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My vet refuses to provide a prescription

Horse Care
#81

[QUOTE=chaltagor;2259705]
Grrrrr.

BECAUSE HUMAN DOCTORS DON’T CARRY THOSE MEDICATIONS!!! [/QUOTE]

Yes, I fully understand this. Doctors write a script and send their patients off to the pharmacy. Vets, on the other hand, cannot do this as a matter of everyday routine because your animal usually needs the medicine NOW – so where are you going to go with your prescription? There aren’t multiple animal pharmacies in every town the way there are people pharmacies. So you buy the medications from your vet.

If you only need a little of the drug, you just buy it and are done with it. It’s the medications that are needed long term (meaning you need a lot of it), or the ones that are super expensive to begin with (before any “mark up”) that are, I think, what most of us are talking about here.

As an example, my small animal vet charged me $ 2.00 for each Doxcycline pill when one of my dogs got Ehrlichia. Okay, fine, wasn’t such a big deal at the time, my dog wasn’t going to be on it forever. However, my dog had a relapse and needed to be on Doxy long term. I still bought the meds from my vet because, quite frankly, it wasn’t going to be a million dollars and I had not idea just how much I was being overcharged. I later looked up what I could have bought the pills for (with a prescription) I was amazed. The highest amount I could have purchased them for from reputable pharmacies was 14 cents per pill. Quite a difference from the $2.00 per pill that my vet charged me. The vet’s mark up was 286%! PER PILL.

That’s why people do not want to, and cannot afford to pay the vet’s prices for medications, and why there are so many complaints. A reasonable mark up would be fine but not 286%. (And this is only one example!)

Therein lies the problem. People don’t mind a vet making a living but come on……

#82

Many years ago I formerly worked for a major pharma firm that had distribution channels for human and veterinary meds.

At that time the labeling for some equivalent veterinary drugs was usually different, although they were made on the same production lines and to the same standards [the company wouldn’t dirty a clean-room between runs just because the mandated standard was slightly less].

There was one guy in the Midwest who for some reason was both a DVM and an MD. His rep said that the guy would use the much less expensive veterinary versions of injectable penicillin in his medical practice, and that if you walked into a (human) exam room, the multi-dose vials clearly labeled as veterinary were sitting there with the other routine meds. This was illegal – the doc could have been reprimanded or lost his (human) medical license – and because of the pricing, worked against the interests of the company, but for obvious reasons the rep had little choice but to say nothing.

But even for identical meds, there were various price schedules for various classes of clients irrespective of volumes, so that even quantity pricing was different by client class. Unless they had negotiated a contract, retail pharmacies didn’t get prices as good as hospitals, and nobody got prices as good as those given to the federal government for, say, VA hospitals. (Drug wholesalers were totally managed at the corporate level and while there was one in my area and I think they got rock-bottom prices, I never had direct access to that.) Veterinarians for identical things had much lower prices (even in smaller quantities) than the retail pharmacies. Anyway, I’m not surprised that you got a big discount and still paid more at a retail pharmacy than you pay buying for your veterinary practice.

#83

Pet Medication Margins

[QUOTE=Claddagh;2259791]
As an example, my small animal vet charged me $ 2.00 for each Doxcycline pill when one of my dogs got Ehrlichia. The highest amount I could have purchased them for from reputable pharmacies was 14 cents per pill. Quite a difference from the $2.00 per pill that my vet charged me. The vet’s mark up was 286%! PER PILL.

That’s why people do not want to, and cannot afford to pay the vet’s prices for medications, and why there are so many complaints. A reasonable mark up would be fine but not 286%. (And this is only one example!)

Therein lies the problem. People don’t mind a vet making a living but come on……[/QUOTE]

I agree that 286% mark-up is excessive but I don’t think this was the vet’s mark-up. I own a veterinary pharmacy and we buy medications from veterinary wholesalers and human wholesalers. In the case of Doxycycline we are talking about a human medication. Veterinarians typically only have accounts with veterinary wholesalers and buy all of their medications through this channel. In the case of Doxycycline (and many other traditionally human drugs), the veterinary wholesalers buys these medications from a human wholesaler such as Cardinal. This adds an additional link in the supply chain and another mark-up. To further inflate the price paid by the veterinarian Cardinal does not have particularly good pricing for generic human medications such as Doxy- you are much better off going to a generic specialist such as Anda or VIP for this type of medication. The net result is that the veterinarian probably pays many times what a human pharmacy pays for this medication because of the structure of the supply chain.

