Pharmacy Choices

Last week, we ran into a problem at the hospital. It brought right to the forefront a complicated, potentially upsetting dilemma faced by veterinarians and pet owners. I’ve carefully avoided preachy blog posts about the costs involved with pet medications. It’s a topic I can’t cover from an entirely fair position and I’ll admit that up front. I’ll do my best to stay objective.

Online pet pharmacies sell pet medications. They are usually cheaper than at the local vet hospital. Veterinary hospitals can’t purchase medications in enough quantity to be able to offer the prices that online pharmacies do. Some companies offer prices that, if we matched them, would cause the hospital to lose money on the sale. We simply can’t do this and stay in business.

Large retailers are now offering, and heavily advertising, pet medications as well. These prices are also lower than at most veterinary hospitals. Prices, again, may be due to buying in high volume, or a strategy to serve as a loss leader. We simply don’t know.

Lastly, some medications are human meds that we use in veterinary patients. Those are also sold by any human pharmacy. Sometimes those prices are lower than what we can offer. The reasons are the same as above.

At this point, it certainly seems like veterinarians and vet hospitals are crying over a loss of revenue. To some degree, that’s true. We’re having to find new ways to serve our clients fairly and well with the loss of revenue from some medications. I think that everyone understands our need to pay and educate our staff well, to have good equipment and supplies, and so on. All professions, all private businesses, all corporations, set out to make a living from their work.

So what’s the catch? There are several. I’m going to use heartworm prevention as an example. The manufacturers of heartworm prevention products generally sell their products directly to vets or through a licensed/approved distributor. The manufacturers tell us that they only sell this way, and that they don’t sell to online pharmacies or retail outlets. Somehow, the products end up at other retailers, though. There are only two plausible reasons: vets buy tons of product and sell it to other retailers, or the manufacturers are selling to retail outlets.

If the products are purchased by vets and sold to other retailers, that’s called diversion, or “gray market” sales. The manufacturer’s can’t safely say that their products were handled properly, stored in the proper conditions, or are free from tampering. As a result, the manufacturers won’t guarantee those products. You’ll have to deal with the retail outlet. And, of course, I’d hope that your veterinarian can help out. The trouble is, if your heartworm prevention doesn’t work the way it’s supposed to, your pet could be the one that suffers. Nobody wants that, not the vet, not the retail outlet, not the owner.

The situation that prompted this post occurred with one of our clients. They requested a written prescription for heartworm prevention for their cat. They took it to a local human pharmacy that was offering pet medications. The store didn’t have what we’d scripted in stock, and told the owner to see if the dog version would work just as well. Thankfully, the owner called and asked rather than just taking the medication home. It wouldn’t have harmed the cat, but the medication was different from the cat version — including an additional ingredient not in the cat product.

As far as I’m aware, human pharmacists and pharmacy staff do not often have any official training on veterinary medications. I’m hopeful that the retail chains offering pet medications will provide education and training for the staff there. If they haven’t, or they don’t, it’s far from an ideal situation. I’m not trying to say that pharmacists are bad people or that they don’t care. They’re probably just as uncomfortable with the situation as we are.

So what’s our take on the situation? We feel that the health and safety of your pet should be in the hands of properly trained professionals. Vets, vet techs, and even our reception staff have been trained to know which medications are the appropriate choices. They’re familiar with the products we carry. The manufacturers guarantee their products’ safety and effectiveness when you purchase through a vet hospital.

While I firmly believe that everyone involved in the practice of vet med and pharmacy has a desire to help keep pets healthy, the simple fact remains that your vet hospital is the best educated advocate for your pet’s well-being. I want all of our clients — and all pet owners — to make an informed choice.

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2 Comments

Filed under ethics, medication, medicine, practice, safety, training

2 responses to “Pharmacy Choices

  1. Sharon Trautsch

    I worked for a vet clinic and know the mark-up on medications. The mark-up is at least 2-3X what the clinics pay for them. I think if clinics dont want to lose money to online dealers, they should lower their prices. They will still make a ton of money on the meds

  2. My primary hope with the post was to encourage people to seek out the best care they can find, with well-trained professionals, rather than shopping on cost alone. Clients deserve to know the pros and cons of their choices as they enter the marketplace.

    It’s very true that markups may sound outrageous and greedy. What we have to consider is that the markup doesn’t directly translate to clear profit. Part of the costs of dispensing a medication are for the labor and overhead that are required. Vet techs deserve to be paid for their work, for example.

    A quick internet search found me a figure from a Seattle Times article on Starbucks coffee. The consumer pays $3.75 for a latte. Starbucks only gets 25 cents in clean profit. That may be an extreme example, but it’s probably not uncommon. The Q&A for the article series is here: http://seattletimes.com/html/shiftingfortunes/2002040236_qa_coffee19.html

    Veterinary hospitals are going to have to adapt to a far more competitive market, and that’s not all bad. I’d be more than happy to shift revenue away from the pharmacy. It takes up a lot of the staff’s time and efforts. Sometimes, though, clients don’t want to go somewhere else to pick up meds. Other clients prefer to have the manufacturer’s guarantee. In either case, we need to stock those medications for our clients.

    There’s definitely a balance to be found between competitive pricing, reasonable costs for the hospital and client, and the health and well being of the pet. I hope that owners and veterinary professionals are able to work cooperatively to improve the care pets receive.

    Thanks for sharing your comment and information. I’m always happy to enter an open, honest conversation with readers. 🙂

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