On-line pharmacies

Re: On-line pharmacies

James Laidlaw — Sat, 29 Sep 2012 14:50:56 GMT

Not like the VMD to make things unclear...! My real rant, which I've lost the energy to sustain now, was that ill dictate prescriptions and their length to my patients, and they shouldn't be amended or changed without some notification from whomever at the pharmacy chooses to. What's the point in putting our clinic contact details on the script for otherwise?

Re: On-line pharmacies

Michael Woodhouse — Sat, 29 Sep 2012 14:34:18 GMT

Dunno then!

Re: On-line pharmacies

James Laidlaw — Sat, 29 Sep 2012 14:31:14 GMT

'Repeat dispense' prescriptions (one or more prescriptions setting out doses to be supplied over a period of time, usually up to a year) {from your link 57 - paragraph 2}

Re: On-line pharmacies

Michael Woodhouse — Sat, 29 Sep 2012 14:18:27 GMT

[quote user="James Laidlaw"]How else could you authorise repeats for up to a year if it's invalid after 6?[/quote]

My reading is that you can't! Just like this pharmacy have told your dogs owners.

Re: On-line pharmacies

James Laidlaw — Sat, 29 Sep 2012 14:09:22 GMT

I do. They need to supply the prescription to the pharmacy within 6 months of signing. How else could you authorise repeats for up to a year if it's invalid after 6?

Re: On-line pharmacies

Michael Woodhouse — Sat, 29 Sep 2012 14:00:03 GMT

[quote user="James Laidlaw"]Pretty sure the prescription needs to be collected in 6 months, not that it cant be written for more than 6 months is what that means. We dictate the length of prescriptions. Some clinics 3 months, some 6, some in-between or longer. I'm not "in the wrong" as you'd care to label me.

[/quote]

BVA's medicine guide states

Prescriptions are valid for a maximum of 6 months from the date of signing

http://www.bva.co.uk/members/documents/BVA_Medicines_Guide.pdf

To me it implies a prescription ceases to be valid six months after it is signed.

I suppose if you want to prescribe a years supply then write it for 12 tubes now.

Re: On-line pharmacies

James Laidlaw — Sat, 29 Sep 2012 13:52:45 GMT

Pretty sure the prescription needs to be collected in 6 months, not that it cant be written for more than 6 months is what that means. We dictate the length of prescriptions. Some clinics 3 months, some 6, some in-between or longer. I'm not "in the wrong" as you labelled me. Start of paragraph 2 of section 57 if you cared to read on: 'Repeat dispense' prescriptions (one or more prescriptions setting out doses to be supplied over a period of time, usually up to a year)

Re: On-line pharmacies

Michael Woodhouse — Sat, 29 Sep 2012 13:41:56 GMT

[quote user="Bob Russell"]£50 per dog - 50 dogs = £2500 for one product. 50 products at give away prices = a lot of money that has to be made up elsewhere. A hefty hike in consultation prices required to make up the difference or major cost cutting including wage bill.[/quote]

And then they pick up a worming tablet too rather than adding a few Drontal to the internet order. And they mention a little problem to the receptionist who then books them an appointment etc. Even with no consultation the contact between the practice and client is ongoing.

[quote user="James Laidlaw"] Are we the ones dictating the drugs prescribed and frequency, amount dispensed and dose rate, or is some pleb (ooh, topical!) at an on-line company going to usurp our clinical judgement, without so much as calling to discuss out of courtesy.[/quote]

No James, it is you in the wrong. A prescription is only valid for a maximum period of six months and any authorised repeats would need to be in that period. To supply a years worth of treatment they would have to buy the 12 tubes at once or come back in 6 months for a second prescription.

VMD GN3: Prescriptions are valid for a maximum of 6 months from the date of signing

Point 57 in this document: http://www.vmd.defra.gov.uk/pdf/vmr11/VMGN03.pdf

I really don't care where I make my money - either from fees or drugs. It is what is left at the end of the year that matters to me. Personally I quite like the status quo where fees are on the surface more affordable and we make income from the drugs too. There is less of a barrier for the client coming to see you for a £20 consult cf a £30 one. We get people ringing up and asking what a consult costs, or a bitch spay or puppy vaccs. Unaware of anyone ever asking what ongoing Incurin or Metacam costs......

Re: On-line pharmacies

James Laidlaw — Sat, 29 Sep 2012 11:33:45 GMT

[quote user="Martin Atkinson"]I doubt the person who wants to save a couple of pounds on Advocate will be with us on this they will only complain more about higher charges.[/quote]

Another reason not to have to talk to them every 3 bl**dy months then!!!

Re: On-line pharmacies

James Laidlaw — Sat, 29 Sep 2012 11:32:33 GMT

Having worked in multiple UK practices over 7 years, I don't think the majority charge enough for their consult time, or extra when cases run over the allotted 10 minutes and cut so many corners on trying to keep costs down that I personally think, from my experience, this is where the biggest losses in veterinary businesses occur. Not on product sales or lack of.

How do you compete with on-line groups that sell product cheaper than you can buy it? Would you shop around for product prices? If you could get a script for your animals would you if it meant saving a few quid over the year?

