Written prescriptions-the original copy

Re: Written prescriptions-the original copy

Bob Russell — Mon, 27 Feb 2012 15:10:28 GMT

Our security copy-proof paper arrived today. I just need to test drive it by fax! All our prescriptions will confirm they are on no-copy paper and prescriptions showing the words copy are not valid!

Just need to work out how to phrase it!

Re: Written prescriptions-the original copy

Clive Ansell — Sat, 25 Feb 2012 11:41:38 GMT

Martin's idea is the best. Why don't we lower drug prices as much as we reasonably can, and charge a realistic prescription fee such as the £36 my GP charges. or at least charge a consult fee for time. I've seen practices charging as little as £1.50 - ludicrous!

Re: Written prescriptions-the original copy

Julian Earl — Sat, 25 Feb 2012 11:23:46 GMT

[quote user="Michael Woodhouse"]

Nicola - not sure I agree about the 'prescription' food issue. Firstly it's not a prescription 'medicine' in any way shape or form. Might be a good idea if all old cats went onto kidney food! Can't think of a case where it would be especially harmful. Might cock up a food trial I suppose.

[/quote]

It doesn't matter whether they require a prescription at all; it matters that a client with a cat wetting the carpet might choose to buy a urinary diet instead of a renal diet, or vice versa, without any veterinary investigation.

Re: Written prescriptions-the original copy

Bob Russell — Sat, 25 Feb 2012 11:11:37 GMT

They no longer seem to be described as Prescription Diets on any of the bags but are Veterinary Diets now!

Perhaps they should not be described as Veterinary Diets any longer as there is often little or no veterinary involvement. We sell very limited amounts of these diets especially with RC Dental large bags suggested price of £80!!

People have to be very well heeled or bonkers to pay this sort of price and the manufacturers seem more than happy for them to be sold by any means possible.

Re: Written prescriptions-the original copy

James Laidlaw — Sat, 25 Feb 2012 07:54:43 GMT

As far as I understand it the "prescription" diets aren't POM-V or on prescription at all. Just a really stupid misnomer. So they can sell them wherever they like. Although I did have a client move to the USA and ask if I could send her a prescription to buy kd in the USA...?! I told her to register with a vet there and haven heard back since.

Re: Written prescriptions-the original copy

Michael Woodhouse — Fri, 24 Feb 2012 23:41:38 GMT

Cat - I agree with you that it is madness that they don't require the original prescription. That is a HUGE flaw in the system.

How are people dealing with those that want prescriptions? We would charge them a reasonable fee for it and in the past have done 'deals' with specific clients. Usually a special price just for them more than the internet price but less than the internet price plus the prescription fee. When we do it we get a different brand to totally differentiate it from our usual stock. So far we have kept the business every time without ever refusing to issue a prescription.

Re: Written prescriptions-the original copy

nikki — Fri, 24 Feb 2012 23:21:41 GMT

At least that pharmacy ask for a script at all. I get so many people coming in who are buying Advocate and all sorts from online pharmacies who dont ask for scripts - they have no idea it's illegal and are just trying to find the cheapest solution. I normally ask for the website details and report to the VMD but seems when they're based outside the UK there's not a lot they can do. Regulation of the UK ones should be possible though - at the moment they seem to be able to do what they like! And why on earth prescription diets are freely available on the internet is beyond me - surely the people who make them can control who they get sold to? Why aren't they only sold to the main veterinary wholesalers? The whole thing is a huge shambles. Definitely agree with writing letters to whoever might publish them - behind you 110%!

Re: Written prescriptions-the original copy

plantagenet — Fri, 24 Feb 2012 22:22:41 GMT

[quote user="Catherine Hemingway"]Another point raised was that they have clients who say that the medicines haven't arrived in the post. They send out another supply and technically they shouldn't but there is no system in place to monitor this and who's to say they haven't got lost in the post. They did try sending medicines by recorded/signed for delivery but again lost business as no one else was so clients didn't like spending the extra on postage.[/quote]

By that token, I could go and get a prescription from boots, say I dropped it and go back for another- they would tell me where to go, which is what the internet pharmacies should do, might get clients coming back to us for meds!

