The downside of cascade and the bin after a month rule

RE: The downside of cascade and the bin after a month rule

Clive Ansell — Wed, 03 Mar 2021 11:33:10 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228876#228876"]Or much easier to transfer it [sterilly of course...] to an empty new 10 or 20ml rubber capped container depending on rate of use>[/quote]

Guess so, equally as good

RE: The downside of cascade and the bin after a month rule

Anthony Todd — Wed, 03 Mar 2021 11:28:18 GMT

Or much easier to transfer it [sterilly of course...] to an empty new 10 or 20ml rubber capped container depending on rate of use>

RE: The downside of cascade and the bin after a month rule

Clive Ansell — Wed, 03 Mar 2021 11:08:23 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228874#228874"]

Clive Ansell said:
to absorb the financial loss

But there isn't any, iu's built into the cc ost, independent of usage!!

[/quote]

Ok, to prevent wastage then. Surely, if a product is unused and has to be discarded at 28 days there a financial consequence to that; in terms of lost product and cost of disposal.

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228874#228874"]

Clive Ansell said:
routinely rotate stock

Not practical, but why not decant some into smaller bottles depending on branch or clinic usage??

[/quote]

Why? for example, if an opened bottle of Cerenia (expensive) gets to 21 of its 28 days, and its clear will not be used, it could be transferred back to a busier main branch or hospital where it will be used. The group I mentioned above have their own vehicle and courier that visits all branches at least once daily. Would be fairly easy I would have thought?

RE: The downside of cascade and the bin after a month rule

Anthony Todd — Wed, 03 Mar 2021 10:19:36 GMT

But there isn't any, iu's built into the cc ost, independent of usage!!

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228873#228873"] routinely rotate stock [/quote]

Not practical, but why not decant some into smaller bottles depending on branch or clinic usage??

RE: The downside of cascade and the bin after a month rule

Clive Ansell — Wed, 03 Mar 2021 09:32:16 GMT

[quote userid="20115" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228851#228851"]The 28d rule is fine, but we need the opportunity to purchase smaller bottles so it’s feasible to get through it in the time scale set. [/quote]

Although I guess it is less of a problem in larger practices with many vets? one, more likely to use products within the timeframe; and two, more able to absorb the financial loss.

Do larger practices, and groups, with small and less busy branches, routinely rotate stock between the main usually busier main branches, so it is used within the 28 days?

A group I sometime locum for do not, and I can't understand why, given that courier travels between branches daily anyway ??

RE: The downside of cascade and the bin after a month rule

Rob Loxley — Tue, 02 Mar 2021 14:16:15 GMT

[quote userid="6550" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule"]We have just had to order a Vit B12 injection using a special import certificate because the only available product is from Italy[/quote]

Apart from oral cobalamin options (cobalplex) you could use Cytamen injections (handy 1ml single use vials)

RE: The downside of cascade and the bin after a month rule

Anthony Todd — Tue, 02 Mar 2021 10:48:28 GMT

[quote userid="5464" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228852#228852"]Problem with this (I've worked on this issue for pharma companies) - is that the cost to produce a smaller bottle is often either the same or higher, when you factor in the extra work involved in producing an extra line. [/quote]

Gosh, you are so right! Never thought of that!

I suppose the drug companies would still continue produce the unwanted, costly, unpreserved, smaller bottle because the odd vet thinks the added cost, waste and admin is such a necessary essential addition to practice admin!!

And, just think of the extra profit when you build in the total waste, cost of disposal and audit into the cost to the client.

It's a win, win,. win!!

RE: The downside of cascade and the bin after a month rule

David Bentley — Tue, 02 Mar 2021 09:25:40 GMT

The 28 day rule is not fine. How come the VMD allows the importation of Immunotherapy vaccines and Staphage Lysate, when it is bleeding obvious that the bottles are going to be used well beyond the 28 days (in the case of Artuvetrin 10 months!) There is absolutely no scientific basis for this rule and it should be fought!

RE: The downside of cascade and the bin after a month rule

Chris Geddes — Tue, 02 Mar 2021 09:23:07 GMT

[quote userid="27194" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228693#228693"]drug companies have to show that their product is still efficacious for a certain period of time[/quote]

They have to show that product is still safe, yes.

[quote userid="27194" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228693#228693"]they have zero incentive to go to the extra expense of testing for 28+ days[/quote]

Absolutely they do. It's not that expensive and it could give their product a USP over others in the market. Sometimes it's best for them not to kick a hornet's nest on an old product, sometimes they've done the tests and not got favourable results.

[quote userid="20115" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228851#228851"]but we need the opportunity to purchase smaller bottles so it’s feasible to get through it in the time scale set. [/quote]

Problem with this (I've worked on this issue for pharma companies) - is that the cost to produce a smaller bottle is often either the same or higher, when you factor in the extra work involved in producing an extra line.

RE: The downside of cascade and the bin after a month rule

Deborah Hope — Tue, 02 Mar 2021 08:47:17 GMT

The 28d rule is fine, but we need the opportunity to purchase smaller bottles so it’s feasible to get through it in the time scale set.

RE: The downside of cascade and the bin after a month rule

N Blakey — Sun, 21 Feb 2021 13:48:09 GMT

I could be wrong but I seem to remember that the drug companies have to show that their product is still efficacious for a certain period of time after broaching so they can be licensed. Even though many of the drugs remain effective after this time they have zero incentive to go to the extra expense of testing for 28+ days.

RE: The downside of cascade and the bin after a month rule

Beats — Fri, 19 Feb 2021 09:48:32 GMT

[quote userid="6297" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228637#228637"]We can order Cobalin-H ampoules from Centaur, 1000mcg/ml hydroxocobalamin, 1ml vials, packs of 5, list price £24.16 +VAT.[/quote]

Our last vit B12 bottle was Australian I think 100ml 6 month shelf-life at about £11 IIRC. no cost for SIC.

