美国国家公共电台 NPR Extreme Temperatures May Pose Risks To Some Mail-Order Meds

 

NOEL KING, HOST:

It's become pretty common to order drugs through the mail, and Amazon has jumped into the game, so that market could get even bigger. But there are still some big questions about safety. Alex Smith is with member station KCUR.

ALEX SMITH, BYLINE¹: The weather in Park Hills in eastern Missouri can be all over the map, according to resident Loretta Boesing.

LORETTA BOESING: We experience temperatures like they would feel in Arizona. You know, sometimes we experience the temperatures like they feel up north.

SMITH: Boesing thinks those extreme temperatures played a part in a health scare involving her son Wesley. In 2012, when Wesley was 2, he got so sick from the flu that he needed a liver transplant. The surgery went well, but just a few months later, lab tests showed Wesley's body appeared to be rejecting the organ. Boesing felt devastated² and guilty.

BOESING: I feel the extra duty of not just protecting his life, but the life that lives on inside him.

SMITH: In the end, Wesley rallied and kept his new liver. But Loretta kept wondering what might have gone wrong. Then she remembered that when his transplant medications were last delivered, they had been left outside by the garage, where they sat for hours. Temperatures that day were in the hundreds, far higher than the safe range listed on the drug's guidelines. At the time, she hadn't worried about it.

BOESING: Even though I see plainly on the bottle, you know, that it says store at room temperature, I still thought, ah, someone's making sure it was safe.

SMITH: But after Wesley's setback³, Boesing swore off mail order altogether. And this year, she started a Facebook group for patients who are worried about mail-order drugs. She thinks all insurers should give their customers easy access to retail⁴ pharmacies⁵ unless mail-order companies can prove that drugs are getting to patients at the right temperatures. There are three big mail-order companies - Express Scripts, CVS Caremark and OptumRx. All three insist they've got the shipping⁶ down to a science.

At a warehouse⁷ in Kansas City, OptumRx workers pack specialty⁸ medications with ice packs and insulated containers. Lead pharmacist Alysia Heller explains that this warehouse ships up to 100,000 prescriptions¹⁰ a day, and it includes a system to account for weather.

ALYSIA HELLER: If there's an extreme heat situation, the system will tell the technician to add an extra ice pack because we've monitored the zip code and the weather in that area.

SMITH: But at OptumRx and across the industry, room-temperature medications, like most blood pressure or cholesterol¹¹ drugs, are just dropped in bubble mailers. Stephen Eckel, a pharmacy¹² professor at the University of North Carolina, thinks that this can lead to some drugs being damaged.

STEPHEN ECKEL: A lot of people enjoy the convenience of mail order, but there are some risks, as we've discussed, that they have to understand.

SMITH: Eckel says it's possible that medications in oral suspension, like Wesley was taking, could be affected¹³ by extreme heat or cold. Eckel thinks it's just a matter of time before mail-order pharmacies start using temperature-controlled packaging for nonspecialty drugs as well and include a temperature monitor in each package so customers know their drugs never got too hot or too cold during shipping. But pharmacy consultant¹⁴ Adam Fein says that approach would just drive up costs. And he points out that many states already guarantee customers the right to use retail pharmacies if they prefer. He thinks the temperature concerns are overblown.

ADAM FEIN: We have literally¹⁵ billions and billions of prescriptions that have been dispensed¹⁶ by mail over many, many years without evidence of widespread harm.

SMITH: Some room-temperature drugs are OK to spend up to 24 hours in temperatures as low as the upper 50s to as high as 104. But scientists just don't know what happens to many medications in more extreme temperatures. In fact, a few studies suggest that some inhalers or drugs like antibiotics¹⁷ can lose potency¹⁸.

Boesing has gotten a waiver that lets her get Wesley's medication at a specialty pharmacy in St. Louis, but she's continued to advocate on the issue.

BOESING: I don't want my son to receive special treatment. I want everyone to have access to safe medications.

