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I found this interesting and would like to know your thoughts....
Recently the grocery store chain Kroger announced that they will stockand sell veterinary prescription drugs including heartworm prevention,flea control medications, and antibiotics. Online pharmacies advertiselow-priced prescription veterinary medications almost every time I turnon the television. 

How do vets feel about this? 

Before I go any further, let me introduce myself for those of you thatdon't know me. I'm the Irreverent Veterinarian. I speak my mind andgive you my honest opinion. I won't sweet-talk you or sugarcoat thetruth. I tell it like it is to everyone– you, the drug companies, the petproduct manufacturers, professional breeders ,and pet owners. Some might say that I'm truthful to a fault, and some people who read mycolumns get really angry. It is hard hearing the truth. 

To be honest, the online pharmacy and grocery store pharmacies issue is a tough one. Personally I'm torn. This iswhy. 

Contrary to what many people think, veterinarians don't have huge margins on their services. It's extremely expensiveto run a veterinary hospital or emergency vet clinic and the doctors certainly aren't making millions once the bills arepaid. Do veterinarians make money on medications? Yes, they do. Do they make a lot? No, they don't. But every bithelps. 

Price is usually the reason that owners choose to buy pet medications at discount chains. I can see how pet owner would want to get the lowest price possible on their pets medications. However, if you check with many vet clinics their prices are often very close to the online pharmacies. Many vets will even match the price. Getting the lowest price can be important – especially in this economy. 

One thing that you're getting when you buy medications from a vet is the knowledge that the medications have been properly sourced and stored. One thing I like about getting prescriptions from a vet is that the quality and safety is generally guaranteed unless something goes really wrong. The products come directly from the manufacturer or a legitimate distributor who can assure the quality of their product. They also are stored appropriately. I've seen inappropriately stored drugs (such as those in wet or high heat environments) actually inactivate and ruin the product. Unless you know how the medications should be stored it can be easy to ruin them. 

In general, I prefer for medications to come from a vet rather than the online pharmacies. There is a lot of controversy on the quality and quality control of online meds. I've read several reports of people ordering medications online and finding they are counterfeit. 

In fact –the FDA began an investigation into stopping sales of numerous counterfeit pet pesticides. The investigation covered many products from discount stores and online companies and included products such as Advantage and Frontline (two common flea control products). The report documented over 44,000 cases of harm to pets due to toxicity levels or inappropriate use of products sold over the counter rather than obtained from veterinary clinics. 

The packaging of counterfeit products can look nearly identical to the real thing– and it's generally printed with text and logos to appear as if it were an FDA approved product. Many of these products are made in India and China in facilities not under the same regulations as those in the US. This includes medications promoted as Canadian. 

In researching this topic I found out that 85% of "Canadian" drugs come from 27 countries around the world that have little or no regulation. China and India account for 70% of global pharmaceutical ingredient production and their safety and regulatory stands are described as "extremely poor." In 2011, Interpol collaborated with enforcement from almost 80 countries and identified a significant number of fake pharmacy websites as part of organized crime organizations. Wow – I personally had no idea. 

In summary , unless you know exactly where the medication is coming from, these products potentially pose a significant health risk to pets. 

According to the National Association of Boards of Pharmacy, 96% of web site pharmacies are illegal or in violation of FDA regulations. The drugs may be past their expiration dates, counterfeit, mislabeled, adulterated or contaminated. I actually talked to a man that worked at a company that relabels expired drugs – yes ,repackaging them with new expiration dates. This practice is highly illegal, dishonest, and honestly scary. 

My Final Thoughts on Online and Grocery Store Pharmacies

As a professional, I want the best for pets. Most vets carry the medications that are guaranteed to be safe and effective. Vets also ensure that you get the correct dose for the age and weight of your pet-especially important for senior, young, or small-breed pets. 

Many vets understand financial pressures and will frequently price-match their medications. Even if they don't, I really think the small premium you pay through your vet is worth it to ensure the quality and safety of a product. Remember: your pet's life could be at stake. 

Disclaimer

The Irreverent Vet is a columnist that regularly contributes to PetPlace.com. The goal is to add a balanced and alternative view of some controversial pet issues. As happens with all of us, veterinarians can't always say what they really think without offending some clients. This commentary allows vets to say what they think and give you, the pet owner, the opportunity to consider another point of view. All opinions are those of the Irreverent Vet and not the views of PetPlace.com and are not endorsed by PetPlace.com.


References:
http://www.fda.gov/Drugs/DrugSafety/ucm170594.htm 

http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedic...

http://today.msnbc.msn.com/id/44717398/ns/today-today_health/t/more...

http://www.foxnews.com/health/2011/09/29/pfizer-pharmacy-group-warn... 

http://www.guardian.co.uk/business/2011/sep/29/fake-drugs-seized-op... 

http://mobile.nation.co.ke/News/Experts+warn+of+rise+in+fake+medici... 

t-especially important for senior, young, or small-breed pets. 

