How we source.

Where a medicine comes from is the most important fact about it. A correctly-labeled, correctly-stored unit of a specialty biologic and a visually-identical unit obtained outside the authorized supply chain can be worlds apart in authenticity, potency, and safety, and the difference is often invisible to the patient receiving it. Our sourcing posture exists to make that distinction a non-question for every family and every prescriber we work with. This page explains precisely how we operate.

DSCSA-serialized US specialty supply

Every therapy we coordinate enters our pipeline through licensed US specialty wholesalers operating under the Drug Supply Chain Security Act. Our primary specialty distributors are McKesson Specialty, Cencora Specialty (formerly AmerisourceBergen Specialty), and Cardinal Health Specialty. Each of those channels is serialized at the package level, each transaction carries the transaction history, transaction information, and transaction statement that DSCSA requires, and every unit that enters our dispensing queue can be traced from the original manufacturer lot to the patient who receives it. If a serial number on a unit we have received does not verify against the manufacturer's records, that unit never moves out of quarantine.

Dispensed through Altima Care

Reserve Meds is a brand operated by Altima Care, a US-licensed specialty wholesaler. Dispensing is performed by Altima Care under the supervision of a pharmacist-in-charge who is personally licensed in the dispensing state. A US-licensed human pharmacist reviews every prescription before it ships. The pharmacy level is not a formality for us; it is the legally responsible party, and the accountability sits with the pharmacist-in-charge. Families and prescribers who ask to speak with the pharmacist-in-charge can do so; contact the consultation desk and we will route the request.

What we do not do

We do not purchase from parallel-import channels. Parallel imports move already-marketed product between authorized markets, and although many such channels are legitimate in Europe, the practice creates chain-of-custody gaps that are incompatible with the traceability standard we operate to. We do not buy from internet pharmacies, from unlicensed brokers, or from secondary wholesalers whose provenance we cannot independently verify. We do not accept reimported product, including product that was exported from the US and is offered back to us at a price concession. And we do not fill an order with an alternative unit sourced outside our chain when the manufacturer-authorized unit is temporarily out of stock; we communicate the delay and work with the prescriber on pacing, or we decline the case.

Why this matters for physicians

A treating physician signing a prescription for a cross-border patient carries professional responsibility for the product the patient ultimately receives. When the chain of custody behind that product is US-authorized, DSCSA-serialized, and dispensed by a licensed US pharmacy, the physician has the same evidentiary floor under them that they would have for a patient in the United States. When the chain behind the product is gray-market or parallel-import, the physician does not have that floor, and the liability distribution changes materially. Our sourcing posture is designed to give prescribers outside the US the same confidence a US specialist would have when writing a script in their own hospital.

Why this matters for institutional buyers

Hospital pharmacies, hospital systems, and specialty clinics that receive product coordinated by us are receiving units whose provenance can be documented at every step. For institutional buyers operating under quality management systems, clinical research infrastructure, or accreditation frameworks that demand source-verified product, we are a supplier they can reconcile against their own SOPs. For institutional partners that perform a formal supplier qualification on us, we provide the documentation package required, including the wholesaler licenses, the DSCSA attestations, the pharmacy license, and the pharmacist-in-charge identification. See the enterprise section for how those arrangements typically work.

Documentation that travels with every unit

Every case ships with a documentation package that includes the prescription, the medical-necessity letter where the destination country requires one, the import-authorization documentation issued by the destination country's health authority, the manufacturer's product labeling, the cold-chain data log where applicable, and the DSCSA transaction records. The prescriber and the receiving institution receive that package at the same time the physical product arrives. Where a destination-country broker is handling customs clearance on our behalf, the broker receives the same documentation in parallel. The paper trail is continuous from manufacturer to patient, and the trail exists in electronic form as well for audit purposes.

What sourcing looks like in practice

When a case clears clinical and regulatory review, our case-coordination team places the order with the US-licensed specialty wholesaler best positioned to fill it, typically based on pack availability, cold-chain handling, and delivery timing. The wholesaler ships to Altima Care under a DSCSA-compliant transaction. Altima Care receives, verifies, and stages the unit for dispensing; the clinical reviewer performs the prescription review under US-licensed specialty pharmacy workflow and approves dispensing. The unit is packaged for international transport, with validated thermal packaging and embedded temperature logging where the product requires it, and picked up by our cold-chain freight partner. Customs clearance is handled by a licensed broker at destination, and the documentation package travels alongside. The unit arrives at the prescriber's specified receiving point, a hospital pharmacy or a treating specialist's clinic, and the receiving party confirms chain-of-custody integrity before dispensing to the patient. At every node, the unit has an accountable custodian.

Adverse events and pharmacovigilance

Authentic product in a clean chain of custody is the foundation of any meaningful pharmacovigilance program. If an adverse event is reported to us or to the treating physician, we can trace the unit back to lot, to wholesaler, and to manufacturer. Serious adverse events are reported to the FDA MedWatch program and, where relevant, to the manufacturer's global safety group and to the destination country's regulator. The quality of our pharmacovigilance is only as good as the quality of our sourcing, and that is another reason our sourcing posture is non-negotiable.

Reviewed 2026-04-22 by Reserve Meds’s AI clinical and regulatory review agents. Human pharmacist-in-charge: Altima Care. Next scheduled review: 2026-10-22.