Tomorrow. On January 11th, the Missouri Board of Pharmacy will be holding a virtual meeting to discuss the temperature issues with mail order pharmacies.
This is the state where Express Scripts is headquartered. It is estimated that the discussion will be held between 10 to noon central time. These pharmacies are getting away with the unthinkable when they are allowed to store most room temperature meds in only bags and expose them to temperature extremes of 120-170 degrees in the summer in trucks and mail boxes or freezing in the winter as many are forced to mail order pharmacies. No one should be forced to take this risk.
Tomorrow, the Board is not expected to make real meaningful changes to temperature regulations & will only be requiring location tracking which is generally already included but does nothing to ensure safe temperature storage or temperature tracking. Per the Board, they've been waiting for months for guidance from US Pharmacopeia (USP), but from my experience, USP generally cares and doesn't drag its feet. USP's guidelines are clear. The Board of Pharmacy even mentions in their regulations that state medications must be stored according to the drug manufacturers' guidelines or USPs. USPs refer to general chapter 659 which states the drug manufacturer label should be adhered to during shipping, usually stating that medications should not exceed 86 degrees and should not freeze.
Missouri Board knowingly allows for mail order pharmacies to break their own regulations every day. Some have stated that this may open the state up to lawsuits. Patients and caregivers, if you are forced to unsafely store your meds while being forced to mail order pharmacies, and your state has regulations such as ours, you may need to seek legal advice. Also, file complaints with your Board of Pharmacy.
The Board has had about 5 years since the first day that I filed a complaint with them. I'm not sure how long this will take, but it's taking too long knowing that many are forced to mail order for themselves or their children.
We were forced to mail order pharmacy again over the summer for my son's meds. The CVS pharmacist called the drug manufacturer at my request to inquire about any additional stability testing beyond what was on the label. There was none. Yet, CVS refused to store my son's medications in any special way. They would still arrive without protection from the heat or freezing cold.
If you look at the makeup of the Boards of Pharmacy in the US, you will find that most members are from the large corporate pharmacies or pharmacy benefit managers (Optum RX, CVS, or Express Scripts) that benefit by the billions by being able to evade ensuring safe temperature storage. These mail order pharmacies also have what's called a pharmacy benefit manager or PBM that oversee reimbursements to competitors. If members are not from these large corporations, they are receiving 80% of their reimbursements for medications from these big 3 PBMs that have merged with mail order pharmacies.
Yes! This is a huge David & Goliath fight which is why I'm asking you to please dial in tomorrow or attend the meeting virtually. Showing up can help greatly.
Honestly, I don't believe that PBMs and their mail order pharmacies would have ever been successful if they were made to be held accountable for delays and improper temperature storage from day 1. At a minimum, if you could please call and listen In. The public will have 2 minutes to speak. I will certainly be giving my full 2 minutes, and it would mean a lot if others would show up in support of ensuring that if patients are forced to mail order that ship meds in unsafe temperatures or don't ship timely, these pharmacies are held accountable.
Mention delays too as that is part of it. Lives are at risk. We need you. Meeting information is below and will be posted on Missouri's Board's website or you may use the dial-in information below. Don't think that your voice can't make a difference. Members of the public may attend the meeting in person or virtually by using the following:
1) Join online at:
Click Here To Join Virtually
Access Code: 2632 906 9147
Password: 95Gm2gMPmG9
2) Calling:
Phone #: 650-479-3207
Access Code: 2632 906 9147
Password: 95Gm2gMPmG9
Thank you for your support,
Loretta Boesing