Who thinks this is a good idea?

Filed under: @ 7:13 am

HR 1406 is currently under the consideration of the Congressional & House Energy and Commerce Committee.

Sponsored by Utah Representative Jim Matheson The Fairness to Pet Owners Act involves regulating veterinary pharmaceuticals.
In essence, the bill as written states that, when prescribing medications for pets, veterinarians have to write a prescription for said medications even if the pet owner wishes to have the prescription filled at their veterinarian’s office.
Means that all pet owners have the ability to take advantage of the lower prices that the bigger human pharmacies can provide. Means that veterinary practices lose the income generated by their pharmacies, but it also means that veterinarians will have lower overhead (less stock in house), lower staff costs (don’t need so many people if prescriptions don’t have to be filled), and we can spend more of our time focusing on our patients.

All very well and good except for a couple of remarkably glaring things that are wrong, wrong, wrongity wrong.

1. The time I gain in not filling prescriptions for my patients will be taken up, and then some, writing scripts for the medications that my patients will need. To say nothing of the amount of money that I’ll have to spend getting the numbers of watermarked, non-reproducible prescription pads that this law will require me to have.

2. A good percentage (I can’t remember exact numbers at this immediate moment) of people with written prescriptions from their physicians don’t fill them with medications for themselves. I have enough problems with client and patient compliance with my medication recommendations already. I DON’T need my clients have to make another stop to have their pet’s meds filled.

3. Even if the client has medications filled for their pet AT THE VETERINARY OFFICE, we’d still be required to write a prescription. Um…. Doesn’t that mean that the client can have twice the amount of medication they’d need? If I fill a prescription for Xanax for separation anxiety for a patient and then the client goes off and gets the written prescription filled at the local drugstore…..

4. This is a biggie.
Pharmacy schools don’t teach anything, ANY! THING! about veterinary pharmacology. Human pharmacists are prone to wild disbelief when presented with prescriptions for something as simple as a thyroid supplement. An adult human (180-250 pounds) takes 0.15mg of thyroid supplement once daily. A 60 pound dog takes 0.6mg of thyroid supplement twice a day.
Cats die if you give them tylenol. Veterinarians are acutely aware of which narcotic analgesic products contain tylenol.
Xylitol in human liquid medications, the differences in metabolism of nonsteroidal anti-inflammatory drugs in cats and dogs as compared to humans. The differences in metabolism of insulin in cats versus people. Antibiotics in rodents and rabbits. Horses and effervescence.
I don’t know one single veterinarian, and through my online contacts I know a LOT of veterinarians in a LOT of different countries, who doesn’t have at least one story about a patient getting the wrong medications, getting the wrong dose, or getting the wrong information about drug interactions from human pharmacies. Mostly due to ignorance on the part of the pharmacist or misinterpretation of prescription instructions based on their knowledge of human medications and human prescriptions. It’s innocent in many cases, but it’s deadly nonetheless.

Veterinarians have the appropriate knowledge base for safely medicating their patients. If pharmacy schools want to add another year or two of classes to their curriculum I’d be pleased to let the human pharmacists take over that part of my job. Until they do I don’t trust that the majority of human pharmacies are going to dispense the proper medications for my patients.
I’m not qualified to make recommendations and distribute information about medications for people. How is it that having a human pharmacist making recommendations and distributing information about medications for my patients is an okay thing?

And this brings us to
5. The way the bill is currently written, the veterinarian is liable if the wrong medication is dispensed or if the medication is incorrectly labeled.
What? I’m liable for the dispensing errors of someone that I don’t employ in a pharmacy that isn’t on my property? How does that make sense?

6. Rep. Matheson has sponsored the bill, but the bill was written in part by Wal Mart and 1-800-PET-MEDS. I’ve said my say about Wal Mart previously, but Pet Meds (known to those of us in the biz as PME) is one I’ve failed to comment on until now. PME purchases a lot of their drugs from grey markets. The pedigree of much of their medication (the paper trail between the manufacturer and the dispensary) can’t be traced. The drugs are less expensive, sure, but when you get drugs from PME you might be getting the drug your pet needs, or it could be baking soda attractively packaged in a grubby backyard in central America.

A lot of veterinarians won’t work with PME. I don’t. If I get a fax from PME with a prescription request from a client I’ll write a prescription for the medication (if the medication is needed and safe for the pet, that is). Where the client gets it filled is their business, but I always aim people to online or brick and mortar pharmacies that I trust. I know veterinarians who match prices for medications purchased from PME, even though they’re probably doing it at a loss, just so that they know that their patients are getting trustworthy medications.

I don’t know any veterinarian who won’t write a prescription for client to fill at a human pharmacy, regardless of the human pharmacy, so long as it’s a medication that the human pharmacies carry. What would be the point of refusing such a request?

The official position of the American Veterinary Medical Association can be found here. They’re a little less vitriolic than I am, but they have to be since they’re the political voice of veterinarians in the U.S. Me, I can rant as much as I like.

So the bill as it stands is foolish, a waste of time, dangerous, and serves only the interests of mega pharmacies who are currently starting to carry veterinary specific medications anyway. Would y’all please write your representatives?
And if you’re feeling especially prickly, fax Rep. Matheson a photocopy of your butt will you?

3 Responses to “Who thinks this is a good idea?”

  1. Kathryn Barcus Says:

    Hey! This is really scary! I hardly trust human pharmacies to dispense medications for humans, let alone for species about which they have had no education. I have had many mistakes perpetrated upon me by innocent, uneducated pharmacists and their assistants ranging from the wrong quantity of a medicine, to the wrong dose to the wrong medication. How can I trust anyone not educated in veterinary pharmacy to understand prescriptions aimed at my cats?

    This seems like a bid by big business pharmacies to squeeze out yet another iota of money from an unsuspecting public.

    Let’s quash this one if we can!

  2. Kathryn Barcus Says:

    In addition, as a printer I know the cost of the prescription security paper required in this state to print any valid prescription, human or not. Many human doctors are allowed to bypass that by faxing or emailing prescriptions to pharmacies. Will veterinarians be allowed to do this? And if they are will it take more or less time to do than by simply filling the prescription in their own offices?

    It seems like some people aren’t thinking of the health of the non human creatures we choose to be guardians of as much as they are thinking of lining their pockets by adding another step to caring for these creatures

  3. Valerie Says:

    Righteous rant, Margaret! All very good points. I remember getting Prozac prescribed for my bald kitty in the hopes that the baldness was anxiety or depression related, and the vet apologizing for not having any stock left in-house and writing a scrip for the pharmacy. She very carefully told me that when she phoned it in, she would make it clear it was for my cat and not me. Then I had to bring the pills back to the office so they could crush them and mix with tuna oil or a special liquid vitamin supplement purportedly extra tasty to cats. Will the human pharmacies take the time/effort for that extra prep? Your typical Walmart, Safeway, Target etc. pharmacy nowadays is a pill counting/box dispensing automat, very few alchemy skills required or expected. Now, there are other types of pharmacies like in hospitals and specialized clinics where those alchemy skills are crucial. My mother, for instance, used to have a special eczema treatment that required the pharmacist to grind tablets with an old fashioned mortar and pestle then carefully place them in a special mineral oil suspension that my mother applies with a dropper. Sounds old-fashioned, but at the time (ten years ago) it was a cutting edge new treatment. She could no longer find a pharmacy who will do that special decoction for her, so she had to move on to other less successful treatments. (Where’s Professor Snape when you need him?)

    Oh, and my bald kitty–she of the prozac decoction? Didn’t help. We never did figure out the bald thing either. She finally passed after eighteen increasingly crochety and hairless years.

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