Hotter summer temperatures and the expansion of delivery of medication by mail have made a longstanding problem worse. Doctors and pharmacists are warning that many medications being sent through the mail are being overheated, which could have dangerous consequences, the New York Times reports. Dr. Mike Ren at the Baylor College of Medicine says fast-acting liquid and aerosolized medicines are among the most likely to lose potency in extreme heat. "A rescue inhaler or an EpiPen—those things are not like a daily blood pressure pill," he says. "They need to work immediately."
Companies including CVS Health and OptmRx say they use algorithms and many different packaging options to protect medications in transit. But the temperature in the back of delivery trucks can reach 150 degrees in summer, way above the recommended range of 68 to 77 degrees for storing medication, the Times reports. A study published last year determined that packages sent through the mail were outside the recommended temperature range more than two-thirds of the time. The researchers noted that federal laws require medicines to be kept at a controlled temperature during distribution from makers, but there are no regulations on temperature when they are sent to patients.
Industry lobbyists have pushed back hard against attempts to bring in regulation. When Marty Lee Hendrick, executive director of Oklahoma's pharmacy board, tried to bring in a temperature control rule for mail-order pharmacies in 2022, the effort failed after lobbyists claimed "micromanaging" the packaging would increase prices by an average of $23 per shipment, the Times reports. "I hate to say this, but we're really probably one big tragedy away from people realizing how serious this is," Hendrick says. "Our time will come. I know it will. But these battles end up being wars."
- Baylor advises that if medication has been exposed to heat, "do not take if it has changed color, texture, or odor even if it has not expired. Capsules or tablets that stick together, are harder or softer than normal, or are cracked or chipped might also be damaged by heat." The Times notes, however, that sometimes there is no visible sign that heat has caused a medication to lose potency.
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