Who is screwing us on drug prices?

Re: Who is screwing us on drug prices?

Martin Atkinson — Tue, 12 May 2015 19:05:59 GMT

[quote user="Bob Russell"]We are planning to move from Seresto to the new monthly flea/tick/lungworm product when it hits the shelves.[/quote]I think you will find that Nexguard Spectra does not have a licence for lungworm Bob despite it containing Milbemycin. Heartworm yes but not Anigiostrongylus.

Re: Who is screwing us on drug prices?

mariette asselbergs — Tue, 12 May 2015 17:57:22 GMT

Socialist or not, it seems obvious that it is not a good thing to link practising (veterinary) medicine with making your profits from pushing drugs. And in large asnimal practice I think everybody can see it coming that we need to be paid for out skilss and advise, not for being drug merchants.

Mariette

Re: Who is screwing us on drug prices?

Evelyn Barbour-Hill — Sat, 09 May 2015 16:13:14 GMT

[quote user="mariette asselbergs"]Over there, by law, vets are not allowed to make a profit on drugs. They can mark up a maximum of 5% to pay for admin cost, stuff that goes out of date, etc.[/quote]

Seems a bit silly, and pretty unfair (except perhaps to a rabid socialist). Drugs on the shelf are capital invested. Am I not to be allowed to get a return on my capital?

Anyway, as seems to have happened, any sensible practice will simply increase their charges. If they are clever, they could even increase by amounts reflecting likely drug use: for instance, orthopaedic work is likely to use lots and lots of analgesic drugs, so the charge for orthopaedic work goes up a lot.

[quote user="mariette asselbergs"]I think this is what the EU wants to be the general rule[/quote]

I have absolutely no comment whatever!

Re: Who is screwing us on drug prices?

Anthony Dennison — Sat, 09 May 2015 09:42:10 GMT

[quote user="Braden Collins"]I think if you're ruthless enough and just ask, it's amazing what they will help out with. [/quote]

Definitely agree with this! My bosses run a hard line with this kind of thing. They didn't think they were getting as good a deal as they could be from our vaccine manufacturer, so put it out to tender by writing to all the manufacturers giving numbers of vaccines used per month etc. Got a much better deal.

Re: Who is screwing us on drug prices?

Michael Woodhouse — Fri, 08 May 2015 22:48:45 GMT

[quote user="mariette asselbergs"]

Don't you have to declare that to the tax office?

[/quote]

I have drugs on the shelf that I get rebate on at the end of the year depending what I bought over the year. I may have sold the item 12 months ago before I find out what price I actually paid.

For tax it's a simple calculation of money collected minus costs (with a bit of accountant jiggery pokery) and what is left is taxed. The fact that I bought the prostaglandin in the last tax year and get the rebate this tax year doesn't matter to them. They don't care.

Re: Who is screwing us on drug prices?

mariette asselbergs — Fri, 08 May 2015 15:22:07 GMT

Don't you have to declare that to the tax office?

Re: Who is screwing us on drug prices?

david kemp — Fri, 08 May 2015 14:44:29 GMT

Given the numerous layers of discount applied to drugs in the uk, it would be almost impossible to accurately work out what you would be marking up from. I would line to know what would happen to internet pharmacies if they had to declare what their true buying price was and a complete destruction of trust between vets and drug company if their buying prices were revealed!

Re: Who is screwing us on drug prices?

mariette asselbergs — Fri, 08 May 2015 13:23:34 GMT

Maybe a bit sideways, but a bit related to this post I think: I just visited my friend who runs a veterinary practice in Denmark. Over there, by law, vets are not allowed to make a profit on drugs. They can mark up a maximum of 5% to pay for admin cost, stuff that goes out of date, etc. It means their consult and ops prices are higher than ours, but their drug prices are much cheaper, and no variation between vets re drug prices. It had been like this now for quite some time and it worked fine. Clients had not noticed much difference in their vet bills and accepted the situation well when it was introduced.

I think this is what the EU wants to be the general rule, and it seemed to me that vets could even start using the system individually before it becomes law.

Mariette

Re: Who is screwing us on drug prices?

Braden Collins — Fri, 08 May 2015 07:46:48 GMT

We got a great deal from our wholesalers by accident. We purchased our first clinic from anoth vet treating it as a branch, but as they employed about 10 vets they had a "good" discount from the wholesaler. When we took over, the other main wholesaler met us, looked at our prices then gave a better offer (and with better service and a nice rep). Our initial wholesaler came back to use again with an even better offer, then agreed to pay for our practice management software as a sweetener.

We would never have thought to approach each of them to give their best price but they went and competed without prompting.

We then had Royal Canin turn on the charm and talked us away from Hills, and have now contributed several thousand towards signage at both our clinics.

I think if you're ruthless enough and just ask, it's amazing what they will help out with.

Despite all this, there's still some stuff we can find online cheaper than our wholesaler can get it (as part of the negotiation process they showed us the cost of products to them). Even the stuff we were told would be "vet only" is available online (I guess they have a vet working for them).

I think at the end of the day if your association with a big pharma company can be mutually beneficial, it is worth working with them, but make sure it is "with" and not effectively "for".

Re: Who is screwing us on drug prices?

david kemp — Wed, 06 May 2015 10:51:57 GMT

We should talk.

Re: Who is screwing us on drug prices?

Bob Russell — Wed, 06 May 2015 09:37:12 GMT

Unless something has changed, Nutramed products are only available from veterinary practices. The loyalty products are claimed directly from them by the client.

I would be saddened if this trust breaks down as these are some of the very few 'nutraceuticals' I have any confidence in! Still a number one cynic though!

