The Business of Pharmacy Podcast™
Aug. 8, 2022

Unregulated Mail Order Temperature | Loretta Boesing, Unite for Safe Medications

Unregulated Mail Order Temperature | Loretta Boesing, Unite for Safe Medications

Loretta Boesing founder of Unite for Safe Medications, discusses the unregulated temperature extremes in mail order pharmacy.


Speech to text:

Mike Koelzer, Host: [00:00:00] Loretta, for those that haven't come across you online, introduce yourself and tell our listeners what we're talking about today.

Loretta Boesing: My name is Loretta Boesing. I'm the founder of Unite for Safe Medications. Unite for Safe Medications, is a nonprofit that started after I learned about the many issues with Miller pharmacy. Then from there I learned about the issues with corporate pharmacies, with our pharmacy deserts.

I keep learning about all the issues with pharmacy that are just really deteriorating conditions, not just for patients, but for our pharmacists.

Mike Koelzer, Host: Loretta. It's cool coming from you. As I read some of your background, you're not coming at this from a selfish reason. Like I might as an independent pharmacy owner, you're coming at it from a patient from your child, being a patient. Is that right?

Loretta Boesing: You're right? Yes. My son, Wesley, had a liver transplant at the age of two. One of the things I tell you, whenever they put your child on the transplant list is that they will be on medications for the rest of their life. So of course, we said, yes, get us on the transplant list, whatever we have to do.

This advocacy has really developed from that, so it starts with his liver transplant and then. Having to be on medications. Not long after that, we used Melo pharmacy for his medications and then his liver transplant was rejected. And, sadly I, at that time, his medications were shipped on a hundred, two degree day.

And I thought, this is just weird. Why would they ship this in just a bag? It didn't feel right in my gut. I questioned it, but I just told myself I'd never use Mo pharmacy unless I could prove it was safe. And then in 2018, we were forced to Mo pharmacy. And that's really where my advocacy began, right away.

I had to determine how hot the trucks were getting? Is this really safe? Is anyone really regulating this? And then that's whenever I started just unfolding all of the issues with not just Mo or pharmacy, but with corporate pharmacy PBMs, I learned about PBMs. It was very interesting how this all came about.

Mike Koelzer, Host: I remember when I was on my honeymoon and my wife still talked to me about this, but we went to this national ice cream place and I got this Sunday that I.

And it came out and it was like a tiny, like watermelon scoop, you know, those watermelon ball scoops. I was ready for this big Sunday. And it was like, it felt like it was a couple of those scoops. And so I got ticked off that back when I was more, uh, Impatient worse than I am now, but I got mad and I took that ice cream bowl.

 in an act of defiance, I set it outside of my car. I put it in the parking lot. I wasn't about to throw that away. They're gonna earn their money cuz I only got those. Little scoop balls of ice cream. Here's the thing I can decide now, not to go back to that place, but you're saying that you were forced to go to the mailer.

SoHey, if somebody else wants 110 degree medicine fine, but I'll go somewhere else where I know that's not gonna happen, but you were forced into it.

Loretta Boesing: no other option. Even after 30 calls, just begging and pleading with CVS specialty pharmacy, please don't make me put my son's medications and these conditions, they refused to budge. And that was even after they shipped his medications again on a hot day with no ice pack. And then after I had reached out to my up driver and I'm like, how hot are the back of those trucks getting he's it is so hot back there that I cannot breathe.

he, and that was on a 90 degree day that I asked him and by noon, all the ice packs, my lunchbox were melted. I said, do you have any air conditioning there at all? And he I'm like, even in the front, he's I got that little fan there and I'm like, no, that's not okay. no one warned me.

I didn't know. so then I reached out to ups, petitioner. At that time, she had over a million supporters on her petition for, uh, ups to air conditioning, not the front of the vehicles where the drivers are, but the back where medications are stored. And that's because she has pictures of those trucks getting 150 to 160 degrees, in, in the summer.

And it is just so sad to know that's what the drivers are exposed to. That's why most of our medications in the United States are being shipped, I don't know how we got here. I know this issue has been raised in the past. 20 years ago, I found out even with my state board of pharmacy, there was, this was an issue that was brought up and discussed.

Mike Koelzer, Host: There was an ups driver in the news that they showed him fainting on one of those Google doorbells. They showed him fainting.

And I talked to my drivers that came in the pharmacy. They said, yeah, there's. Been a few of those across the nation. Lord, let me backup a second. As you think back to your first medicine, you said there was no packaging. Was there an ice pack in there?

Loretta Boesing: No,

Mike Koelzer, Host: There wasn't even that.

