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I think you'd want to make very sure you have good refrigeration on the boat. And then plan your route so that perhaps every 30 days, you know that you will be in a port where resupply will be available. Give yourself a considerable safety margin for resupply, and check in each of those locations to find out if you can get meds locally, what that will entail (sometimes you'll need a local doctor and local rx) and what your options are to simply have meds shipped to you by air express. That can get complicated but if the meds can't be shipped at ambient temperature, maybe your pharmacy can pack them in coolers, or use iced (CO2) shipping that carriers provide.

In some places like Pitcairn, insulin might simply not be stocked since there is a small population and if no one needs one carries it. Plan some routes, check in the ports you'll be in.

And go over the choice of meds with your doc, find out which have the best "shelf" stability, and perhaps consider changing meds if necessary, to use the one that gives you the best shelf/shipping options.

Its "just" a matter of logistics.
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