2011 Flexible Spending Account Changes

In CategoryHealth News

Changes to FSA Plans (for 2011)

OTC’s requires Prescription : If you use your FSA to pay for over the counter medications (any cold medicine, allergies, motion sickness) then you are in for some significant changes beginning January 1, 2011. Your over the counter (OTC) drugs now require a prescription to be reimbursed from your FSA.  There are a few exceptions to this (like insulin, contact lens solution) which are listed below.

Know your documentation :  According to the IRS, you should be able to provide proof of purchase and proof of prescription. For example you can provide either

  1. A customer receipt issued by Lehan Drugs that reflects the date of sale and the amount of the charge, along with a copy of the prescription OR
  2. A customer receipt that identifies the name of the purchaser (or the name of the person for whom the prescription applies), the date and amount of the purchase and an Rx number

What about grace periods? Some companies provide a grace period to use up all the money, so if your grace period extends into 2011, you would have to follow the new rule for whatever you are buying after Jan 1, 2011. Even if the money comes from 2010 fund. For example, if your company provides a 2 ½ month grace period to use your 2010 fund, the cost of over-the-counter medicines and drugs purchased without a prescription during the first 2 ½ months of 2011 will not be eligible to be reimbursed by a health FSA.

List of eligible medications that do not require a prescription

This change impacts only medication. This means any medical equipment and other medical supplies that are covered by your plan will not require any extra documentation. Here is a sample of stuff that doesn’t require any prescription.

Adult incontinence products (e.g.Depends) Health monitors (e.g. blood pressure, cholesterol, HIV, thermometers)
Birth control products (e.g. prophylactics) Hearing aid batteries
Contact lens solution Heat wraps (e.g. ThermaCare)
Denture adhesives Heating pads, hot water bottles
Diabetic supplies (including insulin) Medicine dropper/spoon
Ear supplies (e.g. ear plugs) Motion sickness devices
First aid supplies (e.g. band-aids) Supports/braces (e.g. ankle, knee, wrist, therapeutic glove)

List of eligible medications that require prescription

Unfortunately a lot of medications, over the counter medications, now require a prescription. Some examples include –

Acne medications Lactose intolerance pills
Allergy and sinus medications (e.g. Benadryl, Claritin, Sudafed) Pain relievers (e.g. aspirin, Excedrin, Tylenol, Advil, Motrin)
Anti-fungal medications (e.g. Lotramin AF) Motion sickness pills
Anti-itch medications (e.g. Caladryl, Cortizone) Nasal sprays for congestion (e.g. Afrin)
Cold sore medications Pre-natal vitamins
Cough, cold & flu remedies Sleeping aids
Decongestants Suppositories
Diaper rash ointments Toothache relievers (e.g. Orajel)
First aid creams Wart remover medications
Gastrointestinal aids (antacid) Yeast infection creams (e.g. Monistat)

List of eligible medications that will require a prescription and a letter of necessity

There is no change in this category. Some medications always required an extra letter of necessity from the doctor, like the following.

Calcium supplements Hormone therapy
Fiber supplements Joint supplements
Foot insoles Nasal strips & snore relief
Herbal medicines Vaporizers/humidifiers
Homeopathic remedies Vitamins/minerals/supplements


Now you have to get a prescription too.

What can you do to prepare and use your money wisely

All the changes are going into effect only on Jan 1, 2011. So there is plenty of time to prepare and plan.

Stock up now : You can still buy OTC medications without a prescription until Dec 2010. So stop by Lehan Drugs and stock up on things you might need before the changes take place on 1/1/2011!

*Compression socks/stockings will not require a prescription going forward but a letter of medical necessity will be needed to purchase compression products with FSA funds! 

Set aside the correct amount : When planning how much money to set aside for your 2011 health spending, you should take the new changes into account. If you don’t spend the entire amount because you didn’t get a prescription for over-the-counter medicine you figured into your reimbursements, then you’ll most likely lose the money left at the end of the plan year, or pay a penalty depending on the type of account.

If you have any questions, don’t hesitate to ask a Lehan Drugs pharmacist!

Compression Running Socks – Hype or Reality?

In CategoryHealth News, Product Info

When it comes to running, cycling or training for a triathlon, whether you are a weekend warrior or a serious competitor, it seems we are all looking for an edge to help us train harder and recover more quickly.  It may be the latest shoe design, recovery drink or training program, but there is always something new to try to gain that edge.

In the past couple of years more and more runners, triathletes and cyclists have been turning to compression socks to help their performances and recovery times.  But people want to know, do compression socks actually work or are they just the latest fad?   To answer that question, let’s first take a look at the basic effect that compression has on the circulatory system. 