Loretta Boesing: no, and it was a liquid oral medication, which now I know that a lot of the liquid oral medications used for like specialty conditions. and for [00:05:00] pediatrics, those are not always even tested for stability. So to ensure that medication is protect protected is so important, but even just as important as warning the public, that this is an issue and that, if you're getting your medications by mail, you don't need to just worry about the mailbox you need to worry about how is that medication being transported throughout the supplies chain.

Mike Koelzer, Host: And for our listeners that may not see this, the package inserts that come with every drug they say in there, what excursions are permitted, it'll say this is a refrigerated drug, but excursions are permitted up to. 84 degrees for two days, whatever it is that's listed in there. And I've gotta believe that what you're telling me was way above those.

Loretta Boesing: oh yeah. If it was 102 degree day, that truck was far above 104 degrees, the mill water pharmacies like to go by. They like to say, it wasn't over 104 degrees that day. So it should be okay because us P they will claim it will allow it to get to 104. Unfortunately that's just not always the case.

Mike Koelzer, Host: how do the mailer companies get around? That excursion in the pamphlet. How do they even come up with their own figures that are higher than that? It seems like we, you, it seems like a no brainer for consumers, especially if they're forced into this situation.

Can say, look, the excursions are this. So how do they even say, well, okay, it's not 84, but it's 104. How do they even do that?

Loretta Boesing: So there are on occasion where manufacturers may offer information that may show that the medication was tested up to a higher stability level, but for patients that's not transparent. And honestly, that's not always transparent to pharmacists either. I know pharmacists have reached out for that information and they don't, they won't provide that information directly to the pharmacist unless they give a direct scenario, okay, this patient received medication on a hundred degree day.

It was in the mailbox for this long, but no one really knows how hot that mailbox 

reached. No one knows how hot that truck was that it shipped to. So no one, it's really everybody's best guess as far as whether or not that medication is really safe. And then, as far as, how do they get around that at the Molet pharmacy?

Good question. Because in my state, the regulations are that, through the state board of pharmacy, the regulation is that they must either adhere to the manufacturer's guidelines or the, uh, USPS's guidelines. And I found out that's not happening. When I called the manufacturer, they told me to discard my son's medication.

Whenever I contacted, uh, USB, I found out that, what they should be going by is the temperature that's on the label. Like you had mentioned the excursion. absolutely alarming that they've been able to get by with it, even after I filed the complaint, the state board pharmacy did not do anything. It's hard after knowing that not to just want to jump into action and say, wow, I can't believe this has been going on that long.

Nobody's doing anything. Someone's got to start fighting and. I find out that pharmacists have been on this for years, trying to fight for us to ensure that our medications were shipped safely by mail. And it's mostly I, the independent pharmacist that's been there fighting for us.

And I've, I've got some pretty good information from these pharmacists. That's emailed state boards of pharmacies, about the issues they'll forward me, their emails sometimes, and their communication. I can tell you it feels like we're definitely up against the Goliath. There's a lot of conflicts of interest.

The pharmacy boards that are established to protect patients.

Mike Koelzer, Host: You're seeing a conflict there.

Loretta Boesing: Yeah, it's heartbreaking. It is so sad. I, it feels. So impossible, but I can't stop trying, this is such a common sense issue.

Mike Koelzer, Host: I just got fined by my state board. I have an impeccable record with my state pharmacy board in the last few months. This inspector came by and she said, I. You put the right initials on a non-controlled prescription that was transferred to a local pharmacy. Some pharmacist got pissed at me for putting wrong initials on there or something. And I got fined by the board. And here's the situation where it's a tricky situation in a pharmacy. When it comes to transferring prescriptions, irs phone calls, it's getting put on hold. It's called a busy pharmacy. Who's not answering their phone for 45 minutes.

It's a tricky situation. And what ticks me off is that here, the inspector is coming, looking at one of the trickiest situations in a pharmacy because I'm dealing with. [00:10:00] Chain stores. God bless 'em, there's some good ones, but there's some crappy ones. I'm dealing with them to try to get the right information for transfers and things.

And pretty soon you just give up, it sucks that they're picking on that baloney, and they're not giving a damn about the stuff that you're talking about. It's ridiculous.

Loretta Boesing: it. Yeah, exactly. And it's not just the temperature issue. delays patients, not getting medications for days suffering in pain suffering because they can't focus at work because they didn't get their medications to help their anxiety and their ADHD. suffering with the ability where they lose their ability to walk because their Ms.

Medications don't arrive on time. So how is it that this is okay. and what's really alarming is when it really hits home. It's like the transplant patients going without medications for days. One day. If I withheld my son's medication, what would happen? I would be G I would get charged for child abuse.

