During this week's Missouri Board of Pharmacy Meeting, I raised concerns about temperature issues and delays with mail order pharmacies that patients are forced to use. One Board member mentioned the challenge of the issue being beyond the control of pharmacies, as carriers like USPS, UPS, and FedEx are not regulated by the Boards of Pharmacy.
I disagree as was basically asked how Boards can regulate the couriers when it is "outside of the mail order pharmacies' hands."
I immediately reminded the Board that they have a duty to protect patients. What good is everything the Board of Pharmacy does if at the end of the day, the medications arriving at patients' doorsteps are adulterated to the point they are less effective or harmful?
To address this challenge, I suggested that if independent pharmacies can offer temperature-controlled delivery at a scheduled time, larger corporations should be able to do the same.
Boards can ensure that their regulations define and require proper packaging requirements and safe temperature storage during delivery. Boards can require temperature sensors and ensure patients can easily file a complaint to the Board upon receiving medications that may be unsafe.
Therefore, the Board should enforce its own regulations regarding temperature handling based on the guidelines provided by the United States Pharmacopeia (USP) or drug manufacturers. If guidelines were followed, very few, if any medications would be shipped on 100-degree days in only bags in a nontemperature-controlled truck. It is crucial to require proper packaging or temperature-controlled delivery for medications. Additionally, the use of temperature sensors should be mandated to alert patients when a medication is no longer safe to use.
The fact that this question was raised during the meeting indicates that the Board has allowed improper shipping practices for an extended period, knowing that mail order pharmacies have primarily been using trucks that were not temperature-controlled. This underscores the need for the Board to take immediate action and require the appropriate packaging and temperature-controlled shipping methods.
Furthermore, the situation is exacerbated because many patients are forced to use mail order pharmacies owned by insurance companies. It's unethical to force patients to these pharmacies and allow for medications to be stored in temperatures two times room temperature.
All Boards of Pharmacy must prioritize patient safety by enforcing regulations for proper temperature handling, packaging, and temperature-controlled delivery. By taking these measures, the Board can address the longstanding issue of improper shipping and protect patients from receiving unsafe medications.
Advocacy In Action
The Missouri Board will hold subsequent meetings to discuss this issue.
Thus far, the Texas State Board of Pharmacy has updated regulations. The proposed regulations are open for public comment until July 24th. I highly suggest that comments are made to persuade the Board to use temperature sensors with packaging and to define what a package safe for delivery would mean for each type of temperature storage type. For example, room temperature vs cold chain.
Arizona will have this on its agenda on August 17th.
Your voice can save lives. More states will follow as others contact me and let me know they are willing to share their stories or concerns with the State Boards of Pharmacy. Some boards allow for patients to speak during virtual meetings. I will join the patients and supporters to help them win protection in their state!
Standing Against a Goliath
Almost every Board of Pharmacy member has conflicts of interest with this issue, so their true integrity and regard for patient safety will shine through as patients take these issues to their State Boards of Pharmacy.
Please let me know if you can share your concerns with your State Board of Pharmacy loretta@uniteforsafemeds.com.
Thank you for your support,
Loretta Boesing, Patient Advocate
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