1. Artery musculature:  The arteries in your body have muscular walls.  The musculature of these arterial walls reacts to changes in pressure.

2. Ambient pressure and expansion of the arterial diameter: The special compression profile of compression sport socks increases the ambient pressure on the arterial walls (in effect helping to equalize the pressure inside and outside the artery walls).  As a result, the musculature in the arterial wall relaxes and the relaxed musculature increases the arterial diameter and consequently the blood flow through the arteries.

* Artery without compression                            * Artery with compression *

This increased blood flow seems to have various positive effects on athletes.  A study from 2007 found an 85% decrease in the number of athletes suffering from delayed onset muscle soreness (DOMS)post-recovery when wearing compression socks.  In theory the increased blood flow and graduated compression helps to remove lactic acid from muscles in the lower legs more quickly and consequently reduces soreness in athletes to help them recover more quickly.

Another study published in the Journal of Strength and Conditioning in 2009 by Dr. Wolfgang Kemmler of the Institute of Medical Physics, University of Erlangen-Nuremberg,Germany concluded that runners using CEP compression sport socks had 5% faster running times while using 6% less energy2.

These studies show that both recovery and performance may be increased by using athletic compression socks during and after workouts.  It should be noted, though, that the benefits of compression socks are pre-conditioned on wearing a correctly fitted sock.  If a sock that is worn is too tight or worn incorrectly, the sock can actually have the opposite of the desired effect and decrease blood flow to the muscles.  It is extremely important to see a certified fitter to be measured for socks to ensure a proper fit!

Other benefits of athletic compression socks include:

1) Muscle support – the pressure exerted by the socks decreases vibration trauma to muscles due to the pounding of running. 

2) Shin splint relief – the pressure from compression socks supports the shin muscles and reduces the severity of muscle tearing away from the shin that results in shin splints

3) Achilles heal support – CEP athletic socks have special support for the achilles heal helping to reduce soreness

At the end of the day, although the science of athletic compression socks is relatively new, it appears that they may have an impact on athletic training both in increased performance and decreased recovery times.  If you have any questions about compression athletic socks or compression in general, stop in, give us a call or e-mail us at info@lehandrugs.com!

1Ali, A., M.P. Caine, B.G. Snow. 2007. Graduated Compression Stockings: Physiological and Perceptual Responses During and After Exercise. J Sports Sci 25(4): 413-419.

2Kemmler, Wolfgang; Stengel, Simon von; Köckritz, Christina; Mayhew, Jerry; Wassermann, Alfred; Zapf, Jürgen Effect of Compression Stockings on Running Performance in Men Runners. Journal of Strength & Conditioning Research. 23(1):101-105, January 2009.



Vitamin D and Sunscreen

In CategoryHealth News, Pharmacy

Swimming pools, barbeques, baseball games, golf… summer is in full swing and for many of us that means spending more time outside in the sun.  At this point, most of us are aware of the benefits of using sunscreen. In addition to preventing painful sunburns, sunscreen also appears to decrease the risk of certain skin cancers and helps prevent sun-related aging.  Unbeknownst to many sunscreen users is that these products also prevent the body from making adequate amounts of the hormone vitamin D.

Vitamin D is a fat soluble vitamin that is found in a variety of plant and animal food sources, as well as vitamin supplements and fortified dairy products.  The fact is, the body most efficiently creates the majority of its vitamin D requirements through exposure to ultraviolet rays (sunlight).  Cholesterol in the skin is exposed to UV light, and it is transformed through a metabolic pathway to the hormone, vitamin D.  A mountain of research has shown the importance of vitamin D in supporting a variety of healthy processes in the body. These include maintaining healthy bones, optimizing brain function, supporting healthy pregnancies, and more.

Our modern lifestyles have moved us indoors and stressed the use of sunscreen, removing us from the most natural source of vitamin D. The resulting epidemic of low levels of vitamin D has been associated with increased risks of cancer, mental illness, and poor bone health, among other things.  One set of epidemiologists estimated that maintaining healthy vitamin D levels in Europeans would save their health care system billions at the rate of $1346 per person every year!1

Vitamin D may also aid in cancer prevention. One study found healthy vitamin D levels reduced the risk of developing breast cancer.  Women who were exposed to the highest vitamin D levels were 50% less likely to develop breast cancer compared to those in the study who were not receiving adequate vitamin D.2  It also appeared that women who had high vitamin D exposure during the adolescent years were 25-45% less likely to develop breast cancer.3

With this in mind, it is extremely important to ensure that you are receiving enough vitamin D, especially if you are not exposed to sunlight on a regular basis.  According to the Vitamin D Council, if adults and adolescents are not exposed to sunlight regularly, research indicates supplementation with 2-5,000 units (IU) of vitamin D daily. 4  To obtain this amount, one would need to consume at least 20 glasses of milk per day or take 10 standard multivitamin tablets.

