As an insurance company steered a patient who lives in a desert to a mail order pharmacy, the mail order pharmacy without remorse refused to provide protection of medications from extreme temperatures.
Facts to know:
- This is not a one-off case. The state pharmacy boards and the Food And Drug Administration (FDA) know it. Both, mostly refuse to properly regulate & enforce protections of patients' whose medications are forcefully shipped by mail in extreme temperatures.
- This is the common unethical standard for most insurance or pharmacy benefit manager-affiliated mail order pharmacies, especially for room-temperature medications.
- The pharmacists faced much harsher penalties than the corporation which demands the shipping of most room-temperature medications without protection knowing that trucks and mailboxes offer no protection from freezing and can reach 120-170 degrees in the summer. (These pharmacists should become whistle-blowers.)
- Most medications are not studied to withstand these temperature extremes and maintain shelf life which is the date of the expiration date as written on the label.
- Medications can break down and not only lose potency but can become toxic when exposed to temperature extremes.
- A CVS lobbyist at the Oklahoma Board of Pharmacy spoke against the regulation of temperatures of mail order pharmacies using the excuse that drug manufacturers ship to CVS the same way in non-temperature-controlled vehicles. The lobbyist was educated that this should be reported to the FDA as state boards do not regulate the drug manufacturers, the FDA does. Another Board member, questioned the lobbyist stating, "So we would prevent further adulteration of medication (by regulating temperatures of mail order pharmacies)? I think I would want that."
- When questioning your mail order pharmacy about temperatures, we need patients to document, document, and document. Many patients are being blown off and not told the truth about the dangers of mail order pharmacies improperly storing medications. The dangers go far and beyond potency. Some medications have been shown to increase carcinogens when stored in high heat.
- More patients need to file complaints of improper temperature storage to their Boards of Pharmacy and demand protection for themselves and others.
(ESK below is in reference to the name of the patient. ESK is used to conceal the name of the patient. Caremark is CVS Caremark, a mail order pharmacy owned by CVS, a multi-billion dollar company.)
"Respondents failed to comply with the prescription requirements and ensure the safe condition of the medication, Odefsey, during its delivery to patient ESK at his residence in Palm Desert, California during a period of excessive high temperatures. The circumstances are as follows: Patient ESK received authorization for mail delivery only for the medication Odefsey to his house in Palm Desert.
On or about May 29, 2019, in anticipation of his upcoming delivery of his prescription for Odefsey (RX #4779119), ESK contacted Respondent Caremark via email and advised that it was going to be 100 degrees Fahrenheit in Palm Desert and inquired if a cooling pack would be included with the shipment. ESK was aware that Odefsey needed to be kept at a temperature below 86 degrees Fahrenheit.
On May 30, 2019, ESK again contacted Respondent Caremark via email and advised that it would be 100 degrees the following day and wanted to make sure that the prescription would be shipped so that it was kept at the proper temperature.
Odefsey prescription # 4779119 was reported as having been ready for shipment at 6:39 pm on May 30, 2019 and was picked up for delivery from Respondent Caremark at 7:33 22 a.m. on May 31, 2019.
On May 31, 2019, Respondent Caremark sent an email to ESK and advised that the warehouse determines the necessity of the cooling packs for medications.
At approximately 1:34 p.m., on May 31, 2019, Odefsey prescription # 4779119 was delivered to ESK’s residence in Palm Desert. The temperature between 1-2 p.m. on this date was reported to be approximately 90 degrees Fahrenheit.
(CAREMARK, LLC DBA CVS/SPECIALTY, KELLEE DANIELLE RICHARDSON) ACCUSATION At approximately 4:45 p.m., on May 31, 2019, ESK returned home and received delivery of his prescription. The package as delivered did not contain a cooling pack. Upon receipt of the prescription, ESK emailed Respondent Caremark and advised that the manner of delivery did not include temperature control. The high temperature on that date was approximately 94 degrees Fahrenheit.
On or about June 1, 2019, ESK received an email from CVS stating that “after reviewing your account your medication will be packed and shipped according to temperature requirements.”
On or about June 3, 2019, ESK received a further email from CVS stating “[w]e ship your medication to you in the same manner that the manufacturer sends it to our pharmacies, which are located in areas that experience the same temperature extremes as you do.” ESK was not offered a replacement product even though the Odefsey was sitting in temperatures greater than 86 degrees Fahrenheit for more than 3 hours."
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This was the same excuse that I was provided over the summer as once again, our employer was forcing us to use CVS "Specialty" Pharmacy.
Due to the lack of concern and the ability of these insurance-affiliated mail order pharmacies to evade regulation and proper oversight, our family has since opted out of the employer-sponsored plan like my son's life depends on it, and we pay for a plan through the Marketplace. We are currently able to get his medications locally. Sadly, many others cannot afford to do the same, so they are forced to allow mail order pharmacies to unethically store medications in unsafe temperature extremes. This is especially true for room temperature medications where temperature guidelines on the bottle are mostly and totally ignored by mail order pharmacies.
The only thing special about these specialty pharmacies is the fraud, neglect, and abuse that they are allowed to get by with.
If your mail order pharmacist blatantly uses this excuse of "This is how the manufacturer sends it to us, so this is how we will send it to you." Send complaints to the FDA and to your State Board of Pharmacy. Tell the pharmacist that they should be filing complaints to the FDA and not further shipping medications in a way that could cause further adulteration and harm to patients.
This is an injustice that must stop but will not stop without the general public caring enough to get involved. How long will it take, months, years, or more than a lifetime? It just depends on how quickly we can unite and tear down the walls of corruption and injustice.
How can you help? Contact your State Boards of Pharmacy, your legislators, and get involved in advocacy work. More than any amount of money, your voice is what is greatly needed. Sign up to become a member of Unite for Safe Medications. It's free. We will hold meetings to discuss how the general public can get more involved. We will be holding one next Saturday. We may start small but never underestimate the power of a voice. We will send out the invite for the meeting tomorrow. You can also make a donation to support our advocacy.
“Never underestimate the power of a small group of committed people to change the world. In fact, it is the only thing that ever has.” ~ Margaret Mead.
Thank you to Change.org and to our supporters,
Loretta Boesing, Patient Advocate
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