RE: The downside of cascade and the bin after a month rule

Thomas Johnson — Fri, 19 Feb 2021 08:53:25 GMT

We can order Cobalin-H ampoules from Centaur, 1000mcg/ml hydroxocobalamin, 1ml vials, packs of 5, list price £24.16 +VAT.

RE: The downside of cascade and the bin after a month rule

Eamon McAllister — Thu, 18 Feb 2021 12:40:50 GMT

I think that if anyone had been prosecuted and convicted he or she would have had to be disciplined by the RCVS. To my knowledge that hasn’t happened because no one has been prosecuted and the reason why there have been no prosecutions is that, if rigorously and robustly defended, any case would be thrown out of court thus setting a precedent.

We were told that Cascade Legislation was introduced because the EU demanded it. I never believed that story and always thought that it was introduced by the wealthy Pharmaceutical industry and their accomplices vigorously (£) lobbying parliamentarians over a period of years. However now that we are all Brexiteers we must be allowed to throw this Cascade Legislation on the bonfire of red tape and regulations.

RE: The downside of cascade and the bin after a month rule

Clive Ansell — Thu, 18 Feb 2021 12:01:22 GMT

Yep, all the way to the bank to deposit their loot!

The only way to challenge or change legislation is through the courts, and lobbying MP's, or getting the RCVS/BVA etc to do something useful and lobby on our behalf

RE: The downside of cascade and the bin after a month rule

Anthony Todd — Thu, 18 Feb 2021 09:09:49 GMT

And the drug companies smile!

Most PMSs should be able to match mls, sold, of any drug, with mls purchased.

The results might embarrass some?

As far as I recall the regs were EU drafted so may be revised as we a leaving the Common Market? They were just a copy and paste from the human regs anyway so it could be easy.

RE: The downside of cascade and the bin after a month rule

Clive Ansell — Thu, 18 Feb 2021 09:06:29 GMT

[quote userid="8182" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228617#228617"]Has anyone ever been prosecuted for breaching the Cascade regulations?[/quote]

Not that I know of, but I don't want to be the first so I stick to the rules.

RE: The downside of cascade and the bin after a month rule

Clive Ansell — Thu, 18 Feb 2021 09:04:25 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228618#228618"]Does anyone really think that human tablets licensed for humans are not safe when used in animals unless they,exactly the same tablets, have been "tested" and therefore licensed for veterinary use.[/quote]

All drugs for humans are of course tested extensively in animals, so the data must be there that shows they are safe and efficacious, or not.

RE: The downside of cascade and the bin after a month rule

Dinu Catilina — Wed, 17 Feb 2021 22:58:35 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228616#228616"]I don't disagree with the 28 day rule; if I was being injected with a drug, and I could choose between a brand new, sterile , unopened vial; or one that was opened 2 months ago - I know which I would choose.[/quote]

Yes Clive, but I'm sure there are so many other things that are considered normal in veterinary medicine you wouldn't want it done to yourself. Like having your anaesthetic monitored by a nurse who may or may not be qualified.

I don't think the 28 rule has a big effect on us except for the ketamine wasted but I do hate having to increase costs to the owner because we can't use a cheaper generic.

RE: The downside of cascade and the bin after a month rule

Anthony Todd — Wed, 17 Feb 2021 22:43:17 GMT

Both. Does anyone really think that human tablets licensed for humans are not safe when used in animals unless they,exactly the same tablets, have been "tested" and therefore licensed for veterinary use.

Does nobody realise that preservatives in multidose injectable containers were used without problems for years with "expiry dates " of up to 2 years.

RE: The downside of cascade and the bin after a month rule

Eamon McAllister — Wed, 17 Feb 2021 21:41:09 GMT

Has anyone ever been prosecuted for breaching the Cascade regulations?

RE: The downside of cascade and the bin after a month rule

Clive Ansell — Wed, 17 Feb 2021 20:01:30 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule/228612#228612"]

Just crazy, with no scientific or even anecdotal evidence whatsoever, massive extra waste but massive profit for the manufacturers!

And the entire profession, from the lowly locum or new-grad to the powers-that-be stayed absolutely silent!!

Not a word!

[/quote]

Do you mean the cascade regs in general, or just the 28 day throw away rule?

I don't disagree with the 28 day rule; if I was being injected with a drug, and I could choose between a brand new, sterile , unopened vial; or one that was opened 2 months ago - I know which I would choose.

Cascade regs, I think, should be challenged in the courts. BS that gets in the way, and restricts clinical freedom.

RE: The downside of cascade and the bin after a month rule

Anthony Todd — Wed, 17 Feb 2021 17:45:50 GMT

Just crazy, with no scientific or even anecdotal evidence whatsoever, massive extra waste but massive profit for the manufacturers!

And the entire profession, from the lowly locum or new-grad to the powers-that-be stayed absolutely silent!!

Not a word!

RE: The downside of cascade and the bin after a month rule

Bob Russell — Wed, 17 Feb 2021 15:45:45 GMT

Buggers at the wholesaler told us there was no alternative. Thanks for the information!

RE: The downside of cascade and the bin after a month rule

Michael Woodhouse — Wed, 17 Feb 2021 15:44:51 GMT

[quote userid="6550" url="~/001/veterinary-clinical/small-animal/medicine/f/discussions/29677/the-downside-of-cascade-and-the-bin-after-a-month-rule"]Also as an aside does anybody know why we are having to order our Eurican/Purevax vaccines as rep orders? Apparently one brand is not available??[/quote]

Something to do with coronavirus vaccine, but the rep was sketchy when asked!