse practitioner as your main healthcare provider and to have one provide routine care during an office visit. But you should expect to be referred to a physician for complicated problems.

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PHYSICIAN ASSISTANT (P.A.)

Training: Becoming licensed as a P.A. typically involves a three-year master’s program with coursework in anatomy, physiology, pharmacology, diagnosis, and ethics, as well as training in areas such as family medicine, internal medicine, emergency medicine, and pediatrics. Many P.A. programs also require some sort of patient-care experience, such as working as an EMT, a phlebotomist, or a registered nurse.

Strengths: They can do many of the same things as M.D.s and D.O.s, such as taking medical histories, doing physical exams, ordering X-rays and other tests, and prescribing medication.

Limitations: P.A.s usually aren’t trained to handle multiple complicated diagnoses or complex procedures on their own. And they can work only under a supervising physician.

CR’s advice: It’s fine to rely on a P.A. for routine matters, such as a urinary tract infection or sprain, Lipman says. You can also go to them for follow-up visits for such conditions as high blood pressure. But avoid relying on them for complicated procedures.

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REGISTERED NURSE (R.N.)

Training: Laws vary by state, but R.N.s generally have a Bachelor of Science degree in nursing, an associate’s degree in nursing, or a diploma from an approved nursing program.

Strengths: R.N.s are vital members of a medical team, taking medical histories, assessing symptoms, and supporting patients. They tend to focus more on patient education, “for example, counseling someone with high blood pressure on how to take their blood pressure at home,” Hingle says. That’s because their training “tends to be a lot more relationship-focused than what doctors get in medical school.”

Limitations: R.N.s can’t practice independently or write prescriptions, and they must work under the supervision of an M.D. or a D.O.

CR’s advice: You shouldn’t rely on one as a primary care provider. But R.N.s are a great resource at your doctor’s office if you need diet or lifestyle counseling, or instructions on day-to-day treatment of a disease (such as monitoring blood sugar levels).

Editor's Note: This article also appeared in the March 2018 issue of Consumer Reports magazine.

What Trump's Proposed Medicaid Cuts Could Mean For You

They could force states to limit benefits and cap the number of people enrolled

Consumers Union / Consumer Reports /  Donna Rosato / May 23, 2017

President Donald Trump’s 2018 budget blueprint calls for huge reductions to social safety net programs. In particular, it targets Medicaid, the program that provides health insurance for millions of poor, disabled, and elderly people, about 1 in 5 Americans. 

Republican plans to repeal and replace the Affordable Care Act already has proposed hitting people on Medicaid hard. The Affordable Health Care Act (AHCA) legislation, which the House passed earlier this month, called for $880 billion in cuts to the program. Trump’s budget calls for cutting another $615 billion from Medicaid. Together, the $1.5 trillion in cuts would slash federal Medicaid funds by nearly 50 percent in 10 years.

“This cuts quite a bit more in federal funding than the AHCA alone,” says John Holahan, a fellow in the Health Policy Center at the Urban Institute, a non-partisan research organization. “States are going to have to figure out how to make up the difference."

The budget proposal must be approved by Congress and much could change in the meantime. The Senate is working on a healthcare overhaul of its own. Democrats are opposed to steep Medicaid cuts, as are some moderate Senate Republicans, particularly those in states that expanded Medicaid. 

Still, the prospect of such a massive change to the government's largest health insurance program is troubling to consumer advocates.

“The proposed cuts to Medicaid would decimate the program, dramatically reducing the number of people covered and the quality of coverage for the most vulnerable Americans,” says Betsy Imholz, director of special projects for Consumers Union, the policy and mobilization arm of Consumer Reports.

The budget proposal comes at a time when Americans are increasingly concerned about their ability to afford health insurance.

More than half (57 percent) of those surveyed for Consumer Reports second CR Consumer Voices Survey in March said they lack confidence they and their loved ones will be able to afford health insurance.

And 41 percent now say they're not confident they'll have access to quality care to get the doctors, tests, treatments and medications they need. That’s up from 35 percent in the first CR Consumer Voices Survey in January.

How Medicaid Could Change

Here are five things you need to know about how the possible Medicaid cuts proposed by Trump and House Republican leadership would affect you.


1. The proposed cuts in the Trump budget and AHCA wouldn't take place until 2020.

2. How you are affected will depend on where you live. That's because under the current system, the federal government gives states money based on costs no matter how many are enrolled. The Trump budget blueprint reduces the amount given to states but lets each choose how they receive the money. States could opt to receive a limited and capped amount per person enrolled, or take a “block grant” and decide how to spend it. Trump and other Republicans say block grants give states more flexibility to design their own programs. But experts say it will be difficult for states to make up the shortfall from lost federal funds.