I'm an employee correct - but I don't waste extended periods of time trying to encourage clients who have already found a source of cheaper product on-line that they should buy it from us - I'd struggle to convince them why. I don't go out of my way to advertise that there are cheaper sources of products and as I say, most people are happy to buy the medications we advise directly from us. Those that don't aren't usually the top of the clients that are the most profitable for the practice - usually they are the opposite!

As mentioned in another thread recently - if you go out of your way trying to help those who are being difficult it usually ends up biting you on the backside. I'm only talking about scripts for wormers and flea treatment too, and the vast majority of people still buy them from us in the clinic rather than going online. I see no reason to restrict worming and flea treatment to a 3 or 6 month prescription - and if so, are you seeing them for a consultation before you issue another prescription?

Re: On-line pharmacies

Bob Russell — Sat, 29 Sep 2012 10:56:18 GMT

[quote user="James Laidlaw"]How much profit do you make off advocate? Even with a 100% mark up it won't get you much more than £50 per dog per year. It's not the big money earner, and I'm firmly entrenched in the money made should come from appropriate charging for clinical work, not profits on products sold.

[/quote]

£50 per dog - 50 dogs = £2500 for one product. 50 products at give away prices = a lot of money that has to be made up elsewhere. A hefty hike in consultation prices required to make up the difference or major cost cutting including wage bill.

We are running businesses here and without a balance of income not likely to do well. Are those happy to hand over money to the on-line shops running businesses or working for them I wonder?

Re: On-line pharmacies

Martin Atkinson — Sat, 29 Sep 2012 10:45:48 GMT

[quote user="James Laidlaw"]I'm firmly entrenched in the money made should come from appropriate charging for clinical work, not profits on products sold.[/quote] You are without question right but we have entrenched ourselves so deep into subsidising our professional fees with the sales of pharmaceuticals that it is going to take a long time to climb out and I doubt the person who wants to save a couple of pounds on Advocate will be with us on this they will only complain more about higher charges.

Re: On-line pharmacies

James Laidlaw — Sat, 29 Sep 2012 10:31:08 GMT

How much profit do you make off advocate? Even with a 100% mark up it won't get you much more than £50 per dog per year. It's not the big money earner, and I'm firmly entrenched in the money made should come from appropriate charging for clinical work, not profits on products sold.

Re: On-line pharmacies

Martin Atkinson — Sat, 29 Sep 2012 09:17:39 GMT

[quote user="Rajat"]I;m with James- much rather my patients were on Advocate + my clients happy and still my clients!![/quote] Not a criticism of this philosophy more a query really: are not the sort of clients who are looking to save a few pounds on Advocate, rather than support their local vet and understand that their reasonable vet's fees are subsidised by profits on sales of products and would otherwise rise, also the sort who will complain about every other charge and are generally poor value customers? This in my view is the thin end of the wedge - or rather already quite a long way to the thick end.

Re: On-line pharmacies

Rajat — Fri, 28 Sep 2012 20:44:55 GMT

Clients are not stupid, and we all shop around for the best deal holding them at ransom with scripts costing as much as 2 months worth of advocate then only giving them 3 month scripts at a time seems a bit pretty mean, I wouldn't be happy about it if I were a client. I;m with James- much rather my patients were on Advocate + my clients happy and still my clients!! so what if I lose 5-10-15£ on the sale of a dewormer, I know I'll make it back when it comes to treating the pet and treating it properly!

PS I agree pharmacies should not dictate the length of the repeat script sounds like the clients need to find a new pharmacy!

Re: On-line pharmacies

James Laidlaw — Fri, 28 Sep 2012 19:33:02 GMT

Not my red star by the way... Just had a long day and never had problem with 12 month script before, apparently they're fine with 1 repeat on a 6 pipette script so go figure... I don't really care if someone wants to get meds elsewhere, there's no fair competition when retailers can sell product cheaper than we can buy it, so I'd rather all dogs were on advocate than getting something else, and on it regularly for lungworm prevention too. Everything else meds-wise here is 3 monthly check ups and most of our clients get advocate from us without checkups every 3 months for it, so why write a script for less than I'm happy to do in the clinic. Have some gold stars too by the way.

Re: On-line pharmacies

Martin Atkinson — Fri, 28 Sep 2012 19:12:35 GMT

[quote user="James Laidlaw"]For advocate? I'd think it very, uh... Un-magnanimous to do 6, let alone 3... Each to their own though!

[/quote] Whatever anyone thinks I can't see why my post deserved a red star. The client is depriving you of income getting the product from an on-line pharmacy, you seen quite happy about that but have your arse in your hand over the approach of the said pharmacy so I find it difficult to equate the conflicting attitudes.

Re: On-line pharmacies

James Laidlaw — Fri, 28 Sep 2012 18:48:23 GMT

For advocate? I'd think it very, uh... Un-magnanimous to do 6, let alone 3... Each to their own though!

Re: On-line pharmacies

Martin Atkinson — Fri, 28 Sep 2012 18:20:36 GMT

It's all been said before best bet is to find a wall to bang your head against. That said it seems very magnanimous of you to give a 12 month script, I would have only given 3 or 6 at the most and charged £15 for it.