It's not a small detail. Most biologics used to treat Crohn's disease need to be kept refrigerated throughout their entire journey – from storage at the pharmacy, through delivery, and into your fridge at home. A medication that's been exposed to the wrong temperature can look completely normal and still not work the way it should. And that's something a lot of general pharmacies aren't set up to reliably prevent.

We think patients deserve to know this and to know what questions to ask.

Why temperature matters for biologics

Biologics are a very different class of medication to traditional tablets or capsules. They're complex proteins, manufactured through biological processes, and they're sensitive to their environment in a way that most medications simply aren't.

Most biologics used for Crohn's, including commonly prescribed options like adalimumab and vedolizumab, need to be stored between 2°C and 8°C. Sustained exposure to temperatures outside that range (whether during transit, storage, or repeated temperature fluctuations) can begin to degrade the protein structure. The medication may still look identical in the syringe or pen. There's no way to tell by looking at it. But the therapeutic effect can be compromised.

Some biologics do allow a limited period at room temperature; adalimumab, for example, can be stored at up to 25°C for a short window. But that flexibility has limits, and it doesn't account for medications that have been repeatedly fluctuating in temperature during storage or transit.

What "cold chain" means in practice

Cold chain refers to the unbroken sequence of temperature-controlled handling from when a medication leaves the manufacturer to when it reaches you. Every step matters: how it's stored at the pharmacy, how it's packaged for delivery, how long it's in transit, and what happens if no one is home when it arrives.

A proper cold chain for biologic delivery means insulated packaging with validated temperature control, not just a gel ice pack thrown in a box. It means knowing the temperature has been maintained throughout the journey, not just at the start.

It also means having a clear plan for what happens when delivery doesn't go smoothly – because sometimes it doesn't.

Where things can go wrong

General pharmacies are built around volume and accessibility, which is exactly what most patients need. But specialty medications like biologics sit outside that model — the storage requirements, delivery protocols, and monitoring involved are a different category of service entirely. That’s what specialty pharmacies are for.

What to ask your pharmacy

If you're on a biologic for Crohn's and you're not sure how your pharmacy handles this, these are worth asking:

• • How is my medication stored before it's dispatched?
  • What packaging is used for delivery, and how is temperature maintained in transit?
  • What happens if I'm not home when it's delivered?
  • What should I do if I think my medication may have been exposed to incorrect temperatures?
  • How do I know if my medication is still safe to use?
  • A pharmacy that takes cold chain seriously will have clear answers to all of these. 

How Ace handles this

At Ace, cold-chain management isn't an add-on – it's built into how we operate. We use validated temperature-controlled packaging for every biologic delivery, and our team is trained to manage the specific storage requirements of the medications we dispense. If something doesn't go to plan with your delivery, we want to hear about it straight away so we can work out the right next step with you.

We understand that managing a condition like Crohn's is already a lot to navigate. Making sure your medication arrives safely and works the way it should is something we take seriously, because it's the foundation everything else is built on.

If you have questions about how your biologic is being managed, we're always happy to talk it through. Join Ace or reach out to our team directly.