I am 100% with you - write to the VR and Vet times and hopefully colleagues will give you support.

Re: Written prescriptions-the original copy

Rob Loxley — Fri, 24 Feb 2012 22:20:13 GMT

Yes it seems crazy they never need to possess the original.

It seems pressure on the VMD is needed - we may be thankful that the VMRs get annually reviewed!

As for now the solutions seem to be - write a prescription valid for a short amount of time. Not sure if things allow for us to demand that we fax or send the prescription off to the pharmacy?

Re: Written prescriptions-the original copy

Catherine Hemingway — Fri, 24 Feb 2012 21:06:16 GMT

Clive-this is exactly the idea we came up with today at work

An update on the situation. I have spent the week looking into the legislation behind written prescriptions and there is no rule anywhere stating that the person/company who supplies the prescription medicine has to have the original copy of the prescription. Faxes/emails are perfectly acceptable however it is good practice to request the original copy.

I spoke to the vet who runs/is in charge of the internet company in question today. They are a vet based site and not primarily a human site. I actually had a very interesting conversation with them. They said that they used to insist on having the original prescription posted to them before they would send the medicine out to the client. However as this isn't strictly essential according to legislation and other internet companies were happy to accept faxes/emails they were losing business by insisting on having the original posted to them. They agreed that the system is flawed as potentially the client could gain more medicine against the same prescription elsewhere however there is no legislation saying they have to do any more than they already are.

Another point raised was that they have clients who say that the medicines haven't arrived in the post. They send out another supply and technically they shouldn't but there is no system in place to monitor this and who's to say they haven't got lost in the post. They did try sending medicines by recorded/signed for delivery but again lost business as no one else was so clients didn't like spending the extra on postage.

I did raise the point about the 'special can't be copied paper'. I have confirmed that the prescription did say 'unauthorised copy' all over it on the email. They said that as it otherwise looked genuine. As they had accepted prescriptions from this client from our practice before, for the same medication they felt happy that the prescription was genuine.

The conclusions we have come to are

1-all prescriptions should be posted/faxed/emailed straight from the prescribing vet to the supplier and not given to the client at all

2-the original prescription should be the only copy allowed to be accepted

What do people think? For some reason I feel quite strongly about this and want to see the current rules change. I was thinking about writing into the Vet Record to start with, any other suggestions welcome.......

Re: Written prescriptions-the original copy

Julian Earl — Fri, 24 Feb 2012 17:46:47 GMT

[quote user="Bob Russell"]

We too write prescriptions once in a blue moon so it is not a big issue for us at present. We have far more concerns with owners buying 'veterinary' diets off the internet at prices close to what we pay. The clients are sometimes doing DIY diagnosis and declining supervision!

[/quote]

I'm concerned about them buying prescription diets from the internet at any price! The idea of owners self-diagnosing diabetes or kidney disease or dietary insensitivity etc. fills me with exasperation.

Re: Written prescriptions-the original copy

Bob Russell — Fri, 24 Feb 2012 17:41:08 GMT

Re: Written prescriptions-the original copy

Clive Ansell — Fri, 24 Feb 2012 17:27:14 GMT

Could we not have a system where the client is not given a written prescription, and that it is emailed/posted/faxed to the provider of their choice?

Alternatively, just include a valid until date from the date of writing, and specify no repeats

Re: Written prescriptions-the original copy

Martin Atkinson — Fri, 24 Feb 2012 17:23:35 GMT

[quote user="Bob Russell"]This is precisely why the present systems operated by some of the Internet drug suppliers are deeply flawed! They are interested in clients paying as little in prescription charges as possible because it is the only way they can supply POM-V drugs at a cost favorable to the client.[/quote]

Which is why we try to work the system in our favour. I have yet to write a prescription for anything. I have a prohibitively high prescription fee and will reduce my mark-up to 30% on POM's if clients buy their medication in 3 month lots. In virtually all cases this means they pay little more that they would getting their drugs from a pharmacy and nearly all want to work with me this way so we both benefit. And they'd have to come back for a 3 month check in any case. Those that want a prescription and are not prepared to pay me a premium for it are the ones who are going to nit-pick over everything and are poor value clients so quite frankly they can go somewhere else if they don't like my charges. That after all is the spirit of free enterprise and fair trading the government wanted to promote isn't it?

