Mail-order prescriptions often exposed to unsafe temperatures, study finds

Researchers say that up to 87% of medications delivered through the mail is exposed to unsafe temperatures, which could pose health risks for patients. File Photo by John Angelillo/UPI
Researchers say that up to 87% of medications delivered through the mail is exposed to unsafe temperatures, which could pose health risks for patients. File Photo by John Angelillo/UPI | License Photo

Dec. 10 (UPI) -- Mail-order prescription drugs are exposed to potentially unsafe temperatures up to up to 87% of the time while they are in transit, an analysis presented Thursday at a conference found.

All 48 test shipments used in the study were exposed to temperatures outside the recommended range -- which is room temperature, or between 68 and 77 degrees Fahrenheit -- at some point before they reached their destination.


In the winter, shipments spent between 68% and 87% of their time in transit outside of the recommended temperature range. In the summer, the packages spent 27% to 54% of the time in transit in potentially unsafe temperatures, the researchers said.

When many medications are exposed to temperatures that are too hot or too cold, their chemical composition may be altered and they can lose effectiveness, according to the researchers.


The study was presented during a meeting of the American Society for Health-System Pharmacists, a group that represents pharmacists who work in hospitals and outpatient care facilities.

The society's mid-year clinical meeting and exhibition was held online this year because of the COVID-19 pandemic.

"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," study co-author Karlee Paloukos said in a press release.

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"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," said Paloukos, a pharmacy student at University of Utah.

Even drug orders shipped in standard bubble-padded envelopes during winter and summer months are likely to spend a substantial portion of time outside the recommended safe temperature range for most medications, she said.

Mail-order pharmacies argue that they can deliver prescription drugs -- at reduced costs -- to consumers safely and efficiently, and many health insurance plans encourage beneficiaries to use these services.

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However, recent changes at the U.S. Postal Service have been linked with delays in the delivery of vital drugs, putting those who need them at risk, experts say.


For this study, Paloukos shipped a total of 48 non-refrigerated packages containing a temperature data logger to six locations -- Baltimore; Chicago; Tucson, Arizona; Palo Alto, California; Largo, Florida; and Katy, Texas -- using the U.S. Postal Service.

Shipments were sent in two phases, from December 2019 to February 2020 and again from June 2020 to August 2020. Each phase had four shipments to each location, she said.

Seven out of eight shipments were included in the analysis, and data from one summer mailing was excluded because it was lost due to COVID-19-related delays, according to Paloukos.

"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, director of medication safety and quality for the American Society for Health-System Pharmacists.

"We must ensure appropriate storage and transit conditions are maintained, especially for medications that are most impacted by temperature changes," Kliethermes, who was not involved in the study, said in a press release.

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