3. If enrolled in Medicaid, you might face stricter work requirements and have to cover more costs, such as higher co-pays, out of pocket. That's because the Department of Health and Human Services is encouraging states to experiment with ways to curtail costs. Under current law, several states, including Maine and Wisconsin, have already applied for waivers to make such changes, says Robin Rudowitz, an associate director for the Program on Medicaid and the Uninsured at the Kaiser Family Foundation.

It's unclear how much money such changes would save, says Rudowitz. For example, only 15 percent of Medicaid dollars are currently spent on able-bodied adults who might be subject to new work requirements, according to an analysis by the Kaiser Family Foundation and the Urban Institute.

4. The disabled and the elderly will be hit the hardest. The disabled account for 42 percent of Medicaid spending, while the elderly account for 21 percent, to pay for services such as long-term care and nursing homes. Another 21 percent of Medicaid spending provides health insurance for children.

5. It's still unknown how many Medicaid recipients might lose coverage in the end. The Congressional Budget Office's initial analysis of the AHCA passed by the House, estimated that 14 million people would drop out of the program if the bill became law. The CBO plans to issue a new analysis Wednesday meant to reflect amendments to the initial AHCA legislation. But that analysis won't take into account the proposed cuts in the Trump budget.

As a result, it's unknown how many people might lose coverage overall, says Dee Mahan, director of Medicaid Initiatives at Families USA, a non-profit focused on consumer healthcare issues. "But this is a massive cost shift from the federal government to states. States won't be able to make up all this money," says Mahan. "A lot of people will lose their coverage."

Consumers deserve full transparency about the performance of the hospitals they choose

Consumer Reports / By Catherine Roberts / April 06, 2017
www.consumerreports.org

More than 1,000 U.S. hospitals perform heart surgery, and about half voluntarily share their complication and mortality rates with Consumer Reports.  

That’s a good start, and up 16 percent from 2014, when we first published heart hospital ratings. But it also means that many hospitals still don’t make heart surgery success rates readily available to patients.

That’s a problem, says David Shahian, M.D., who oversees data and quality measures at the Society of Thoracic Surgeons (STS), the organization that gathers the numbers from hospitals and shares them with Consumer Reports.

Public reporting not only provides vital information to patients about where to get heart surgery but also encourages hospitals to improve, “by comparing them to their peers and showing them where they are falling short,” he says. “We believe transparency and sharing your outcomes is a professional ethical responsibility.”

We contacted these 23 hospitals that perform a large number of heart surgeries but don’t publically report through STS or Consumer Reports to ask why not—and if they would share results with us, and with patients.

• Arkansas Heart Hospital, Little Rock, AR
• Baptist Memorial Hospital, Memphis, TN
• Christiana Care Health System, Newark, DE
• Dartmouth-Hitchcock Medical Center, Lebanon, NH *
• Florida Hospital, Orlando, FL*
• Forrest General Hospital, Hattiesburg, MS
• Hackensack University Medical Center, Hackensack, NJ*
• Hospital of the University of Pennsylvania, Philadelphia, PA*
• Houston Methodist Hospital, Houston, TX
• Kansas Heart Hospital, Wichita, KS
• Leesburg Regional Medical Center, Leesburg, FL
• Mayo Clinic Hospital, Rochester, MN*
• Methodist Hospital, San Antonio, TX
• Mount Sinai Medical Center, Miami Beach, FL
• New Hanover Regional Medical Center, Wilmington, NC
• Northeast Georgia Medical Center, Gainesville, GA*
• NorthShore University Health System, Evanston, IL
• OhioHealth Riverside Methodist Hospital, Columbus, OH
• Penn Presbyterian Medical Center, Philadelphia, PA*
• Saint Francis Hospital and Medical Center, Hartford, CT
• St. Vincent's Medical Center Riverside, Jacksonville, FL
• The University of Vermont Health Network University of Vermont Medical Center, Burlington, VT
• University of Maryland Medical Center, Baltimore, MD*

* This hospital does not currently make its data publicly available but has committed to doing so in the next update.

More on Heart Health

• Take Charge of Your Heart Health
• Understanding the Stages of Heart Disease
• The Healing Power of a Heart-Healthy Diet
• How Heart Attacks in Women and Men Are Different
• Slowing Down the Rush to Open Heart Surgery
• Top Hospitals for Congenital Heart Disease
• Who Really Needs Cholesterol and Blood Pressure Drugs
• Blood Pressure Monitor Buying Guide  

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What Hospitals Say About Heart Surgery Success Rates

Some hospitals, such as the Mayo Clinic in Rochester, Minn., said they missed the deadline. One, Kansas Heart Hospital in Wichita, told us that it doesn’t report due to the costs of belonging to the STS database, which usually come to several thousand dollars per year.