Most veterinarians are paid substantially less than human doctors. In general veterinarians under charge for their services and over charge for medications and supplies. One way or another veterinarians need to make a profit to stay in business. If you feel prescription fees, medications, and supplies are too expensive (I would probably agree with you) but in most cases those same practices under charge for spay and neuter surgery, office visits etc. I guess the point is that as a veterinary client you can’t have your cake and eat it too- you can’t expect the benefits of low priced office visits and surgery AND complain about price-gouging for medications, prescription fees, and supplies.

FYI- in some states veterinarians are required to write prescriptions for clients with a valid veterinary/client/patient relationship. Here is a link to a list of every state and their policy for writing prescriptions-
http://members.verizon.net/~vze2r6qt/supplies/legal.htm

As far as I know, no state has a stance on prescription fees or veterinary mark-ups.

Ian Hudgings
Vet Pet Solutions
(303) 320-6034

#84

Thanks for the info…

Just as an update. I took my horse to Cornell. When they learned that I could get the Adequan for $13 cheaper a vial they happily wrote the script with for 7 vials with 5 refills! :smiley:

1 Like
#85

I don’t get this ‘tradition’ of acting as vet and pharmacist, all in one and charging you up the ying yang for a piece of paper with their signature on it to buy the meds someplace else.

Apparently, that signature does carry some value. :wink:

#86

I gripe a lot about heartworm preventative being prescription only and so expensive when dispensed by vets around here. There’s a new one out that is only $5 a month for the 50-100 pounds AND includes tapeworm medicine. My vet neither carries it nor will prescribe it, but he will happily dispense the ones that cost twice as much. Since I have many dogs, this really is irritating.

I knew an MD who would write his own heartworm scripts for his dogs and send them off to a vet supply house. Those scripts got filled.

Is there any reason an MD couldn’t write a prescription for his/her own adequan?

#87

Any day I can get into my doctor’s office for what I pay to take my small AND large animals TO the vet, or even better, have the doctor come to ME for a farm visit fee, they can supply me with all the meds they would like and/or charge me for writing the scrip. When I was without insurance, going to the MD was a major expense for me.

Apples and oranges.

Personally, I do not begrudge vets the cost of meds. I breed Chihuahuas, and I could get all my prescription meds (heartworm, for example) through any number of mail order places, but by the time I pay for shipping, it’s not that different. Their care is excellent, they know my dogs, and I like that. I like that they know me, too. As a self-employed person, I like to get paid and paid well for the services I render. Vets shouldn’t be any different. (MDs either, FWIW, I just objected to the comparison.)

#88

You know, that thought occurred to me also. I can do without TS (or whatever) in order to properly care for my horse. They come first. Always.

#89

The worlds best vet

I think I have the worlds best vet. (NW Vet, Stanwood, WA). Not only will he give me a perscription, but he will advise me when/where I can save money on drugs. He’s more than happy to sell them to me, but he really is a part of my business and looks out for me at the same time.

Mel

#90

You might be interested to know that in this country vets are ethically and professionally bound NOT to write a prescription unless they have examined the animal and checked and recorded its details and the details of the medication prescribed in its passport.

Therefore here an owner can’t go in and say “do this”.

This code of conduct protects the horse from use of inappropriate or incorrect use of pharmaceuticals.

Likewise here owners can’t do intravenous injection at all - can do intramuscular or intradermis though.

#91

[QUOTE=vineyridge;2355822]
I gripe a lot about heartworm preventative being prescription only and so expensive when dispensed by vets around here. There’s a new one out that is only $5 a month for the 50-100 pounds AND includes tapeworm medicine. My vet neither carries it nor will prescribe it, but he will happily dispense the ones that cost twice as much. Since I have many dogs, this really is irritating.[/QUOTE]

If you can’t afford to take care of your pets, you have too many pets. Did you ever stop to think that maybe there was a reason your vet doesn’t want you to use the $5/month product?

[QUOTE=vineyridge;2355822]I knew an MD who would write his own heartworm scripts for his dogs and send them off to a vet supply house. Those scripts got filled.

Is there any reason an MD couldn’t write a prescription for his/her own adequan?[/QUOTE]

Um, vets aren’t allowed to write scripts for humans, not even for themselves. So NO, a human doctor should not be able to write scripts for animals and have them honored. Different training, different license. This is just another example of the stupidity of the PetMeds pharmacies.

#92

I have written my own Adequan prescriptions, if only for ease of logistics. Never had a problem getting them filled. I still consult my vet for appropriateness of diagnostics. I have also gotten big bottles of human TMP/SMZ for use in my horses. It’s just easier. Again, my vet is certainly “in the loop”. If it’s beyond my comfort level, I wouldn’t do it. Antibiotics and Adequan are not outside my comfort level.

Likewise here owners can’t do intravenous injection at all

Thomas, I’d be curious to know how on earth this gets “policed” or enforced?

