Drug Wars: Is the Fairness to Pet Owners Act Truly Fair?
How much do you pay for those drugs your pets need? Whether it’s dog- or cat-specific insulin for her diabetes, pills to keep those pesky bugs at bay or her really expensive arthritis medication… it’s pricey!
I feel your pain. My household teems with six chronically sick dogs whose medical problems were too much for their owners. (Yeah, that’s how vets end up adopting animals). And a rotating crop of rescued cats raises the roof on my drug bills — big time! Other people must feel the pain, too. Why else would lawmakers step in to ensure pet owners get access to the best deals out there?
It's All About a Written Prescription
Here’s the scoop: Last February, Rep. Jim Matheson reintroduced the so-called Fairness to Pet Owners Act (H.R. 4023). The proposed law would require that every veterinarian provide a written prescription for every drug prescribed, whether the client asks for one or not.
Historically, pet owners have purchased animal drugs and products at their veterinary hospitals. Got an itch, an infection or a parasite to fend off? No need to waste your time running off to a pharmacy — we have just the drug for you! It’s conveniently accessible in our in-house pharmacy.
We carry the drugs because, in the past, human pharmacies never bothered to stock veterinary products. Why would they? Not only were old-school pet drugs none too profitable, human pharmacists were not trained in the science of animal drugs and their effects on our patients.
But fast-forward to the 21st century, and now every human pharmacy and big-box pet retailer wants in on the action. The fact that pets are viewed as family members like never before means pet owners are willing to pay way more for drugs and products than they did in years past.
Even behemoth human drug retailers like Walmart, Costco, Walgreens and CVS (among others) want their slice of that juicy pie. They’re offering pet drugs, too — to pad their bottom lines. And the truth is, their entry into the pet marketplace is a good thing for you, the pet-owning consumer — pricewise, anyway. But that doesn't mean your veterinarian is happy about it. Why? Because it's not always in your pet's best interest.
Possible Safety Issues
As I mentioned, your average pharmacist is not trained in animal drugs. Managing the possibility of serious drug interactions, being alert to mislabeling and potential overdosage issues (when interpreting handwriting, for example) and keeping up on inactive ingredients of which to steer clear (toxic xylitol elixirs come to mind) means that your veterinarian is still probably your best bet for prescription safety — especially if you have older pets who get lots of mixed meds.
But let's be honest: For many pet drugs (including preventive meds, such as heartworm tablets), purchasing from human pharmacies isn't usually a serious safety concern. Moreover, plenty of pet-only Internet pharmacies are ready and willing to sell you drugs more cheaply — with fewer safety-based problems than human pharmacies might offer. They’re even certified in the animal arena (unlike the Walgreens of the world).
How Veterinarians Keep Other Costs Low
There’s another issue, however: When you buy drugs somewhere besides your veterinary hospital, it means veterinarians take in less money. It impacts how we pay for our lights, our phones, our staffs and our workers' compensation insurance (among other niceties you may never pause to consider). And since we compete with other veterinary hospitals on surgery, exam fees and X-rays (for example), we struggle to keep prices on these items low. In fact, the markup on all that other stuff (drugs and products) is what has historically kept our practices in the black.
In other words, drug sales subsidize our medical services. You pay less for a spay because we make up for it with profits from selling flea drugs.
That is why some vets have decided to resist change — even if it means they have to do so "kicking and screaming," as more than a few have exclaimed. Many veterinarians have taken that attitude even further: They’ll outright refuse to write you a prescription.
For the record, that is a practice that the American Veterinary Medical Association (AVMA) has deemed unethical and one that I personally abhor. And that is where the Fairness to Pet Owners Act comes in. If it passes this time around, the law would alter veterinary business as usual in a few key ways.
The Letter of the Law
According to the AVMA, "[This law] will cause undue regulatory and administrative burdens on small business veterinary practices and could potentially raise the costs for pet care." What's more, "H.R. 4023 would require a veterinarian to provide a copy of each prescription for a companion animal, whether or not requested by the pet owner."
Additionally, a veterinarian may not "require the client to purchase an animal drug at the clinic for which the veterinarian has written a prescription; charge a client a fee for writing a prescription as part of (or in addition to) the fee for the examination and evaluation of a pet; or, require a client to sign, or supply a client with, a waiver or liability disclaimer should the prescription be inaccurately filled by an off-site pharmacy."
That's lots of stipulations, right? Although I absolutely agree with the intent of the legislation — to keep drug prices reasonable for pet owners — I have a lot of problems with the proposed law.
The bill doesn’t merely call on vets to offer a choice; it requires us to provide a paper trail for our recommendation. So what am I supposed to do? Write a physical script and then void it when my client chooses to get it filled with me?
Plus, when you consider that veterinarians like me already take steps to make drugs as cheap as Internet pharmacies (when feasible) and always offer clients written prescriptions when requested as part of their policy, it doesn't seem fair. Basically, I'm already providing the consumer-friendly benefits intended with the law, but now this legislation would make me waste more time with administrative tasks, when I could be spending that time with my patients.
With all the competition from Internet pharamacis and big-box retailers, our in-house pharmacy is hardly the profit center it once was. Not to mention that I have to pay to keep meds stocked at all times for instant availability in the event of acute illness. Those factors contribute to making this bill wholly unpalatable.
You’d be hard-pressed to find a veterinarian more receptive that I am, in principle, to this kind of pro-consumer change, but this law places undue burdens on veterinarians. But then, a proposed law like this one would not be necessary if a small subset of veterinarians hadn't been so unwilling to do the right thing in the first place by offering consumers a choice in where they buy their drugs.
So, what do you think? Is this legislation unfair to veterinarians? Is it necessary for you, the pet owner? Give me your opinion below.