I would be neglectful, but the PBMs or me outta pharmacies that they force us to, they can do this every day. And yeah, you're right. State boards. Just turn the other way. Nobody's protecting patients and there's no justice.

Mike Koelzer, Host: Why are they turning the other way?

Loretta Boesing: it's obvious why, it's one, it's not regulated. They like, you got fined. What do they get? nothing happens. It's happening. You can look at consumer reports sites, you can look on all of our social media. There's so many people complaining. A lot of people. they don't know where to complain.

So PBMs will tell our legislators. even sometimes the state boards of pharmacy will say,we don't get a lot of complaints. Most patients don't know where to complain too. So I went to Florida. I let them know I'm like most patients, they don't even know where to complain too.

Can you at least maybe put that on the package? Oh, that was like a big, I never saw a board work so quickly to get through that committee and end it, they would not even do that.

Mike Koelzer, Host: Are you saying that I got fined and you're saying that these companies are so big that they might find them something and that's gonna be the end of it. Is that what you were alluding to?

Loretta Boesing: There was recently, I believe in California, maybe that, there were some fines issued, but the fine was. Less than a percentage of United healthcare as well. I mean, what's that gonna do? You know, that's not, it was Optum and I'm like, that's not, that's gonna just be like, okay, we'll just figure that in the budget for the year, you know, and move on.

Who cares? it's just patience, right? That's what it feels like. The boards just are not protecting us. It's absolutely. I hate to say it, but it's their fault that for every patient that goes without medications, for every patient that gets harmed

Mike Koelzer, Host: Loretta you and I met just at this show here and I saw some of your stuff before, but it's really cool that you're not a Karen Cause I


Loretta Boesing: don't wanna be a Karen

Mike Koelzer, Host: now. I thought I was gonna come on here and you were just gonna maybe just gripe about something but, but your stuff is Structured and deep and focused just from our little conversation we've had right here. Let me ask you this. Could you have done any of this? Without the internet. Was that a huge thing to get other people involved? I always think back to the me too movement that kind of happened now with, uh, this guy, whoever CNN that kind of happened because of the internet in my mind.

How much has the internet played a part in this?

Loretta Boesing: a whole lot a part of it because there's so many amazing people that I would not have been able to connect with. Otherwise, this is very detailed. Issue you,I would, I have a background in the past. I was a social worker, worked in hospitals, a little bit of background in insurance.

if I wouldn't have even had that, I think it would've even been harder for me to understand how to navigate the channels. It's hard. It's a lot, but yeah, for sure. Twitter and every day that's, my goal is to reach out, I, I don't have the money. I don't have this wealthy position, I don't have a spot on the board.

I don't have the connections on the board, but what I do have is an amazing group of patients and pharmacists, and especially the pharmacists who have just been willing to help teach me about the issues and involve me when there's opportunities to speak and for patients' voices to be heard. without that.

Without social media. I don't know. I'd be able to do any of this.

Mike Koelzer, Host: Even with social media and even with all the stuff we have, it's still like you turn around one day and it all seems to be swept under the. and that's with everything. So you can only imagine how this would go. If people couldn't communicate as well as they can now on the internet slash social media.

Loretta Boesing: Right? What? Yeah. So in the very beginning, that's what started. Everyone may think too with the pharmacist, that's where it really started with reaching out. So that up's petitioner she's you need to start a change data org petition. And I did. And from there we got a lot of support. It grew to [00:15:00] and has 178,000 supporters to stop the forcing of a millimeter pharmacy.

And then, whenever. Called the US Department of labor. I didn't have a Twitter account, but after the US department of labor said, the representatives said, we get these calls all the time. This you're not the only one. And unfortunately it's unfair. It may be unethical, but it's not illegal. So that's when I'm like, oh, this is awful.

 he's like, here's what I suggest you do. Start a Facebook group and start a Twitter. And that's where my Twitter started. And I believe it's just amazing.

Mike Koelzer, Host: It seems that. If you define this a certain way, it is illegal. For example, I'm thinking about misbranding that you're selling medicine and you're saying it's this, but it shows up. And it's no longer that because of chemical reactions or degradation, whatever. So it seems like if lawmakers or lawyers got even relatively creative, they could come up with a bunch of laws.

Why something is not valid if you order it, but it shows up as not that,

Loretta Boesing: Yeah, absolutely. It feels like it should be labeled as a fraud or

scam. And

 I just tweeted a FTC about that today. I keep trying to let them know that, Hey, this is an issue it's going on and you're not doing anything, but, honestly, it's going to take a lot more than that because it can make every rule, every law.

But if no, one's there to enforce the law. like in Missouri, we have a great rule.

Mike Koelzer, Host: yeah.

