Does your insulin always come packed carefully in ice? Or perhaps not anymore? Medical insurers, notably CVS/Caremark, are cutting costs by skimping on packaging used to keep insulin safe during shipping. And a bunch of PWDs are mad as hell about it.
T1 writer and advocate Riva Greenberg wrote to me not long ago saying:
"What they are doing is cutting costs by not packing insulin in cold gel packs anymore if they determine the temperature is between 32 and 86 where you live when they send it. And, they make it sound like a benefit, 'Even tough insulin manufacturers say that it is okay to store insulin for limited time periods at temperatures up to 85 degrees, CVS Caremark is taking extra care to make sure that your insulin is protected by shipping insulin with a cold gel pack if the temperature in your area is forecasted to be 78 degrees or higher.' Yet, they used to ALWAYS ship insulin with a cold pack, so this is a lower standard of care. And what's to say the storage facility where your insulin lay overnight is not above or under the quoted temperature they are going by?"
Riva thinks it's an outrage, and possibly just the beginning of the kind of cost-cutting we're going to see in healthcare that could be potentially dangerous.
Another T1 advocate named Ellen Ullman (a research associate at Close Concerns), who lives in balmy Florida, has just started a group on LinkedIn to protest CVS Caremark's "unacceptable and unethical insulin shipping practices." Not sure why she chose LinkedIn, but there you'll find a growing number of discussions on the recourse for patients who want to change this policy.
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According to input from Dr. William Quick (of DiabetesMonitor), "there is a precedent for the FDA taking action against drugstores for failing to keep insulin in spec." Back in 2001, he explains, Sanofi-Aventis notified the FDA of problems resulting from Walgreens shipping insulin in non-refrigerated condition. The FDA ordered Walgreens to conduct a product recall under the title: "Temperature Abuse-product shipped unrefrigerated by recalling firm" (described here).
I've only had a shipment of insulin go bad once, but it took me DAYS of high blood sugars, discomfort and aggravation to figure it out and correct the problem. Even if you live in a temperate climate, there's no way of knowing what your insulin goes through on its way to you. So I'd say, skimping on gel packs is just petty pinching, bound to cause more trouble than it's worth.
So if insulin shows up on your doorstep NOT packaged with a protective gel pack, what would you do? Assume it's OK? Call the company to protest? Watchful trial and error?
As long as the mail order service says they're monitoring for "temperature in your area forecasted to be 78 degrees or higher," are you concerned about this?