I came across this post on Facebook, "Mailbox temperatures can reach 150°F. Your medications shouldn't be sitting in there."

That powerful message isn't just a slogan. It's a reality that millions of patients face every summer as they are forced to mail order pharmacy and not provided an opportunity to protect the integrity of medications. 

While many people and sometimes even pharmacists pay attention to only the outside air temperature, far fewer realize that the inside of a mailbox, delivery truck, or package locker can become dramatically hotter. In direct sunlight, mailbox temperatures can soar well above 120°F and, in some cases, approach 150°F.

For patients relying on life-sustaining medications, that should concern all of us.

Many medications are labeled to be stored at controlled room temperature, yet there are few regulations requiring patients to be warned when their prescriptions may be exposed to dangerous heat during shipping or while waiting in a mailbox. Even more concerning, there is very little publicly available information to help patients know whether a medication remains safe after being exposed to extreme temperatures.

Patients are often left asking:

Is my medication still safe?
Has the heat reduced its effectiveness?
Should I replace it?
Who is responsible for making that determination?

I was encouraged to see drug manufacturer Genentech publicly release a Storage Temperature Excursion Tool that helps determine whether certain medications remain safe after temperature excursions. This is exactly the kind of transparency patients need. Unfortunately, very few manufacturers make this information publicly available, especially for medications stored at room temperature. In fact, when State Boards of Pharmacy have requested this information from some drug manufacturers, they have claimed that this information was proprietary information or information that if made public could harm their competitiveness.  

I hope that others will advocate to demand this information be transparent, because too often we are forced to mail order pharmacies that are not properly tracking temperatures or telling patients the truth about the risks. 

We need:

Stronger protections for medications shipped through the mail.
Better education about the dangers of extreme heat exposure.
Greater transparency from manufacturers regarding temperature excursion data.
Policies that prioritize patient safety over convenience.
No one should have to wonder whether the medication they depend on has been damaged before they even take the first dose.

Mail order pharmacy complaints should be filed with your State Board of Pharmacy. If you are using mail order pharmacy, let me know how your medications are shipped and if you are having any issues. loretta@uniteforsafemedications.org

Loretta Boesing, Patient Advocate

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Photo Credit:  Allcare Pharmacy and Compouding