Loretta Boesing: Who's so now who's held accountable when they don't follow it. So I called the Attorney General's office in my state too. And I'm like, Hey, the state board's not doing what they're supposed to be doing.

And I need to report these companies. And they said, that's not a consumer issue. A consumer issue would be like someone, built a deck and didn't finish the job. And, that would be a consumer complaint issue that you could report. And I'm like, so you can deliver me medications that are junk.

And that's not a complaint. And the state boards of pharmacy don't do anything. And I can't complain about that either. So I'm not done with them yet.

Mike Koelzer, Host: All right now, just a second. Loretta, when we were talking about the state boards, first of all, I was thinking that as you were telling me, I was thinking, okay,they're getting bought out by these companies or something, but then we talked a little bit about how well these fines don't help and things like that.

But now we're talking again about the state boards, not doing anything. If you could lean a certain way, is there something nefarious going on with state boards? Like they're protecting these big companies because they're somehow greasing. Their board pockets or something.

Loretta Boesing: It's obvious that's what's happening. And if you look at, the state boards, funding, it comes a lot from these large companies that we're against 

Mike Koelzer, Host: I didn't know that it does.

Loretta Boesing: yeah. Unfortunately. And, uh, um, also you, okay, so Missouri's board at one time, the present told me that, it's, not just an issue with. Melwood pharmacies, but there are independent pharmacies too, that are Melwood pharmacies that, you know, if they had to package those medications correctly, it could hurt them as well. But the problem is that we're not given an option. Like you said, we're not gonna choose.

So something has to be done. We have to do something to protect patients. I'm sorry for those, who's gonna be hurt by that, but it should be patient safety first. And that's what the board says that they're there for. So

Mike Koelzer, Host: Years ago, there was a car called the Pinto. I think it was Ford or something. 

And. You read a lot about it in business law books but it's kind of cliche now, but basically it was that the Pintos were exploding because the gas tank was in the back of the car in a bad spot or something like that.

So the lesson goes that the Pinto maker decided how much money is it gonna cost to recall this versus paying for people who have died. And it came out that it's a lot cheaper just to pay off the lawsuits of people who had died than having this recall. And it sounds to me. This is just a big, nothing burger for these big manufacturers in PBMs and so on, because there's just nothing that's gonna hurt them, but I've got ideas.

Loretta Boesing: Do you

like ideas as far as what would hurt them?

Mike Koelzer, Host: Yeah. Here's her step and this isn't my thought. These are some prior guests I've had, but the money hurts them, of course. But let's say we can't attack 'em with money. so then, and I I know you've thought of this, but then it's embarrassment and embarrassment comes by having them, across the news.

And so my next question, and this is maybe obvious of where I'm going with that, but have we tried to get John stale in front of these people with a microphone. Face and whoever the people are,I forget who they are, but I'll just say John stale, that [00:20:00] exemplifies where I'm going with that.

Loretta Boesing: . Yeah, absolutely. Some are always trying to reach out to the media to try to get them to cover the issue and to cover the story. Here's the problem that I faced a lot of times is that often I spent a lot of time at, so NBC, reported on the issue with issues with moat pharmacy did an in depth investigative report.

There were some really brave patients that spoke up, but that was over a year in the making. It took a long time to find patients who were brave enough to speak up. And many of them had remained anonymous, just like the pharmacist, speaking out can be risky. And whenever you're, speaking out and your insurance is through your employer or you're speaking out and, your insurance is even through the government.

Some people are afraid of the government retaliating in some way or. The one pharmacy that they're allowed to use. They're afraid that they'll come back and do something in retaliation cuz they spoke out. It's really sad because you, as much as you wanna reach out to me and you do, that's absolutely a huge part of what I do.

it's gonna take a lot more than that even. and sadly, whenever you look at those articles and you look Atmas, Pimas of pharmaceutical care management association, the lobbyists for the PBMs and the Millwood pharmacies, you look at what they say. So in, in our NPR article, that discusses specifically my son's story NPR ORMA said, we adhere to, it was along the lines of this.

I don't wanna quote directly. but it was, we adhere to all the FDA's guidelines for mill pharmacies. That's great. CCMA but there's. I called the FDA and the FDA told me that they don't regulate mill water pharmacies. So that's complete deception, know, you're not warning the public, you're not warning our physicians.

And,the same thing that they'll say with NBC, it was something similar like, oh, well, refrigerated medications. We include ice packs with those, but the. But it's like they completely ignore the room temperature medications, it's unreal that they're able to like, just sway the public and that in that article, they talked about adding temperature sensors.

of course they're reluctant to do that. I did receive some temperature sensors from temp time and shipped 'em throughout the middle of the summer. Not one came back within the acceptable temperature range. and then, us P has a mean kinetic temperature that they allow medications to reach.