#93

[QUOTE=deltawave;2356293]

Thomas, I’d be curious to know how on earth this gets “policed” or enforced?[/QUOTE] Controlled rather than enforced…

Because you can’t get the products to do it without a prescription obtained from a vet and the vet has to authorise administration on the equine passport. Here if you just ring a vet and say “I must have x for my horse” he’d say “get lost” or “I’ll be right there” or if he has already treated the horse and its a repeat prescription he’d say “come in with your passport and collect it”. If you’re asking for something that is intravenous you get the first response.

If a vet intends to administer, prescribe or dispense any substance or medicine to a horse then he has to be shown the horse’s passport.

The vet is obligated by law to check that he’s satisfied the passport supplied relates to the horse in question

Passports contain all the horse’s unique identifiers on

The enforcement means that you can be asked to show your passport at any time by a DEFRA inspector. They’re required when you move a horse too. You are committing a criminal offence if, for instance, you sell your horse without a valid passport, or transport it without one and liable to be fined for this failure to comply with the Passport Regulations.

#94

Not unlike restricting non-farriers from purchasing farriery supplies, by requiring a farrier license number in order to place an order. Restraint of trade and income-protection, in the name of ‘protection’. Just as with the OP whose vet clearly is self-protecting his income, unfortunately for him, this less restrictive country makes that more difficult.

#95

Well with something like ACE or Banamine, which can be given IM or IV, that would be a difficult thing to enforce. I have both products in my “vet box” and both were provided by my vet for emergency use. Not saying the “system” here vs. the UK is wrong or right, but those 2 medications in particular are very widespread in tack rooms everywhere–I imagine in the UK, too.

#96

[QUOTE=Lookout;2356430]
Restraint of trade and income-protection, in the name of ‘protection’. .[/QUOTE]
That is of course one way of looking at it, but its a perverted view and bears no semblence to truth.

In fact the UK Farriery Registration Act came into force:

to prevent and avoid suffering by and cruelty to horses arising from the shoeing of horses by unskilled persons

To promote the proper shoeing of horses

To promote and regulate a high standard of training of professional farriers

To prohibit the shoeing of horses by unqualified persons and for the purposes connected therewith

To provide for legal sanction to report to a governing body to criminally prosecute and fine anyone who is unskilled who is providing such a service

Having seen what is happening on this posting, its my opinion that some owners and many horses there would be better off with such protection.

http://www.chronicleforums.com/Forum/showthread.php?t=71423&page=45

Horse owners, the general public and professionally trained competent farriers have nothing to fear from such legislation. Such as minimally trained BUA’s and self-proclaimed ‘trimmers’ that have attended spurious short courses though would be out on their ears. So Lookout, you aint got a chance of working at what you do there over here. Indeed and as you know Strasserites have been successfully prosecuted here for causing pain and suffering.

#97

[QUOTE=deltawave;2356436]
but those 2 medications in particular are very widespread in tack rooms everywhere–I imagine in the UK, too.[/QUOTE] Genuinely no where near the same or as widely used here.

#98

What do you keep in your tack room for colic? Genuine question–I always feel better if I have SOMETHING on hand.

#99

[QUOTE=deltawave;2356436]
Well with something like ACE or Banamine, which can be given IM or IV, that would be a difficult thing to enforce. I have both products in my “vet box” and both were provided by my vet for emergency use. Not saying the “system” here vs. the UK is wrong or right, but those 2 medications in particular are very widespread in tack rooms everywhere–I imagine in the UK, too.[/QUOTE]

Banamine and Ace are “staples” for me too (especially the Banamine). If you are an experienced horse owner, capable of assessing a situation where a horse is in distress, than you want to have these medications on hand. I always have them in my medicine cabinet. When the current bottle expires, I get a new one (even if the old one has never even been used - which is actually a good thing! :winkgrin: ). I just can’t imagine not having these medications available in an emergency.

If one of my horses needs a shot of Banamine, they need it now. Both my vet and I want the medication adminsitered immediately if it is needed. By the time my vet drives to my farm might be too late (we’re talking at least a half hour drive, barring the fact that he just might be on another call even further away).

#100

Yeah, you’ve memorized the mantra well. Don’t forget:

To ensure the old boys’ club stays intact, turf is protected, and nothing is changed from the Middle Ages to modern times. To ensure owners don’t have a right to choose for themselves what they want for themselves and their horses. Yeah well, new countries have been started to get out from the oppressive grip of such practices.
The flames of ‘protection’ hysteria are fanned by those protecting their self interests above all else, because as we know people are so stupid they need legislation protecting them from every possible thing.

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