Study: Mail Order Scripts Exposed to Unsafe Temperatures

Mail-order prescriptions shipped during winter and summer months are likely to spend a substantial portion of time outside the recommended safe temperature range for most medications, according to new research presented at the American Society for Health-System Pharmacists (ASHP) Midyear 2020 Clinical Meeting and Exhibition on December 10.

To test whether mailed prescriptions fall outside recommended ranges in transit, Karlee Paloukos, a pharmacy student at University of Utah and researcher on the study, shipped a total of 48 non-refrigerated packages containing a temperature data logger to 6 locations through the US Postal Service, according to a ASHP news release.

Packages were shipped 4 times to each location in winter and 4more times to each location in summer. Every shipment was exposed to temperatures outside the recommended range—room temperature, between 68 and 77 degrees ºF—at some point during transit.

The percentage of time spent out of those temperatures ranged from 68% to 87% in the winter and 27% to 54% in summer.

“If a medication is stored improperly during the mailing process, and subsequently arrives to the patient altered, either chemically or physically, then patient safety could be at risk,” Paloukos said. “Patients should be warned of these risks and have the option to fill their prescriptions at a local pharmacy, where temperature storage logs are meticulously tracked to ensure the integrity of the dispensed medications, at the exact same cost.”

“This study highlights an important consideration as mail-order pharmacy continues to evolve to meet the growing prescriptions needs of Americans,” said Mary Ann Kliethermes, PharmD, director of medication safety and quality at ASHP. “We must ensure appropriate storage and transit conditions are maintained, especially for medications that are most impacted by temperature changes. The round of lost packages raises another concern about mail-order drugs, as medications should make their way to patients who need them.”

The independent study was not sponsored by ASHP.

Paloukas suggested that increased regulation of mail-order pharmacies “to ensure appropriate storage conditions are maintained throughout transit is paramount.”

Packages were mailed to Baltimore; Chicago; Tucson, Arizona; Palo Alto, California; Largo, Florida; and Katy, Texas from December 2019 to February 2020 and again from June 2020 to August 2020.

References:

1. Mail-order medications often exposed to unsafe temperatures, study shows. News release. ASHP; December 10, 2020. Accessed December 10. https://www.ashp.org/news/2020/12/09/mail-order-medications-often-exposed-to-unsafe-temperatures-study-shows?loginreturnUrl=SSOCheckOnly

2. Paloukos K, Speckman M. Assessment of unrefrigeration shipping methods used by mail-order pharmacies and exposure of medications to usnafe temperatures. Presented at: ASHP Midyear 2020 Clinical Meeting & Exhibition; December 6-10, 2020; virtual.