Mike Koelzer, Host: We got data, loggers shipped those across. None of them were within the mean kinetic temperature ranges allowed by USP, I forget where I read it one time, but they were talking about if the government really wanted to clamp down on people, speeding, they could do it so easily. They could put chips here, do this, or, have all these cameras and sensors and all that. If they really wanted to stop speeding, they could do it, your stuff there.

if they even gave. A hoot, they would put in sensors on all this stuff, easy to do. They don't want to do it. Of course.

Loretta Boesing: no. and it would be, really they would need to monitor the temperatures that medications are being shipped in such as, some type of lagger and the ups trucks. So I'm working on that. and I, but as long as it's not required, as long as there's no regulation, it's really hindering innovation in these areas where we need it.

I don't think we would be having this issue if 20 years ago, they would've dealt with the issue as they should have, as they, as patients were starting to get forced to know what our pharmacies,

but yeah, as long as no one's tracking it, no patients are being warned. And even with regulation, it's their word against mine on how the medication was shipped, in a.

Mike Koelzer, Host: Loretta, I know if I was in your position, I would want what's good for my child and society and all that, but I would want this problem to be changed. But as I went along, 

I would get so pissed that I would love to see a hailstorm of fire coming down on the PBM CEOs. I would get so mad at them. What is your goal now? 

I want change.I'm angry. Absolutely. I'm angry. I'm angry. It's more sad than anger. It's just when it's really hot outside. And I walk out and I know that there are just other parents of children who are getting their medications that way. Yeah.

Loretta Boesing: It's hard, but, um, it's not, you know, The sadness just motivates me.

And sometimes it may come across as angry. But really I'm very loving. It's just, I, I love people and you just don't hurt people. And on top of that, laws have to change and they have to be 

Mike Koelzer, Host: Laws

Loretta Boesing: Laws, rules.

Yeah. Get in trouble. Whenever I say laws to the board of pharmacy. So I gotta make sure I save rules,

Mike Koelzer, Host: But again, we talked about, there probably are laws being broken, misbranding and all that kind of stuff. It almost sounds like when somebody says rules, they want to pretend like it's, I'm just putting evil thoughts into them, but it's almost, when they say rules, they wanna pretend that it's not a law.

It's just a rule. It's like, no, it's, it's a law.

Loretta Boesing: Yeah, you need to [00:25:00] enforce it. Do your job, protect us. This is like the most important thing you do. All of, all of what they do is talking about medications, being, held in a way, the entire process, every process that the pharmacies do, has to be a certain way to protect the patients.

What if a patient doesn't even get their medications and you do nothing there for weeks, they don't get their medications and they do nothing. But,it's beyond that now. It's so much bigger because after I learned about the issues with the mill at the pharmacy, there was a corporate chain pharmacist that also started reaching out to me and, finding out that our pharmacy, our local pharmacies were closing well, I want what's best for my child. not just for today. So I get special treatment. Now we get to use our local pharmacy for Wesley's specialty meds, but, and with the board of pharmacy and inspector said, oh, you're probably gonna get special treatment now and set it in a way as if that would be enough, that would just walk away. And I would just be fine, but no, he's gonna be on these medications forever.

And now it's by that time, I had already connected with thousands of other patients through social media, that were having the same issues. and I couldn't stop there. no, you're not gonna do this anymore to patients and think you're gonna get by with it. And I don't care if I have to spend every day of my life fighting for it, it's going to stop.

And I hope that, you know, know, and I, I know I'm saying that, but I have to believe that in my heart. But like I said, I know that there are people that have been fighting this issue a long time before me just like the issues with chain pharmacy, they hit the spotlight because of COVID, but there are people that were fighting that so long before and,I hope that this isn't just a generation where, the issues are mentioned, they hit the news and then we just continue on business as usual, because these issues were brought to the board a long time ago, both of them and nothing was done.

So I hope that we're the generation that changes things and that we continue to encourage, the next generation of pharmacists and patients to, to advocate because these guys we're all pharmacists and patients, we're all being used just as a siphon for their profits.

It's not about care.

Mike Koelzer, Host: 

Maybe the boards have to be embarrassed somehow.

Loretta Boesing: Yeah. absolutely, I'll be speaking at the national association of boards of pharmacy meeting in Oklahoma city next month. And I absolutely will be speaking about the issues with the boards and, I will be trying to get as much media as I can there. And I hope that anyone listening would also do the same because it's important that the board is held accountable for their inaction in this issue.

And, if they're not able, whether it's because of corruption or whether it's because of,the issues just too large for them to handle, because maybe they don't have the staff or the people to handle them, then we need something else in place

to make sure patients are safe.