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It's funny when you think about it that many of us, myself included, get medications from giant pharmacy benefit providers. These are often generic drugs from who knows where.  That said, I do order my dogs' medications on line from 1-800-Petmeds. To date I have had no problem with this. I liken vets selling food and medication to doctors selling medication. I think there is a greater tendency to prescribe something if you make a profit from it. I prefer to not have that connection for people or pets. I think big, well known pet prescription providers are at least as likely to check their sources as vets are.

Good point on the promoting certain meds. (just like their "good" food)

Well this IS very interesting. We only attempted once to buy Heartguard from an online pet catalog. They had to get the script from the Dr. and he held off because he new we had an appointment the next week. When he talked to us he asked why we were going to purchase it that way? The price of course with 2 dogs we have to watch prices on everything. He decided to match the price. I probably wouldn't ask him to do it again, I'm shocked they did it that time. The article is pretty on with the vet price being a few dollars more than the stores. However, we have been buying our Frontline Plus from Farm and Fleet or Menards because we can use a coupon most of the time. So now I'm freaked out that they are not the same?? I'll be following this post to find out more!

Thanks for the info!

Good points Caitlin.

Mail order rxs. are unfortunately the only reasonable way to go for many of us with insurance unfortunately. I hate even to see the small pharmacies closing and chains dominating. But I don't think there's a way to stop all of this.

Do the pet insurance companies not pay for Rx drugs if you get them through a human pharmacy?

The problem with this Caitlin and Mail order pharmacies are a darn bit cheaper than walk in pharmacies...I get a 3 month script of my med for 487.00 mail in....if I walk in I get 1 month for nearly the same price.

I too would prefer to speak, see, watch the Pharmacist get my meds together, unfortunately it in not financially possible.

All of this is the result of having a system of health care for profit.

I believe that there is a conflict of interest when vets sell Rx drugs. I am not alone in this, either. There have been numerous articles published about this, including one in The Bark magazine, and Marion Nestle PhD has also discussed it in her writings. I believe this is also being looked at by the FDA.

After all, your doctor doesn't sell you your prescription drugs. You get them from a pharmacy. This helps insure that the doctor is prescribing the drug that he/she feels will be the best one for your condition, and not the one that yields the highest profit. Everyone has bills to pay, and vets are not immune to being influenced by these issues. In their defense, your vet also doesn't sell as much of anything as the local CVS does, so perhaps they also pay more for an antibiotic, for example, and therefore have to sell it for a higher price.

Regardless of the remarks by the vet who wrote this article, I know now for a fact that the markup in a vet's office for most Rx drugs is much higher than it is at your local human pharmacy. Jackdoodle is now on three different generic drugs that are also used in humans, and his IMS has been phoning the prescriptions in to my local pharmacy. The cost of these human quality drugs has been half of what my regular vet had been charging me. And there is no fear of counterfeiting, either, at least I hope not, because these are the same pharmacies where I get my own medications.

Just today, a prescription was phoned in for JD to a compounding pharmacy, because the drug is available through vets only in a powdered form, which is bitter tasting and must be mixed with food. The pharmacy will make capsules for him.

I have had bad experiences ordering heartworm preventatives on-line and don't do it any more. In that case, I found the savings to be so small, it just wasn't worth it.

Many flea and tick meds, especially topicals, are available without prescription at pet supply stores, and these are also less expensive than the price charged at the vet.

However, my vet's office offers rebates, and other specials, such as buy 3 and get one free. This month, they have an offer of three free doses of Frontline, no purchase necessary.

So to sum up, I do think that there is a conflict of interest in vets selling drugs, I know that their markup is quite high, and there are also cheaper alternatives than either the vet or the on-line websites.  

Exactly the point I was making. I do think it is a conflict of interest. I was also incensed once at the $10 fee for dispensing a few pills, in addition to the cost of the medication, that I had to pay for Rex.

My vet actually charged me twice the retail price for a non-prescription shampoo once. His price was $26 for a 6 oz bottle, and I subsequently found the product on-line for $13.50. Even with shipping, that's a significant savings. Again, perhaps the vet pays more for it than the on-line company, but I have bills too.

My vet recently charged me almost $2 per tablet for 500 mg. metronidazole tablets. I just got them at CVS for $1 per tablet.

My vet also charged me a $9 "hazardous waste" charge to disposed of the syringe when JD got a B12 shot. The shot was also more expensive. Subsequently, JD got the shot at two specialists' offices. The difference in price was shocking:

Regular vet: $25 shot + $9 disposal = $34

First specialist (In same town as reg. vet): $18 shot + $2 disposal = $20

That right there really upset me; that's a 70% markup from the specialist's office to the regular's vet's office. I wonder if the fact that the specialist charges $150/hr has anything to do with that.

And then JD got his shot at the new specialist's office. $12 for the shot, and no disposal fee.

I know I've taken this discussion off-track a bit, but I think it's important for people to know this.

 

I have to pay several dollars each time the doodles have injections for disposal too. But I think it's $3-4 per dog. If you can try ordering some things from Amazon. I pay $79 per year for free two day shipping regardless of amount spent. Not all things are covered though. Still I find it a good buy.

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