SMITH: In Missouri, the Board of Pharmacy will review its mail-order prescription⁹ policies and has invited Boesing to testify later this week. For NPR News, I'm Alex Smith in Park Hills, Mo.

(SOUNDBITE OF DARREN KORB'S "FORECAST")

KING: And that story is part of a partnership¹⁹ with NPR, KCUR and Kaiser Health News.

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 devastated   

v.彻底破坏( devastate的过去式和过去分词)；摧毁；毁灭；在感情上（精神上、财务上等）压垮adj.毁坏的；极为震惊的

参考例句：

• The bomb devastated much of the old part of the city. 这颗炸弹炸毁了旧城的一大片地方。
• His family is absolutely devastated. 他的一家感到极为震惊。

3 setback   

n.退步，挫折，挫败

参考例句：

• Since that time there has never been any setback in his career.从那时起他在事业上一直没有遇到周折。
• She views every minor setback as a disaster.她把每个较小的挫折都看成重大灾难。

4 retail   

v./n.零售；adv.以零售价格

参考例句：

• In this shop they retail tobacco and sweets.这家铺子零售香烟和糖果。
• These shoes retail at 10 yuan a pair.这些鞋子零卖10元一双。

5 pharmacies   

药店

参考例句：

• Still, 32 percent of the pharmacies filled the prescriptions. 但仍然有32%的药剂师配发了这两张药方。 来自互联网
• Chinese herbal pharmacies, and traditional massage therapists in the Vancouver telephone book. 中药店，和传统的按摩师在温哥华的电话簿里。 来自互联网

6 shipping   

n.船运（发货，运输，乘船）

参考例句：

• We struck a bargain with an American shipping firm.我们和一家美国船运公司谈成了一笔生意。
• There's a shipping charge of ￡5 added to the price.价格之外另加五英镑运输费。

7 warehouse   

n.仓库；vt.存入仓库

参考例句：

• We freighted the goods to the warehouse by truck.我们用卡车把货物运到仓库。
• The manager wants to clear off the old stocks in the warehouse.经理想把仓库里积压的存货处理掉。

8 specialty   

n.(speciality)特性，特质；专业，专长

参考例句：

• Shell carvings are a specialty of the town.贝雕是该城的特产。
• His specialty is English literature.他的专业是英国文学。

9 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

10 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

11 cholesterol   

n.（U）胆固醇

参考例句：

• There is cholesterol in the cell of body.人体细胞里有胆固醇。
• They are determining the serum-protein and cholesterol levels.他们正在测定血清蛋白和胆固醇的浓度。

12 pharmacy   

n.药房，药剂学，制药业，配药业，一批备用药品

参考例句：

• She works at the pharmacy.她在药房工作。
• Modern pharmacy has solved the problem of sleeplessness.现代制药学已经解决了失眠问题。

13 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

14 consultant   

n.顾问；会诊医师，专科医生

参考例句：

• He is a consultant on law affairs to the mayor.他是市长的一个法律顾问。
• Originally,Gar had agreed to come up as a consultant.原来，加尔只答应来充当我们的顾问。

15 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

16 dispensed   

v.分配( dispense的过去式和过去分词 )；施与；配（药）

参考例句：

• Not a single one of these conditions can be dispensed with. 这些条件缺一不可。 来自《现代汉英综合大词典》
• They dispensed new clothes to the children in the orphanage. 他们把新衣服发给孤儿院的小孩们。 来自《现代英汉综合大词典》

17 antibiotics   

n.（用作复数）抗生素；（用作单数）抗生物质的研究；抗生素，抗菌素( antibiotic的名词复数 )

参考例句：

• the discovery of antibiotics in the 20th century 20世纪抗生素的发现
• The doctor gave me a prescription for antibiotics. 医生给我开了抗生素。

18 potency   

n. 效力，潜能

参考例句：

• Alcohol increases the drug's potency.酒精能增加这种毒品的效力。
• Sunscreen can lose its potency if left over winter in the bathroom cabinet.如果把防晒霜在盥洗室的壁橱里放一个冬天，就有可能失效。

19 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。