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Veterinary care for our beloved pets is essential if they become unwell, and ensuring they receive the right medications is a crucial part of that care.
That said, many pet owners are frustrated with the skyrocketing cost of veterinary drugs, especially when the same medication for humans is often much cheaper.
These high drug costs, combined with the rising cost of “gold standard” care, can create a financial strain and even impact the ability to provide continuous care for pets.
But what many people don't realize is that veterinarians are bound by strict regulations that limit their ability to prescribe more affordable human drug alternatives.
These rules, known as the prescribing cascade, mean vets must follow a specific hierarchy when prescribing medications, prioritizing licensed veterinary medicines over cheaper human equivalents.
Ignoring these regulations can have severe repercussions for vets, including fines, suspension, or even losing their license.
It is crucial to understand the complexities and challenges vets face when prescribing medications and explore actionable steps that pet owners can take to ensure their pets receive necessary treatments without breaking the bank.
In this blog post, we'll uncover the hidden truths behind the inflated prices of veterinary drugs, the impact of the prescribing cascade, and five practical strategies you can take to get more affordable medications for your pets.
The Evolution of Veterinary Drugs
When I first started out in veterinary medicine, we more frequently used human medications for pets.
The options for pet-specific drugs were limited, so many of us relied on well-established human drugs, albeit often in less palatable forms for animals.
Fast forward to today, and pharmaceutical companies have jumped at the opportunity to repurpose these human medications into pet-friendly versions.
This might sound like a positive change, making it easier to administer drugs to our pets. They’ve made pills more palatable, smaller, and sometimes provided liquid versions. But there’s a catch—these adaptations often come with a tenfold increase in price or even more.
While the modern adaptations might make treatments slightly easier and less stressful for pets, the cost has become prohibitive for many when dealing with long-term conditions like heart failure, high blood pressure, and diabetes.
The Prescribing Cascade: A Vet's Legal Bind
And the solution is not as simple as your vet just choosing to use the human rather than pet version of whatever drug is needed.
In the UK, and in various countries with similar regulations, veterinarians have to abide by a strict framework known as the prescribing cascade. Introduced around 1995, this cascade outlines a sequential process for prescribing medications.
First Step: Use a veterinary medicine authorized in the UK for use in the same species and for the same condition.
Second Step: If there is no such product available, use a veterinary medicine authorized in the UK for use in another species or for a different condition in the same species.
Third Step: If there is still no suitable product, use a medicine authorized for human use
Fourth Step: As a last resort, use a medicine that has been specially prepared by a pharmacist, veterinary surgeon, or a person holding an appropriate manufacturing authorization
The significant point here is that veterinarians must follow this sequence. Skipping steps, even to use a cheaper human drug with the same active ingredient, is not allowed.
This was made even more stringent in 2005 when it was clarified that cost alone is not a valid reason to deviate from this cascade. Non-compliance could lead to severe penalties, including the revocation of a vet’s license.
Why Your Vet's Hands Are Tied on Drug Costs
Imagine your dog has heart failure and needs a drug like furosemide, which is available as cheap human generics. Despite knowing these human versions work just as well, your vet can't prescribe them. They must go with the licensed veterinary option, no matter how exorbitant its cost.
The legality of the prescribing cascade, along with new laws, means that even suggesting you buy human paracetamol (acetaminophen) from your local store could result in severe consequences for your vet, potentially even leading to jail time under the new legislation in the UK.
The legislative body in charge, like the Veterinary Medicines Directorate (VMD) in the UK, ensures strict compliance with these rules, even to the extent of limiting where veterinarians can source their drugs.
Ironically, this often means vets can't purchase medications at prices as low as what you might find at an online pharmacy. Nevertheless, it's the vets who bear the brunt of the blame for high drug costs.
Practical Ways to Save on Pet Medications
Understanding these constraints, there are still ways you can reduce the cost of your pet's medication.
Ask if there is a cheaper version of the same medication you could give instead - many drugs have generic versions produced by different manufacturers that may be cheaper, although often the cost difference is not that great
For long term medication, ask for as much to be dispensed as your vet is happy to give you - this will cut down on additional dispensing fees
Ask for a written prescription - there will be an additional cost for this but in most cases, the cost saving on the drug purchase will still make this a cheaper option.
Ask for the prescription to be for the active ingredient, rather than the trade name - this will allow you to shop around for the cheapest version available rather than being stuck with just one brand name option
If there is an over-the-counter human option then use that instead - just don’t expect your vet to get involved with any recommendations about this!
Navigating the Cost of Pet Healthcare
Navigating the intricacies of pet healthcare can be daunting, particularly when laboring under the weight of escalating medication costs.
While the laws governing the prescribing cascade were put in place to ensure the safe and effective treatment of your pets, they often contribute to the financial strain many pet owners face.
Understanding these laws can help you appreciate the constraints your vet operates under and can guide you to make more informed decisions.
This is just one way in which pet healthcare is broken. I discuss some of the others in this post.
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