The skin is capable of producing approximately 10,000 IU of vitamin D in response to 20–30 minutes of full summer sun exposure (no sunscreen) — 50 times more than the US government’s recommendation of 200 IU per day!  Why the big difference?  It turns out the recommended daily allowance is what is required to prevent a disease called rickets (softening of the bones), not what is required to keep other body processes functioning properly.

Come in for a consultation with one of our pharmacists to determine if you are at risk for vitamin D deficiency.  We can help you increase your intake of vitamin D through quality, bioidentical vitamin D supplements to ensure that you are getting all that you need for optimal health. 

For more extensive information on Vitamin D, visit http://www.vitamindcouncil.org/

Yours in Health,

Jon Lehan, PharmD

 1. William B Grant, William B. Grant, Heide S. Cross, Cedric F. Garland, Edward D. Gorham, Johan Moan, Meinrad Peterlik, Alina C. Porojnicu, Jorg Reichrathe, Armin Zittermann, Estimated benefit of increased vitamin D status in reducing the economic burden of disease in western Europe, Progress in Biophysics and Molecular Biology, March 4 (2009) 1–10.

2. Garland CF, et al. The role of vitamin D in cancer prevention. American Journal of Public Health 2006;96:252-258.

3. Knight JA, et al.  Potential reduction in breast cancer risk associated with vitamin D.  Proceedings for the American Association for Cancer Research, Volume 47: 2006.  Abstract #4009.

4. http://www.vitamindcouncil.org/treatment.shtml

There have been recent recommendations by the Environmental Working Group on sunscreens.  To read the full report and help select a sunscreen, visit http://www.ewg.org/2010sunscreen/full-report/

March is DVT Awareness Month!

In CategoryHealth News

DVT, or Deep Vein Thrombosis, affects an estimated 350,000 – 600,000 Americans each year.  DVT is a condition where a blood clot forms within the deep veins of the leg.  These clots can block the flow of blood, which in turn can cause pain, swelling, and discoloration of the legs.  In more serious cases, DVT can cause a pulmonary embolism, in which the clot breaks loose and travels to the lungs where it can cause damage from lack of oxygen to the lungs and other organs.

You may be at risk for DVT if any of the following factors apply:

  • Major surgery
  • Recent trauma (fall, broken bone)
  • Family history of blood clots
  • Sit or stand for long periods of time
  • Overweight or obese
  • Pregnancy
  • Varicose veins
  • Oral contraceptives
  • Confined to a bed

To help prevent DVT, especially if you are at increased risk:

  • Stretch your legs and move them as often as possible
  • Drink plenty of fluids
  • Wear gradient compression socks or stockings
  • Maintain a healthy weight
  • Wear comfortable clothing and shoes
  • See your doctor with questions or concerns


For more information on the benefits of compression stockings and the variety of styles and colors, check out our website at http://www.lehandrugs.com/home_medical/compression_stockings.html

Medications and Nutrient Depletion Part II

In CategoryHealth News, Pharmacy

As promised, here are some very commonly prescribed drugs, and a little about how they can affect a patient’s nutritional status and overall health.   

Acid reducing medicines (Omeprazole, Prevacid, Zantac, Nexium, etc.)

 It seems to me that acid-reducing medications are prescribed more and more often, for a variety of conditions.  They are certainly one of the most commonly prescribed medicines we dispense.  I’m sure you don’t go a day or two without being exposed to an advertisement for Prilosec or Prevacid.  These medicines can relieve discomfort, cure ulcers, and protect the stomach from other medications.

These medicines also affect the absorption of certain vitamins and minerals.  The digestive system has been calibrated over the centuries to efficiently absorb nutrients from food, processes which may be dependent on the pH, or acidity in the gut.  There are several essential vitamins and minerals that might be affected.  

These include:

  • Calcium

  • Vitamin D

  • Folic Acid

  • B-12

 Of special note is vitamin D.  A mountain of recent research has shown the importance of vitamin D in supporting a variety of healthy processes in the body.  Low levels are associated with increased risks of cancer, mental illness, and poor bone health, among other things. Vitamin D is obtained in the diet, and through exposure to sunlight.