Mike Koelzer, Host: Loretta, if you go to the board and let's say you get all the boards listening to you, I wish that you could say, we need a change on this, we need to change. And then you just say, and Mike is pissed off because you charge him a thousand dollars, fine for those damn initials,

Loretta Boesing: I wish I could say too. I absolutely thought about an interesting ending like that. I wanna have an interesting, moment where maybe I can be a Karen just for a few seconds, I don't know if I'll get brave enough, but we'll

Mike Koelzer, Host: Lata of the people that contact you through social media or online and things like that. What percent? And guess if you need to, some of 'em people you don't know, but what percent is male versus female?

Loretta Boesing: When I look at the, website visits,

it's about, 60% female, 40% male

Mike Koelzer, Host: I want more than that, that doesn't seem shifted enough because arguably more women do the medicine part. I know my wife, if I'm at work, she's the one that's getting the antibiotic three times a day to the kids and that kind of stuff.

But 60, 40 seems a little weak. What I want, if I've got something I want to get done, I want a woman to do it. A pissed off woman. 

Loretta Boesing: I can tell you that, now the fighters I will say are mostly women are like the ones who are more willing to speak to the media.

Mike Koelzer, Host: That's what we need more, more 

pissed off women.

Loretta Boesing: I hate to say it, but yeah, usually they are very much,you mess with our children and that's another thing. The parents are usually more brave than just the individual person that gets the wrong medication, or that doesn't get their medication for days, it's usually the mom. that are just like, no, not my kid. You're not doing the same. And at first you come off like a Karen, because you are angry, you are hurt that someone is hurting your child. there's moms that have to see their children go days without their cancer treatment.

And it's just, [00:30:00] how do you do that? And not get angry, 

Mike Koelzer, Host: I don't know the definition of Karen, but I'm gonna say it right now. I'm gonna make it up. The definition of a Karen is someone who has an inordinate response, too high of a response. For not a big enough issue, right? they're going in at a 10 when the issue is a two, this is the opposite of that.

Here, you've got an issue. That's a 10, my child might die and. that should go up to 2, 5, 10. That should be a comparable thing. So I was joking about Karen. This has nothing to do with that because it's the flip of this, right?

This is an important issue that you can hardly ever do enough for this.

Loretta Boesing: No, I agree. And, when you see the patients in that situation, and here's a sad thing after they'll tell me this has happened. And then I say, Hey, will you share your story with the media? Will you file these complaints? They're too afraid to so many are too afraid to cuz they're afraid if they do they'll make their employer mad.

They'll lose their insurance. It's so messed

  1. we're not supposed to call the insurance up and complain about the PBMs and stuff, but we do sometimes. And once in a while, you'll get somebody who. Doesn't know, they're not supposed to talk to us and they'll say, okay, we're gonna do something about it the next day.

Mike Koelzer, Host: Okay, we're gonna do this. We're gonna talk to someone. and then they'll say, we'll call you back tomorrow and let you know the price difference. you got someone who you think is on your side. And then the last day they call and they say, we're not gonna do that. It was nice talking to you.

someone on the top told 'em to clamp it down and you don't know who's the mafia in this thing. You don't know who's got the tentacles where, whether it's your employer, the board, your boss, your insurance, you just don't know.

Loretta Boesing: Yeah. And I think that social media again helped me there because I think to me, being able to get that story out in the news right away with our local news, it helped, a little bit more with that fear because I'm like, okay, it's in the news now. Now if they fire to be another news


 if they retaliate, it's gonna be another news story and you better believe there will be, but it is a fear.

I mean, it's a there's fear of, for the longest time, I was afraid to even go outside because you're afraid like you, someone may try to come after you and kill you cuz you realize now that you're fighting against the wealthiest corporations in our nation, you're not fighting against just. The New York next door, you know, even if it's, this is, uh, a big deal, but we do need people that are brave enough to say, look, this is an injustice and someone has to risk it all and be willing to get out there and fight for it.

Mike Koelzer, Host: I had a guy once that we were in a little bit of a legal situation, I forget what exactly but I brought a baseball bed and put it under my bed. You just don't know you have this feeling and I,we don't have guns in the house just, we're not against them.

 I know usually more negatives come with a gun in your house than a positive sometime because the kids might get 'em or there might be a family argument, things like that. So for whatever reason, we don't have guns, but I did sleep with my baseball bat underneath my bed.

Is that what you do

Loretta Boesing: Just about, especially when I'm traveling out and about, you know, when I'm going to other states and I'm not sharing a room with anybody, Yeah, I've got my hairspray ready. you know, I dunno, curling iron, whatever you can find blocks the doors, it's scary.

