Mail-Order Drugs Could Be Another Climate Change Casualty

Nearly a quarter of prescription spending before rebates and discounts goes to drugs sent by mail. As someone who gets my drugs by post, I can see why: It’s extremely convenient, provides access to drugs that may not be in a local pharmacy’s formulary and makes it way easier to get refills while traveling.

But a recent NPR report examining how high temperatures affect mail-order drugs got me thinking about how we may be looking at another unexpected consequence of climate change.

Some medications are temperature and/or light sensitive, requiring special handling. In the pharmacy, that’s pretty easy, because they can be kept in the right conditions. When meds go by mail, however, patients are at the mercy of shipping companies. Employees are supposed to use cold packs and label packages so parcel delivery companies are aware of the necessary precautions, like not tossing a box into the pavement in the blazing sun.

But, as Alex Smith reports for NPR, that doesn’t always happen. Patient advocates are pressing for reforms to ensure that a broader range of medications are given special handling precautions, with better oversight to make sure those recommendations are actually followed. They’re also asking for these drugs to be made available in local pharmacies for patients who would prefer not to mail order their medication.

When it comes to sensitive handling for drugs, many people may think of vaccines, which frequently need to be refrigerated. The refrigerated supply chain has been a huge problem for agencies working in the Global South, where stable access to refrigeration is not a given. Drug companies are slowly starting to respond to that issue with formulations that are stable at room temperature, a huge improvement for people working hard to fight vaccine-preventable illnesses.

This situation is a reminder that refrigeration is an issue closer to home for many of us — and our pets, in some cases. And that’s where climate change comes in.

If it’s challenging to make sure medications are kept at safe temperatures now, how will that change in the future?

Average temperatures during the summer months are already getting hotter in many parts of the globe — sometimes so hot that planes can’t take off, roads are collapsing and utilities can’t manage overloaded grids. Extreme cold can be an issue too, as seen during the chilly polar vortices that keep freezing the East Coast.

That could be bad news for mail-order medications — especially those delivered to people’s homes, rather than post office boxes, where a package might sit for a while before being brought inside.

It may not be enough, in other words, for advocates to ask for better supply chain management and the universal use of predictive systems that track weather and help mail-order pharmacies prioritize shipments. We should be proactively thinking about climate change.

That might look like more robust insulation for both heat and cold; unsafe temperature indicators that change color to alert people to the fact that a drug got too hot or cold during transport; cooling and warming options for sensitive medications; and frank conversations about drugs that simply may not be safe to ship.

Of course, this substantial investment in safety should be accompanied with continued advocacy on behalf of the planet to slow or stop the climate trends that are making this an increasingly hostile planet to call home.

Photo Credit: Getty Images

43 comments

Thomas M
Thomas M21 days ago

thanks

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Sophie A
Sophie A1 months ago

Thank you

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Knud Thirup
Knud Thirup1 months ago

Thank you for sharing

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Jessica C
Jessica C1 months ago

thx

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Olivia M
Past Member 1 months ago

thanks for posting

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Toni W
Toni W2 months ago

TYFS

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Toni W
Toni W2 months ago

TYFS

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Loretta B
Loretta B2 months ago

Hi. I'm the one that was in the NPR article and will be sharing your story to my Issues with mail order pharmacy page. Please know that I have a list of over 100 reasons why mail-order pharmacy doesn't save money and risk people's lives. The impact on the environment is a major issue Express scripts brags that they used 22,000,000 ice packs & big thick styrofoam coolers. Please think about what that's going to do for our environment. In our town and surrounding towns in the last 3 months we've had our recycling service halted. I am very concerned about this issue and I am so happy that you have brought this up. I do have someone who is will be working on a petition for this very issue. It will be separate than mine. We have to think. In the NPR article they said they ship out over a billion of these packages a year. In addition, some States have picked up that most 90 day fills that are filled the 1st time are never refilled. Although, some are allowed to be on auto ship. Some states are making the 1st refill a 30 day refill through the mail-order pharmacy for this reason. I've seen tables full of medications that go out auto ship that go unused. I have some of these pictures on my issues with mail order pharmacy page. I'm afraid many of these medications are also ending up in our landfills or flushed down the toilets. The person working on the petition for the en environmental component also had her life risked due to forced mail-order pharmacy as her medica

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Roxana Saez
Roxana Saez2 months ago

TYFS

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Marija M
Marija M2 months ago

I believe that is trie.

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