Heat spells trouble for mail-order medications

Mail-order pharmacies run well-coordinated supply chain operations to ensure medications are safely delivered to patients' doorsteps, but extreme temperatures are complicating the process, The New York Times reported Aug. 13.

Pharmacists and physicians told the Times that high temperatures inside delivery trucks could cause certain medications such as insulin or epinephrine injectors to overheat, degrade and become less effective.

Delivery drivers have reported temperatures as high as 150 degrees Farenheit inside their trucks, which far exceeds national drug handling standards of 68 to 77 degrees. A 2023 study published in the Journal of the American Pharmacists Association also found that simulated medication shipments spent 68.3% of transit time outside acceptable temperature ranges across all shipment methods, carriers and seasons. In addition, FDA regulations do not apply to medications being transported to patients, leaving oversight to state authorities. 

The Times interviewed more than a dozen patients who said they believed their medications were damaged by heat and humidity in transit. In some cases, patients reported serious health issues after taking the drugs, according to the report. 

Mail-order pharmacies said they use special precautions to protect the integrity of temperature-sensitive drugs, including weather-resistant packaging. Bryan Rabakon, senior vice president of supply chain and engineering for OptumRx, told the Times it monitors the duration of shipments and automatically sends a new package if transit times exceed a certain threshold. The company discontinued use of temperature-sensitive tags due to a high rate of false positives, he said. Cigna, which owns Express Scripts, did not respond to the Times' request for comment. 

Read the full article here.

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