Questions to ask your NPP operator

The problem this page addresses

Cross-border specialty-drug operators vary widely. Some are US-licensed specialty pharmacies with DSCSA-compliant wholesaler relationships; some are European re-exporters; some are informal brokers with opaque supply chains. From a patient or physician’s perspective — especially a first-time one — it is hard to distinguish a real operator from one that simply has a good-looking website. The cost of getting this wrong is counterfeit product, a cold-chain failure, or an import seizure.

Quality signals worth weighting

Signals that meaningfully reduce risk: a US state pharmacy license and a verifiable DEA/registration footprint; a named, reachable US-licensed pharmacist in charge; DSCSA-compliant wholesaler sourcing (Cardinal, McKesson, Cencora/AmerisourceBergen, or a licensed specialty wholesaler) with transaction documentation on request; named destination-country counsel or regulatory advisor; published cancellation and refund terms; published pricing structure (not just opaque quotes); a physical US address that matches state-board records; and willingness to let the patient’s physician talk directly with the pharmacist.

Signals that should slow you down

Red flags include: inability to produce a specific state pharmacy license on request; prices materially below every other quote without a clear explanation; pressure to prepay with no cancellation terms; sourcing claims that do not map to any DSCSA-registered wholesaler; reluctance to let the treating physician speak with a pharmacist; routing through jurisdictions that are not part of the declared supply chain; and marketing language that implies the operator can “get around” regulation in the destination country.

How to read a quote

A quote for a cross-border specialty shipment typically has four components: the drug acquisition cost (what the operator paid the wholesaler); the specialty-pharmacy dispensing fee; the international logistics cost (cold-chain packaging, carrier, customs broker); and the operator margin. A reputable operator will show you the structure even if they don’t disclose their acquisition cost exactly. If a quote is a single lump sum with no structure, that is itself a signal.

What we publish

Reserve Meds publishes its cancellation and refund standard on our ethics page, discloses our sourcing posture (DSCSA-compliant US specialty wholesalers) on every drug monograph, and names our US-licensed dispensing pharmacy (Altima Care) on the site footer. Patients and physicians are welcome to verify our state pharmacy license directly with the state board.

Further reading

See Questions to ask before ordering for a practical diligence checklist, and Counterfeit drug risk for the downside side of the equation.

Start a request

Start a request