Stop Forcing Mail Order Pharmacy as Only Choice of Coverage & Monitor Package Temperature
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**Since starting the petition, I realized there are many issues other than temperatures with FORCED mail-order pharmacy. There are life-threatening delays, lack of face-to-face relationship with pharmacists for people with chronic conditions, and rapid closures of our independent pharmacies although a recent study showed people prefer independent pharmacy (2018, Gill).
Our son, received a life-saving liver transplant at the age of 2. His life depends on the potency and effectiveness of chemotherapy/immune suppression medications to prevent his body's immune system from fighting off his transplanted liver. In the past mail order delivered his liquid oral medications in nothing but a plastic envelope on a 102-degree day on a hot enclosed not temperature controlled UPS truck. Shortly after, he went into liver rejection which could have resulted in complete liver failure or death. I speculated that the medication could have been too weak after the delivery of medications in high heat. I vowed to never again risk his life with mail order pharmacy.
Recently, we were mandated/forced to only use mail order pharmacy in order to receive coverage for his life-saving medications. Hesitant, I begged for an ice pack. The package arrived in only a bag on an about 90-degree day again without an ice pack. The hot non-temperature controlled enclosed delivery truck can reach temperatures up to 170 degrees. His labs elevated again afterward. My son wants to know, "Why would they do that?"
I contacted the manufacturer, who does all of the testings for my son drugs who stated that both of my son's medications should be discarded and considered less potent once stored above 86 degrees as higher temperatures and freezing could result in lower potency. I also found out that liquid medication is the most harmed by the mishandling of medications outside of the manufactures temperature storage guidelines.
I contacted the mail order pharmacy who refused to replace or take back the medication. They said the law & USP Pharmacopoeia allows them to ship up to 104 degrees, although the manufacturer states it is not proven safe at these temperatures. However, I have received communication from USP Pharmacopoeia who writes the guidelines for storage and they also said that the mail order pharmacy should follow the manufacturer's guidelines of 59-86 degrees for storage.
I contacted the FDA, who states that the mail order pharmacy should be using the manufacturer's guidelines that have been proven safe.. However, since the mail order pharmacies are regulated loosely by the State Board of Pharmacy, not the FDA there was nothing that the FDA could do.
Since starting this petition, I connected with another petitioner for air conditioning of the back of UPS trucks as the trucks are not temperature controlled. Her husband went into renal failure because the UPS trucks are hot and enclosed and temperatures reach up to 170 degrees. It's like walking into a low temp oven. When the temperatures of the outside are colder than your freezer, I'm not sure how cold the trucks are but I'm certain mailboxes and doorsteps can get in negative temperatures.
I made over 30 calls to the insurance company begging for them to please let us pick my son's medications up at the local pharmacy at which they are filled. My son's physician wrote a note/appeal as his transplant team has stated that they have tried to voice their concerns about this issue with their pediatric/child patients and no one is listening! The insurance company still denied the doctor's appeal for us to pick up my son's medications in the safest way. It was not until the Media became evolved that the insurance company budged.
I felt helpless and have united with many other pharmacists, physicians, patients, mothers and fathers, and caregivers who feel the same way. Helpless.
Mail order of prescription drugs should be a choice not the only option of coverage. Mandatory mail order programs from all plan types (INCLUDING the plans that are regulated by ERISA) needs to cease until mail order pharmacies are forced to store and monitor medications during their deliveries at the temperatures tested and proven safe by the manufacturer. I would never put my son's medications in a hot non-temperature controlled environment, and shouldn't be forced to only use this option in order to get coverage for his life-saving medications.
Mail order pharmacies may appear to save money, but when my son ended up in the hospital after taking medications that could have been compromised by having lower potency, the cost of the rejection was thousands of dollars. If his liver would have fully failed, the cost of his liver transplant for just 5 days (he was in the hospital for 5 weeks) was over $1,000,000. The lax regulation and oversight may save money on prescription drug plans but may come at an increased cost to the health plan itself. Also, keep in mind the endless waste of medications that automatically are sent regardless of whether or not patients need them.
Also, people with chronic, complex conditions, should always have the option of face to face interaction with a pharmacist who knows their complex needs and medical history. The pharmacist and patient relationship is crucial to the successful outcome of the patient's overall health. Taking this away is harmful to patients and be more costly to our already stressed healthcare system.
Since starting the petition, many have also stated that they experience life-threatening delays in receiving their prescriptions. Medications get lost, stolen, people are going days without medications that their life depends on. Only allowing mail-order pharmacy for coverage is unethical and irresponsible.
Another important fact. Mandatory mail order programs are discriminatory. It is estimated that 40% of our homeless are disabled. How is mandatory mail order fair and working for them as they may not have an address and not even know where they will be from day to day?
It is crucial that All plans should include true fair coverage and reimbursements of our pharmacist.
Please help! We need legislation to protect all patients by ending the mandatory mail order pharmacy coverage in every type of plan offered in the nation. We need your help to make mandatory mail order an option, not a mandate.
If you would like to support my advocacy, I plan on speaking to every regulator and State Board of Pharmacy that I can reach across our nation.
If you are interested in sharing your story or concerns with regulators and State Boards of Pharmacy, please let me know. Remember to include your state!
Facebook Page: Issues with Mail Order Pharmacy @justamomwholovesherson
The greatest way that you can help is by sharing this petition & gathering 2-3 people in your community who are having issues and speak to your legislatures.
YOUR URGENT SUPPORT WILL SAVE LIVES! THANK YOU!! WE APPRECIATE ALL OF THE SUPPORTERS, CAREGIVERS, & PATIENTS.
Reference: Gill, Lisa L. “Consumers Still Prefer Independent Pharmacies, CR's Ratings Show.” Product Reviews and Ratings - Consumer Reports, 7 Dec. 2018, www.consumerreports.org/pharmacies/consumers-still-prefer-independent-pharmacies-consumer-reports-ratings-show/
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