I'll be honest with you. it's not that I don't realize the risk, it's that you gotta put your fears aside and you have to go out and fight for what's. Right. And if we don't start fighting for our local pharmacies and to be able to access them and safe access to medications, then what's gonna happen later on whenever your kid is even grown up and he needs an antibiotic or, everyone should know after the pandemic, just how important that pharmacies are to public health in general.

People think of the now, but you gotta think of the later, what's gonna happen next time.

If I don't fight this fight, Wesley ends up in the hospital and I have to see him in pain and suffering because I didn't fight this for him.


Loretta Boesing: The mail order pharmacies, I have them on record too, saying that they support what we're doing, keep doing it. you, they believe in local pharmacy access. They know that the rules and the guidelines that they're shipping these medications out, they're going by guidelines that aren't set.

Even recently on Facebook, PillPack pharmacists said you're blaming the pharmacist. We don't have any control or say over it. we have to do what the corporate corporation says. I'm like, know, I get it. I know you don't wanna risk it all and lose your job. And maybe you're not the one, but someone has to be able to say, wait a second, this isn't right.

And I just, I hope for more whistleblowers out of this, 

Mike Koelzer, Host: Loretta, the mail order companies saying that they are with you is kind of like hearing OJ Simpson standing up for women's rights.

Loretta Boesing: Yeah. Yeah. It's like, I think here's the issue. And it goes with the retail pharmacist too, the corporate retail pharmacist, they just feel so tied to the company's [00:35:00] policies. like I do believe that they know that what's happening is wrong. But they just feel so powerless and I believe it's happening right now as we speak there. These corporate pharmacies want these young pharmacists, so that way they can hurry up and get them trained to work themselves to death, train them to just be a policy man, just do your job.

You don't have time to ask questions. But,they, we really need the next generation pharmacist. We need someone inspiring them to be more than just the go through the corporate routine every day. You need to get out there and do more.

Mike Koelzer, Host: Yeah, the problem with mail or pharmacy is. It's such a behemoth it's such an integral part of who they are that they can even fathom changing.

Loretta Boesing: yeah. Yeah. That's a hard thing. So with Mo pharmacy, you do have, right now, it's really popular because a lot of people have found that the motor pharmacies have,because the insurance companies own the mill pharmacy. They can set the price at the mil or pharmacy at, zero to $30 where they can set the independent price, a hundred percent.

So if I'm gonna go use my pharmacy there for a while, it is gonna be a hundred percent of the cost. That is a major issue. but that's another issue that has to change. And that's why I do advocate also, to change that. And if I can never speak to legislators on that issue, I will.

And that's why, you know, one thing I do like to do is to connect with other advocates on this issue. So for example, I've connected with, Dan Schneider, the 

pharmacist I've connected with,just online through, some of the insulin for all advocates. the women from the pleading edge, the movie, about the issue with assure and,Johnson

Mike Koelzer, Host: I heard it, but I didn't see it. Yep.

Loretta Boesing: Yeah, those are the people that I try to connect with.

because they were they're, they're successful in what they're doing and I want to be successful in what I'm

doing.the hardest thing is realizing all these awesome, amazing advocates and connecting with them is just realizing what brought them there that made them such powerful advocates.

And it really is their passion and they either themselves or someone that they love were harmed by issues. but they're passionate, they're effective. They're getting the job done. And those are usually the people I'm like, okay, how did you do it?

And I'll be meeting with Dan Schneider inOklahoma next month.

And I'm sure that hopefully he'll have some tips for me. And I look forward to that because I am just starting out, and I, but I'm willing to, take help or, to get as much. Advice from the people that have been successful in this

Mike Koelzer, Host: I guess I'm kind of a pessimist. When I think about taking on the, the big people, but

without exception, every cause that has been turned over, whether it's, voting rights and, you know, uh , meat, packaging, and you know, all that stuff. I can't think of one that wasn't started grassroots.

Loretta Boesing: Yeah,

Mike Koelzer, Host: And as you were saying, you don't know where that path is, but if you put enough people out there and enough stories somebody breaks through, but you don't know who it is.

Loretta Boesing: Yeah, exactly. And that's why I feel we're at right now. We don't know where this change is going to take place. It may not be my story, but you know what, I'm going to use it and I'm gonna yell at it and we're gonna try our best. but absolutely look at how, like, whenever I started, when I reached out to the women, who are in the bleeding edge that they told me, they started the Facebook group.

And then before, I'm like, how long did it take for you to see change 10 years ago? It took them 10 years of hearing women's stories, just, suffering, just uniting together before they would see change. And of course the Netflix movie also really helped, you know, to raise awareness about the issue because that brought more public pressure and it taught the public.