 In northern areas, such as ours, we don’t have the benefit of sun exposure many months out of the year.  If you’d like to learn more about Vitamin D, check out www.vitamindcouncil.com for more information, or contact a Lehan’s pharmacist.

 Antibiotic therapy (Levaquin, Amoxicillin, etc.)

Antibiotics have revolutionized healthcare, saved countless lives, and battled some of the most deadly diseases known to man.

 They are also quite effective in destroying the microbes in our intestines that we rely on for proper digestion, intestinal health, vaginal health, and even proper functioning of our immune systems.

Supplementing with a high-quality probiotic helps maintain the correct intestinal flora and can prevent antibiotic side effects.  Ask one of our pharmacists how to tell the difference between higher and lesser quality products to ensure you are getting optimal benefit.

Cholesterol-lowering drugs (“Statins” i.e. Lipitor, Crestor, Simvastatin, Lovastatin, etc.)

Statins, or HMG Co-A reductase inhibitors, lower cholesterol.  There is evidence they can improve cardiovascular health and reduce major health events.

 They also deplete Coenzyme Q10.  CoQ10 is a substance vital for normal functioning of the mitochondria, or the “engines,” in every cell of our body.  Healthy levels of coenzyme Q10 are critical in supporting the normal functioning of those energy pathways.  One patent application by a major drug manufacturer for their product references this depletion, and even goes so far to recommend replacement for all patients!

There are other benefits from taking taking CoQ10.  A review of clinical trials in 2007 also showed CoQ10 may help lower blood pressure..

 Note: Coenzyme Q10 is not well absorbed when taken orally.  Certain formulations can provide more efficient absorption.  Ask one of our pharmacists for recommendations.

 Beta blockers (atenolol, metoprolol, propranolol, etc.)

 These medicines help control blood pressure, heart rate, and can improve survival in certain chronic heart conditions.

 They also reduce levels of coenzyme Q10, and they deplete melatonin, a hormone vital in the normal functioning of our sleep-wake cycle.

 We’ve provided you a very short list, and many other medications may cause nutritional deficiencies.  Sometimes nutritional supplementation with vitamins or minerals is an effective means to help combat drug-induced deficiencies.  Don’t hesitate to contact a Lehan’s pharmacist for more information, or for other recommendations to help you maintain optimal health and nutrition.

Medications and Nutritional Deficiencies

In CategoryHealth News, Pharmacy

Until recently, I’d never really been into “vitamins.” I eat a fairly well rounded diet. OK, I eat a lot of food, and I’m well rounded. I’ve been fortunate to have good health and even better genes. So, like many healthcare professionals, to some extent I probably take for granted the nutritional status of my patients.

I attended a conference a few weeks ago on nutritional and hormone balance in healthy aging, however, and my eyes were really opened to the importance of nutrition in all aspects of health. Often times we as health care professionals give lip service to a healthy diet, or a multivitamin, but don’t spend the time emphasizing specific nutritional changes or needs that can ensure optimal health in our patients.

In all truthfulness, I didn’t learn a lot about nutrition in pharmacy school. I did, however, learn a lot of biochemistry and pharmacology. It turns out that understanding those disciplines is key in understanding the importance of nutrition.

In pharmacy school ,we were forced to memorize mountains of equations and biochemical pathways. To be honest, I figured I would never use that information again. It turns out, understanding those pathways is crucial in understanding nutrition’s role in health. So as I’ve dredged my memory remembering things like the “Kreb’s cycle” or “liver enzymes,” I’ve really gained a new appreciation for our bodies’ reliance on proper nutrition.

So, since I’m a pharmacist, the follow-up question might be as follows: do medications affect our overall nutritional health?

Simply put: Yes! Medications can cause deficiencies of nutrients necessary for the normal functioning of the human body.

One estimate suggests that 25% of all adverse reactions to medications are caused by nutrient depletion!

Medications have great potential to improve our health, cure diseases, and improve our quality of life. However, medicines are rarely “magic bullets.” My high school social studies teacher, Mr. Nakonechny once said “You can figure out how to dig a perfectly square hole, but you still have to find someplace to hide the dirt.” In my next post, we’re going to examine the dirt: several commonly prescribed medications and nutritional depletions they may cause.

If you just can’t wait, feel free to contact us for more information about the importance of recognizing drug-induced nutritional deficiencies and how they can be corrected to achieve wellness.  You can e-mail me at jon@lehandrugs.com or give us a call at 815-758-0911 or 815-217-3890 for more information!