Re: Written prescriptions-the original copy

Bob Russell — Fri, 24 Feb 2012 15:53:47 GMT

[quote user="Tanya Fielding"]

if the original is retained by the client there is nothing to stop them getting several prescriptions from different pharmacies.

[/quote]

This is precisely why the present systems operated by some of the Internet drug suppliers are deeply flawed! They are interested in clients paying as little in prescription charges as possible because it is the only way they can supply POM-V drugs at a cost favorable to the client.

It was such a shame that the VMD felt unable to introduce proper controls as are required by human on-line pharmacies.

The originals should be in the possession of the supplier.They should either return the original one marked cancelled to the prescribing vet or at least send a fax/emailed copy marked cancelled so the prescribing vet can make sure no abuse of the system is taking place. It makes a mockery of all the controls on veterinary medicines!

Re: Written prescriptions-the original copy

Tanya Fielding — Fri, 24 Feb 2012 15:42:04 GMT

if the original is retained by the client there is nothing to stop them getting several prescriptions from different pharmacies.

Re: Written prescriptions-the original copy

Catherine Hemingway — Fri, 24 Feb 2012 11:53:33 GMT

We used to use Securelinx copy protection paper but it's no longer made so will be swapping over to SecuDoc now.

I'm more concerned about our patients' health. For example say you started a cat on NSAIDs and supplied a prescription for a months worth and then asked the client to come back to check bloods for CRF/liver. If the client still has the original prescription they could obtain more than a months supply. Hence potential for a cat in CRF having long term NSAIDs which wouldn't be appropriate and I'm sure we'd get the blame somehow grrrrrr

Re: Written prescriptions-the original copy

Bob Russell — Fri, 24 Feb 2012 11:03:32 GMT

Found Secudoc on ebay!!

Re: Written prescriptions-the original copy

Bob Russell — Fri, 24 Feb 2012 10:59:36 GMT

Why would an on-line veterinary pharmacy be that interested in rules?

A human-linked pharmacy such as Chemist-Direct are regulated by the General Pharmaceutical Council. Veterinary 'pharmacies' have managed to avoid proper regulation and its costs.

Unless this behaviour is reported to the VMD no action is going to be taken.

Most of these sites are run by vets therefore the profession has to self-police! Ha! Ha!

Report to the VMD or GPC as appropriate. I suspect sod all will be done but you have done your bit to keep the system secure, they have flouted theirs.

I too would be interested in this 'no copy' paper!

Re: Written prescriptions-the original copy

plantagenet — Fri, 24 Feb 2012 10:27:56 GMT

It sounds like whatever precaution we take, the internet pharmacies will do what they like and the VMD will do nothing.

Somewhere in the system there vets working for these pharmacies - can they be held to account?

Re: Written prescriptions-the original copy

Mike Martin — Fri, 24 Feb 2012 09:25:43 GMT

[quote user="Julian Earl"]but aren't they only valid for six months from the original date?[/quote]

Why not add something to say this prescrip is only valid from 10 days from the signed date. That's plenty of time to fill it? Why does it need to be 6 months?

Re: Written prescriptions-the original copy

Julian Earl — Thu, 23 Feb 2012 22:31:12 GMT

We only supply prescriptions with the wording, " Only valid if signed over a practice label" and duly stick on a dispensing label to sign over and on to the prescription itself. Without a stuck on label, the prescription should not be accepted. It wouldn't stop a prescription being returned to the client of course, but aren't they only valid for six months from the original date?

Re: Written prescriptions-the original copy

Laurence Webb — Thu, 23 Feb 2012 22:21:52 GMT

No, although I am interested to know about the paper that can't be copied. Where do you get that from?