These issues can be somewhat complex. So it is important that they're taught to the public in that way. And I, I hope in time that we need to tell this story about the patients harmed by milita pharmacy and in pharmacy deserts erupting

and losing access to our local pharmacies.


Mike Koelzer, Host: The problem with this situation is the PBMs have it great, because when you get somebody who's sick, they don't, a lot of times have the fight inside of them. They're sick. They're dealing with the hospital. They're dealing with family members. They're worried about insurance.

They're worried about their job and they're just thankful they have. They're thankful they have some medicine, they're thankful and that's like a person that doesn't usually fight. So it's an oddity that people like you switch that around and then have that fight in them.

It's [00:40:00] a great thing. But a lot of people. Don't have it because they're so downtrodden when they're sick and the family's sick.

Loretta Boesing: Yeah, for sure. That's an issue and it brings a sense of responsibility when you realize that you do have a voice to fight for them, you, it's like when I go outside and it's hot and I start thinking about, oh my goodness, I'm in Missouri. It's not even the hottest state, there's somebody's medications out there.

and I get that the patient's medications have been melted and sitting in their mailbox, capsules actually melted together. and you know that they're at risk and it's hard. It's a lot of responsibility. So, you know, if you have a voice, you

I just have to use it. The first time that I realized Wesley's medications were shipped like that, and I thought that it could have been an issue was in 2012, you know, I should have started then.

And I just, I hope more people won't wait until they learn about the issues and get involved.

Mike Koelzer, Host: Here's the thing. you don't think that a corporation would do something. So obvious, right under everybody's noses, you'd have to say to yourself, well, of course this is fine. that's a pharmacy that's run by pharmacists 

 There's a study where they have 10 people in a room and nine of them are actors. And then they ask everybody which line is longer on the Blackboard and the nine people pick the shorter one. And then the 10th person said, 

I must be wacky today and they picked the shorter one too. So when you're doing that with the medicine, everything's telling you that should be fine. And most people just don't question it. They think they're batty if they question it.

Loretta Boesing: Yeah, I know. And that's because you had the mill pharmacies, if you call them, they'll say, oh, it should be okay. You know, it didn't get over 104, you know, but they ignore that whatever temperature the mailbox got, they're really good and trained really well about how, the way to kind of ease patient's concerns.

And even though deep down after you question them enough, they know what's wrong, but, they just know it's not regulated, but 

 You're right. there's that issue. And then you also have, on, on, on a larger scale that you have Melwood pharmacies responding. We ship medications safely.

You know, I look at the most recent news articles. There was one news article recently that said the delivery trucks actually take our medications and they bring them inside during the night. And so that way they're not left on the trucks all day there's so much, so much that PMA and the PDMs put out, like for the delays, they'll say, oh,most medications are delivered on time.

 just like they did 20 years ago. So you look back 20 years ago, you look at the articles and they say, oh, where are you getting that news from? We've delivered millions of these medications and everything was fine. they don't tell the story that there's many. Of complaints of delays and no one's adequately tracking, there is some tracking of it, but we need more, there needs to be more tracking, more accountability, just to help protect patients.

Because right now it's just our stories against theirs. And like, you, you hit on the point that, you know, it's a lot of patients are afraid to, or they just don't know because it's really hard to believe that something like this is left unregulated. 

Mike Koelzer, Host: Let's say that there are some pharmacists listening to this, and let's say that we might have three minutes of their attention after they get out of the car. After listening to this, what could they do in those three minutes? That's gonna be the most helpful for you. 

Loretta Boesing: They could share any patient stories that they can, you know, know, try to get patients to share their stories absolutely follow me on Twitter. We need them to also be vocal, even if they have to anonymously talk about the issues. They can sign the change, and petition to stop the four mills at the pharmacy.

And then we also have a Facebook page issues with mill water, pharmacy that you can follow there, I post all issues with mill water pharmacies with PBMs, with corporate pharmacies. So it's just a mixture of everything just to keep everyone updated on the latest news and what's happening and just get involved, you know, and any suggestions that you have.

I, I wish I could say that I knew

everything, but I'm still learning. 

Mike Koelzer, Host: Loretta boy, I'm sad to hear your story. But I'm thankful that you've raised this up to do something about it. And my hope is that we all move in the right direction to make some changes on this.

Loretta Boesing: Yeah, I really hope so too. I hope that people will realize that this is not gonna take just me or my story. Again, it's gonna take all this working together. We need pharmacists, patients, doctors, nurses, just everybody coming together to really try to put some pressure, you know, to get this issue changed.

 It's just so overwhelming again, to have their support and thank you so much for having me.

Mike Koelzer, Host: All right, Loretta, we'll talk again soon.

Loretta Boesing: Thank [00:45:00] you