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  News from the Maryland Veterinary Medical Association                                                    Winter 2011

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Choosing an Online Pharmacy

by Elizabeth DeLomba, DVM, MBA

For years, clients purchased prescription drugs and other products from their veterinary clinic. There was no price shopping, no “market pricing”: they trusted us to be fair, and their trust was not unfounded. Now with price comparisons only as far away as their laptops or smart phones, clients are more informed than ever about the availability and pricing of medications. Pet owners are constantly being bombarded with advertising for “cheap” online drugs. This method of drug distribution is new and has brought a new level of visibility to veterinary drug pricing. However, clients really don’t know what other aspects of pharmacy to look out for when they are shopping online for drugs.

Currently home prescription delivery accounts for less than 5% of veterinary pharmacy purchases. However, home delivery grew over 50% every year from 2001 through 2008. The number of prescriptions delivered to clients’ homes is estimated to rise to about 20% within 10 years. This is just an estimate, but the trend is clear. People like the convenience of having medications and diets delivered to their homes.

As a result, veterinarians are being confronted with faxes, calls and clients who want to purchase products from sources other than the clinic. Veterinarians and staff need to have knowledge about the alternative pharmacies that their clients may choose to use. State pharmacy boards consistently reiterate that clients do have the freedom to make their own decisions. As veterinarians we do have the responsibility to provide our clients with facts so that they can make an informed decision. Veterinarians and staff are the advocates for the patient’s health. By fully informing pet owners you are educating them and building trust. Many clients just look for the cheapest price, but price alone is a poor criterion for pharmacy selection. Fortunately, there are a few key factors that you can use to help your clients make the best decision possible.

First, it is always useful to have an unbiased resource to reference for clients. An excellent one out there is the FDA publication for consumers about selecting an online veterinary pharmacy. It is called Purchasing Pet Drugs Online: Buyer Beware. This article addresses the pitfalls of buying online and outlines a few key points to look for when choosing an online pharmacy. Their bottom line recommendations are to choose a pharmacy that has Vet-VIPPS accreditation or select an outsourced home delivery pharmacy that is associated with the veterinarian. Many Veterinarians are unfamiliar with Vet-VIPPS certification. Vet-VIPPS stands for Veterinary-Verified Internet Pharmacy Practice Sites. This accreditation is awarded by the National Association of Boards of Pharmacy (NABP) after an extensive examination of the pharmacy’s policies and procedures as well as a comprehensive physical inspection.

Is Vet-VIPPS important to you and your clients? It should be. This certification is an independent confirmation that a pharmacy is upholding the highest standards for consumer protection. It was designed to equip veterinary clinics and pet owners with the means to identify online pharmacies that are properly licensed and comply with state and local laws and regulations. Vet-VIPPS accreditation helps you and your client know that the pharmacy they are dealing with is legitimate. More information about this important pharmacy credential is available at this NABP link.

One thing that is not addressed in the Vet-VIPPS accreditation process is the veterinary supply chain of the drug product. There are no laws that restrict sourcing of non-controlled veterinary prescription drugs to a closed distribution system. As a result we may see products offered by online pharmacies that did not purchase them directly from the manufacturer or from an authorized distributor. The easiest way to determine if the product is sourced from the manufacturer is to ask the pharmacy if the manufacturer guarantees the product. A manufacturer’s guarantee is different from the guarantee that most direct-to-consumer pharmacies may offer.

When a direct-to-consumer pharmacy dispenses a given manufacturer’s drug that was purchased outside the manufacturer’s authorized distribution channel, uncertainties may arise concerning the product’s safety, purity and effectiveness. Veterinary drug manufacturers sell their products to their authorized licensed distributors, licensed pharmacies and to veterinarians. Using these legitimate, authorized channels the manufacturers are assured that their products are being handled properly to ensure intended effectiveness. When a pharmacy purchases a drug from a source other than the manufacturer or authorized distributor, the drug is considered to be distributed in the “gray” market.

Gray market medications may be subject to adverse handling and storage conditions and become ineffective as a result. Since manufacturers don’t know how their products are handled and distributed in the gray market channel, manufacturers will not offer their standard guarantees on the products. This leaves the pet owner and pet vulnerable. The gray market channel can even allow entry of counterfeit drugs. Filling prescriptions with pharmacies that only purchase drugs from manufacturers or their authorized distributors will virtually eliminate this possibility.

There is another benefit in filling prescriptions with a pharmacy that has a direct purchasing relationship with veterinary drug manufacturers. When a manufacturer must recall a drug, such authorized pharmacies will be promptly notified of the recall, enabling them to expeditiously contact the clients who received the recalled drug. You hear about large recalls that make national news, but smaller recalls of a single lot of medication also occur. If the pharmacy purchased the drug from the gray market that is subsequently recalled, the pharmacy may not receive any recall notice. A veterinarian that contacted a major online pharmacy one week after one of the smaller recalls was announced learned that the pharmacy was completely unaware of the recall event. This lack of awareness may result in medication failure and patient illness.

With the growth in online pharmacy, many veterinarians are choosing to augment their pharmacies with their own home delivery strategy. This makes sense because it allows the veterinarian to control and monitor treatment recommendations. There are a number of good choices for vet-sponsored home delivery available. In all cases these pharmacies allow you to set your prices and choose which products you would like to offer to your clients. Home delivery services vary in product selections and customer service options. Some require that you bill your clients directly while others have you open an internet merchant account. The internet merchant account permits the third party pharmacy to bill clients on your behalf and ensures that the financial transaction is not viewed as unethical. In all cases, this is a way for the veterinarian to offer more value to the client and satisfy their desire for a home delivery option.

Advising your pet owners about pharmacy purchases takes a few minutes and gives you the opportunity to show them that you care about their pets’ health and well being. Home delivery of veterinary pharmaceuticals is likely here to stay. Veterinarians must be informed and help their clients make the best possible decisions about their pets’ care.

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Important Links from this article

Sidebar: AVMA Guidelines on Internet Pharmacies

Purchasing Pet Drugs Online: Buyer Beware

Vet-VIPPS Accreditation

© 2011 Maryland Veterinary Medical Association

Annapolis, MD 21403 • (410) 931-3332 • fax (410) 931-2060 •