Note that some hospitals, including prominent hospitals such as  Cedars-Sinai Medical Center in Los Angeles and New York-Presbyterian Hospital in New York City, do provide heart surgery success rates to STS, and make it available on the STS website, but don't consent to publish that information through Consumer Reports.

Providing patients with that information should be a priority for any facility, especially those with national standing, says Doris Peter, Ph.D., director of Consumer Reports’ Health Ratings Center. “Hospitals that do these procedures likely profit nicely from them, and I would expect them to invest some of that into improving quality and sharing data with the public.”

How to Get the Data You Need

Shahian says that if the hospital you’re considering doesn’t share its data with Consumer Reports or STS, try to get that information on your own.

But calling the hospital directly isn’t the best bet: When we tried that at several hospitals, the staff wasn’t able to connect us with the right person to answer our questions.

Instead, Shahian recommends asking your surgeon these questions:

• Does the hospital where you perform surgery participate in the Society of Thoracic Surgeons database?
• If so, how does it perform in the STS ratings, and would you be willing to go over their most recent report with me?

If the surgeon won’t have that discussion or says the hospital doesn’t collect the data, Shahian says to consider another doctor and medical center.

FDA Finally Says 'No' to Antibacterial Soaps

Consumer Reports / Lauren Cooper / September 02, 2016

Here's why—and the products to watch out for

The Food and Drug Administration is banning the sale of antibacterial soaps and body washes after manufacturers failed to prove that the products’ active ingredients are safe and effective.

“Consumers may think antibacterial washes are more effective at preventing the spread of germs, but we have no scientific evidence that they are any better than plain soap and water,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “In fact, some data suggests that antibacterial ingredients may do more harm than good over the long term.”

The ban applies to products containing 19 antibacterial ingredients, including the two most common ones: triclosan, which is found in liquid soaps, and triclocarban, found in bar soaps. Manufacturers have until Sept. 6, 2017 to either reformulate products with any of those 19 ingredients or remove them from the market.  

The ban does not apply to other products containing those ingredients, including toothpastes and cleaning products. And it doesn't apply to antiseptic hand cleaners such as Germ-X and Purell, which typically contain alcohol and related compounds and don't pose the same risks.

The Dangers

Consumer Reports has long argued that antibacterial chemicals in household products likely do more harm than good.

“These chemicals could be contributing to the global crisis of antibiotic resistance," said Michael Hansen, Ph.D, senior staff scientist at Consumer Reports.

Triclosan, for example, kills bacteria in much the same way as an antibiotic, and research suggests that the widespread use of it might be contributing to the spread of antibiotic-resistant bacteria.

“Some bacteria are close to evolving resistance to all antibiotics as a result of the overuse of antibiotics—a dangerous situation that could lead to deaths from once easily treated infections,” Hansen said. "These products and these ingredients may just make the problem worse."

Antibacterial compounds in consumer cleaning products might pose other health risks, too.

“There is evidence that exposure to triclosan interferes with the production and activity of hormones in the body, which could contribute to infertility, early puberty, obesity, and other problems,” said Marvin M. Lipman, M.D., Consumer Reports chief medical advisor.

“And with little evidence that they are more effective than soap and water, they are not worth the risk,” Lipman said. “When it comes to fighting disease, hand washing is key, but using regular soap and water does the job," he said.

When soap and water are not available, an alcohol-based hand sanitizer such as Germ-X and Purell is OK. (Click on www.consumerreports.org/health/fda-says-no-antibacterial-soap to watch the video on the most effective hand washing technique.) 

Products to Avoid

Manufacturers have a full year to reformulate or remove their antibacterial soaps, and they can continue to sell antibacterial toothpastes and cleaners. But Consumer Reports health and safety experts say you should avoid them, starting now.

We found triclosan listed as an ingredient in Noxzema Ultimate Clear Bacteria Fighting Cleanser, Dial Complete Antibacterial Foaming Hand Wash, and CVS Antibacterial Gentle Cleansing bar, as well as in Colgate Total toothpaste. And we found triclocarban listed on Dial For Men Power Scrub soap bar, Rite Aid Renewal Antibacterial Gold deodorant soap, and others.

