Cold-chain shipping
Cold-chain shipping is the temperature-controlled packaging and transport of medications that must stay refrigerated — such as compounded GLP-1 injectables and many peptides — from the pharmacy to the patient’s door.
- Required for refrigerated injectables
- Expedited carriers and validated packaging
- Ship early in the week
- Delivery exceptions drive support volume
Why telehealth programs live and die on it
Most of the compounded products DTC programs ship — semaglutide, tirzepatide, many peptides, some hormone preparations — are refrigerated injectables. If the product spends too long above its temperature range in transit, it may lose potency, and the pharmacy has to replace it. Delivery exceptions are the single largest patient-support driver in a GLP-1 program.
How pharmacies do it
Insulated shippers with gel or ice packs sized to the transit time; expedited carriers (overnight or two-day); ship days chosen to avoid weekend dwell in a warehouse — typically Monday through Wednesday; temperature indicators in higher-risk lanes; and a replacement policy for excursions.
- Insulated packaging validated for the lane’s transit time
- Overnight or two-day carrier service
- Ship-day rules to avoid weekend holds
- Tracking attached to the order and surfaced to the patient
What the program should build
Proactive tracking and exception messaging. A patient who is told “your shipment was delayed by weather; the pharmacy is reshipping” before they notice is a retained patient. A patient who discovers a warm box is a support ticket and often a cancellation.
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
Which telehealth medications require cold-chain shipping?
Refrigerated injectables — compounded GLP-1s, many peptides, some hormone and fertility products — and any preparation whose stability data requires refrigeration.
What happens if a cold-chain shipment is delayed?
Pharmacies generally assess the excursion against the product’s stability data and reship if the product may have been compromised. Programs should surface the delay to the patient before the box arrives.
Who pays for a replacement shipment?
Usually the pharmacy or the carrier, depending on the cause, under terms set in the pharmacy agreement. Programs should confirm the replacement policy before the first order.