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Contact 2: Monitoring the drugs delivered by mail-order pharmacies

PARK HILLS, Mo. – An increasing number of people across the country get their prescriptions delivered by mail. A Park Hills, Missouri mother is raising questions about how those medications could be affected by exposure to extreme temperatures in the transportation process.

“I am certain there are a lot of people’s lives in jeopardy because of this,” said Loretta Boesing.

But the life that matters most to Boesing right now is that of her 8-year-old son, Wesley. Six years ago, he received a life-saving liver transplant. Since then he’s relied on a pair of medications to protect his body from rejecting the transplanted liver.

“At this point, I’m very picky about the pharmacies we use. I really trust Cardinal Glennon Children’s pharmacy. If I had my choice, that’s where I would go,” Boesing said.

Despite living more than an hour away from Cardinal Glennon, the Boesings travel to St. Louis to pick up Wesley’s medications. Loretta says she’s happy to trade the convenience of a closer pharmacy for the confidence she feels knowing Wesley’s meds are being shipped and stored in the recommended temperatures.

Shortly after Wesley’s transplant, a mail-order prescription delivery mix-up resulted in his medicine being left outside in the heat overnight. Loretta says he took the medicine and became seriously ill. Since then, she’ll leave nothing to chance.

“His life depends on that medication. Without that medication working effectively he could risk losing the liver and have to get transplanted. Worst case scenario he could pass away,” Boesing said.

The Boesings had no issues until their insurance changed to CVS Caremark in January. Loretta says the company informed her Wesley’s medications must be shipped by mail to their home and that they could no longer pick them up in St. Louis. Loretta felt helpless.

“I just vowed to never use mail order pharmacy for my son unless they could guarantee it was safe,” said Boesing.

Guaranteeing that safety is a topic we wanted to explore, so we visited Terry Seaton, Professor of Pharmacy Practice at St. Louis College of Pharmacy.

Certain parts of the country have been studied. They have mailed packages with temperature sensors in them, predominantly in the southwestern part of the country in Arizona and showed a high range of variability. Temperatures as high as 130 degrees,” Seaton said.

Seaton says temperature impacts each medication differently and that liquid medications are most vulnerable while tablets and capsules are often the most stable.

We reached out to CVS Caremark to learn how it ensures medications are safely shipped.

In a statement, the company replied:

“We use packaging that meets or exceeds industry standards and follow specific shipping guidelines for each of the products we ship to maintain the appropriate temperature throughout the process. In addition, we purchase the drugs we dispense directly from manufacturers and authorized distributors to ensure product integrity from the manufacturing plants through delivery to our pharmacies.”

Nonetheless, Loretta Boesing believes there needs to be more oversight to ensure the pharmaceutical industry is making sure medications stay within the recommended temperature limits every step of the way.

“I don’t just want this done for my son at this point. I want this done across the board,” she said.

After Contact 2’s Mike Colombo contacted CVS Caremark, the company told us the Boesings would be able to continue picking up Wesley’s medication at Cardinal Glennon. If you have concerns about your medicine’s exposure to extreme temperatures, Terry Seaton recommends asking pharmacist or mail order pharmacy questions about their storage and transportation specifications.

If you notice health irregularities after taking medicine that you believe may have been exposed to extreme temperatures, share that concern with your doctor.