Those and other banned antibacterial ingredients are also included in many household cleaners. So avoid products that have an "antibacterial" claim on their label, or that contain any of these newly banned chemicals:

• Cloflucarban
• Fluorosalan
• Hexachlorophene
• Hexylresorcinol
• Iodine complex (ammonium ether sulfate and polyoxyethylene sorbitan monolaurate)
• Iodine complex (phosphate ester of alkylaryloxy polyethylene glycol)
• Nonylphenoxypoly (ethyleneoxy) ethanoliodine
• Poloxamer-iodine complex
• Povidone-iodine 5 to 10 percent
• Undecoylium chloride iodine complex
• Methylbenzethonium chloride
• Phenol (greater than 1.5 percent)
• Phenol (less than 1.5 percent)
• Secondary amyltricresols
• Sodium oxychlorosene
• Tribromsalan
• Triclocarban
• Triclosan
• Triple dye

Is there a cure for high drug prices?

Anyone who takes medication realizes how much the cost has risen. 
Bernie Sanders gave CR's article "A Must Read" designation on his website.

Consumer Reports / updated July 29, 2016

The cost of prescription drugs for tens of millions of Americans rose $2 billion last year, and all signs point to a continued rise. At stake is nothing less than the ability of Americans to afford the medicines they need. Can we stop the madness?

Last August, Martin Shkreli, then the CEO of Turing Pharmaceuticals, did something considered so reprehensible that he was dubbed “the most hated man in America.” What caused the outrage? He increased the price of a little-known but important drug called Daraprim from $13.50 to $750 per pill. Daraprim is the best treatment for toxoplasmosis, an infection to which those with HIV/AIDs or cancer are susceptible.

The story went viral, and calls came from around the country, including from U.S. Rep. Elijah Cummings, D-Md., to stop drug entrepreneurs from gouging consumers for pure profit. Overnight, Shkreli became the poster child of pharmaceutical greed. And yet raising the price of a drug by that much is 100 percent legal.

What makes the case of Daraprim so important is that it brought a serious—and growing—healthcare problem out into the open: America spends a tremendous amount of money for prescription drugs—$424 billion last year alone before discounts, according to a new report by IMS Institute for Healthcare Informatics, a firm that tracks the pharmaceutical industry. And that number is rising fast with no sign of slowing down. What’s more, there are few regulations that shield consumers from the Martin Shkrelis of the world, or from drug companies that decide to raise prices to astronomical levels.

The Rampant Rise of Drug Prices

The practice of raising drug prices on new—and old—medications is common and widespread. From a nationally representative telephone poll conducted by Consumer Reports Best Buy Drugs in March, we learned that three in 10 Americans (about 32 million people) were hit with price hikes within the previous 12 months, costing them an average of $63 more for a drug they routinely take—and a few paid $500 or more. We also found price increases on everything from longtime generics used to treat common conditions such as diabetes, high blood pressure, and high cholesterol to new treatments for diseases such as hepatitis C. Our poll shows that when people were hit with higher drug costs, they were more likely to take unhealthy measures such as skipping doctor appointments, tests, or procedures, or not filling their prescriptions or taking them as directed.T

Take the case of Marlene Condon, a nature writer living in Crozet, Va. Two years ago she paid about $32 for 180 tablets of hydroxychloroquine (a generic available for almost two decades) to treat her rheumatoid arthritis. When the drug’s price more than doubled to $75, Condon says she was annoyed but paid the bill anyway. Then, last September, the price of her drug skyrocketed, costing her $500 out of pocket. Condon panicked and did what thousands of Americans do under those circumstances: She stopped taking the drug. Her arthritis pain grew much worse. Walking and doing simple household chores such as washing the dishes became almost impossible.

The Forces of Profit

Our analysis suggests that high prices for generic and brand-name drugs stem in part from a battle over profit between mammoth industries—big pharma and insurance companies—with consumers caught in the middle. On the one hand, pharmaceutical companies blame insurance companies for passing along high costs to consumers. And insurance companies point to very high-priced drugs for which there are few or no alternatives, which ultimately affects how much insurance coverage people receive and how much they must pay out of their pockets.

“Even as more patients have health insurance coverage, many more are facing high pharmacy deductibles and rising out-of-pocket costs, and other barriers to care, putting their ability to stay on needed therapy at risk,” says Holly Campbell, a representative at PhRMA, an industry association that represents pharmaceutical manufacturers.

“If there’s one treatment and there’s no alternative and no competition, then that’s where the challenge is,” says Matt Eyles, executive vice president of policy and regulatory affairs at America’s Health Insurance Plans (AHIP), a national trade organization for the insurance industry.

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• Reason 1: Drug Companies Can Charge Whatever Price They Want
• Reason 2: Insurance Companies Are Also Charging You More
Reason 3: Old Drugs Are Reformulated as Costly ‘New’ Drugs
• Reason 4: Generic Drug Shortages Can Trigger Massive Price Increases
• Reason 5: Specialty Drugs Are Costing All of Us

What the Government Can Do

Consumers are looking to the government to take action to control drug prices. In our CR Best Buy Drugs poll, 77 percent of people taking a medication said the government should allow more generics onto the market sooner; 74 percent want the government to pressure drug companies to charge less. Seventy-nine percent say insurers should pressure pharmaceutical companies to lower drug prices; 81 percent said consumers should do the same.

More specific steps that could help control costs include asking the government to:

• Set a limit on out-of-pocket costs. That would ensure that consumers have some protection against very high costs or sudden large spikes in prices. For example, last year California enacted a law so that a consumer won’t pay more than $250 for a single prescription drug per month, or $500 for certain high-deductible plans.
• Approve more generic versions of common drugs. Currently, 4,300 generic drug applications await an FDA decision. The agency says it’s working to review new applications within 15 months.
• Allow limited importation of drugs from legitimate Canadian and European sources, which currently is illegal under U.S. law. The ability to import drugs from countries that have a regulatory system similar to that of the U.S. could alleviate shortages or moderate prices.
• Use government’s existing “march-in” rights. It works like this: If there is a problem with the public’s access to a drug (a supply shortage or an exorbitant price), and if a drug was developed using taxpayer money, the Department of Health and Human Services has the right to force the company to allow another manufacturer to make generic versions that are cheaper for the consumer.

What Drug Companies Can Do

The most obvious help pharmaceutical makers can provide is to charge less—or at least slow the pace of price increases. There is a precedent: Rising drug prices in the 1990s led to public outcry and congressional hearings. And fearing price controls, nine drug companies, led by Merck, made a pledge to keep price increases at or below increases in inflation.

“Pharma has a right to make a profit,” says Riley of the ACP, but it also has a “moral obligation” to be transparent about its pricing because it benefits greatly from government-funded research. “The American taxpayer has been providing the venture capital to fund their products,” he says. “The public deserves to realize a return on that investment in the form of medications they can afford.” But pharmaceutical industry representatives think the focus on price alone is misguided and threatens “to squander our opportunity to usher in the next wave of medical progress,” says Campbell at PhRMA. States are starting to fight back. This past June, Vermont passed the first legislation in the U.S. that requires drug companies to justify high costs and price increases, and to calculate the financial effect on insurance premiums with a select set of drugs. California is currently considering a similar bill.

What Consumers Can Do

Although much of drug pricing is out of consumers’ hands, consider these tips to find the best deals at the pharmacy:

• Talk to your doctor about the cost of the drug she is prescribing. For less expensive alternatives,ask about generics, which can cost up to 90 percent less. Your doctor might consider “therapeutic substitution”—a different drug that works as well. If your insurance drops or reduces coverage of a drug, your doctor can also help by appealing to your insurance company for an exception to cover the drug anyway. The administrative process for filing the exception is different with each insurance company and can take a few weeks before a decision is made.
• Shop around and negotiate. Consumer Reports’ secret shoppers have found that retail drug prices can vary widely, even within the same ZIP code. Our shoppers also found that asking, “Is this your lowest price?” could get you further discounts.
• Check online. If you pay out of pocket, check GoodRx to learn a drug’s “fair price.” You can also fill a prescription with a low-cost online pharmacy based in the U.S., such as HealthWarehouse.com. Be careful of fraudulent websites: Use only an online retailer that operates within the U.S. and displays the VIPPS symbol to show that it’s a Verified Internet Pharmacy Practice Site.
• Choose a plan that covers the medications you need. Compare plans during your open-enrollment period because coverage may change from year to year. Keep in mind that high-deductible plans have lower premiums but require you to pay a larger chunk of your drug costs.

Consumer Reports Is Working to Lower Drug Costs

You are outraged by rising drug costs, and we’ve listened. Because we do not accept money from the pharmaceutical industry, we can call it like it is. If a drug is too risky or a poor value, we are not afraid to say so. We want your voice to be heard by industry and government. We are advocating for a range of evidence-based solutions for lowering consumers’ out-of-pocket costs, ensuring access to essential medicines, and getting better value for our country’s prescription-drug spending—without sacrificing safety or effectiveness. See ConsumerReports.org/drugprices for more.

Editor's Note: This article also appeared in the August 2016 issue of Consumer Reports magazine.

Funding for the preparation of this article was provided in part by the Atlantic Philanthropies and by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumerfraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

*Clarification, July 29, 2016: An earlier version of this article indicated that Woodard’s injection lasts about a week. He gives himself a daily injection from a pen that lasts about a week.

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