The wholesalers were set up by vets, for vets. Centaur was a cooperative, owned by the member practices. Over time they have been bought up by big business and the member practices have become of little importance beyond numbers.

I would happily ditch them for a vet owned and run wholesaler aiming to help preserve traditional veterinary practice!

Re: Who is screwing us on drug prices?

Rob Loxley — Tue, 05 May 2015 22:12:34 GMT

[quote user="david kemp"]you just buy what you would have bought any way just at a cheaper price[/quote]

Forgive me if this isn't the point of joining a buying group? Why do the negotiating with every drug company, x times per year, when someone else with larger buying power will do it for you?

[quote user="david kemp"]Use dedicated human pharmacy website for things like tramadol,chloramphenicol[/quote]
[quote user="david kemp"]Use dedicated consumable sites DMS/Kruuse [/quote]

Or negotiate with your vet wholesaler; ours price matched the majority of human generics and consumables that we were buying elsewhere.

Re: Who is screwing us on drug prices?

david kemp — Tue, 05 May 2015 17:12:08 GMT

I have stayed out of buying groups and managed to obtain net net pricing which compare to buying groups (and in most cases better than buying group).

I believe that buying groups will eventually fail as their own buying power diminishes with the march of the corporates and they cannot deliver definite brand loyalty (you just buy what you would have bought any way just at a cheaper price). corporate and large practices outside of a buying group bring specific products to a practice and in return get a better discount.

The products that really irk me are the products such as royal canin foods and neutraceuticals (Feliway/Dap included) which manufacturers clamour to get our endorsement to promote and then plead that it is outside their control when they appear on websites at "loss leading" prices.

My staff are tired of hearing me battle with reps. The nutramed range has done so well because it controlled the supply chain and went direct.

My advice for any one listening

1. Use wholesaler only for Vet POM V products and food if you can be bothered to stock RC/Hills/IAMs etc

2. Stay out of buying group and negotiate direct

3.Use dedicated human pharmacy website for things like tramadol,chloramphenicol

4.Use dedicated consumable sites DMS/Kruuse

5.Explore selling own brand foods and products which you source direct.

Yes it requires more than one account and needs managing but the savings are amazing and our ordering nurse saves her salary every day with a few key strokes.

I have started to look at the possibility of a new wholesaler dedicated solely to providing Vet POM products acting as both buying group and distribution centre, using national carriers to move high value low volume products. Wholesalers are starting to look like very expensive logistics companies delivering huge volumes of high volume low value food (which we endorsed!) on behalf of internet pharmacies using the profit they make on YOUR drug sales to fund cheap (or free) carriage charges.

Re: Who is screwing us on drug prices?

Martin Atkinson — Tue, 05 May 2015 16:31:07 GMT

[quote user="Bob Russell"]

Openness has gone, low headline prices and more hidden charges that you can shake a stick at! Grubby sales techniques and dubious practices rife!

It amazes me how many 'Delboys' the profession has within its midsts and how low some are willing to stoop! Sadly they do seem to make money though!

[/quote]Which makes me wonder how the Animal Trust are doing considering their apparent philanthropy and no profits. A damn site better than me I suspect!

Re: Who is screwing us on drug prices?

Bob Russell — Tue, 05 May 2015 14:40:08 GMT

I very much doubt the CC were expecting such cut-throat competition between on-line suppliers, Pretty crap outcome when you consider the purpose was to improve openness and competition between vets!

Openness has gone, low headline prices and more hidden charges that you can shake a stick at! Grubby sales techniques and dubious practices rife!

It amazes me how many 'Delboys' the profession has within its midsts and how low some are willing to stoop! Sadly they do seem to make money though!

Re: Who is screwing us on drug prices?

Andrew Mellor — Tue, 05 May 2015 14:08:11 GMT

[quote user="Bob Russell"]

We have a disclaimer at the bottom of our prescription forms making it clear we cannot take any responsibility for medication supplied by a third party and that it is the clients responsibility to satisfy themselves the products are genuine.

I take responsibility for making the choice of a specific POM for a patient and any medication supplied by us. Beyond that it is 'buyer beware'!

[/quote]

What a very good idea I will pinch that if that's ok !

I actually wonder if the comp commission or whatever it is now called should re-look at the whole thing, I think it has gone way too far the opposite way !

Re: Who is screwing us on drug prices?

Bob Russell — Tue, 05 May 2015 14:05:40 GMT

I take responsibility for making the choice of a specific POM for a patient and any medication supplied by us. Beyond that it is 'buyer beware'!

Re: Who is screwing us on drug prices?

Andrew Mellor — Tue, 05 May 2015 13:56:52 GMT

I was told by a reliable source that Vet wholesalers would send stock back to the manufacturer once it got to within a few months of use by date so they were not left with out of date stock, the drug company would then have to pay to destroy that product to comply with waste management/ vmd rules etc , then online pharmacies came along and the drug company sells this short dated stock for a fraction off normal value 10% maybe - that way they make money rather than having to pay out. online pharmacy can make a decent profit and still be way under cost price!!

The other thing to add : - I tell my clients about one of my other clients that bought rimadyl 50mg palatable from online pharmacy , I saw the receipt all looked ok uk based company dog died 3 days after starting ( multiorgan failure , tablets were round - I spoke to Pfizer as it was then and nowhere in the world did they produce round palatable rimadyl , unfortunately owners had thrown away remaining tablets so I couldn't get them tested as to what they were.

Re: Who is screwing us on drug prices?

Bob Russell — Tue, 05 May 2015 13:11:08 GMT

On the EMA website it looks as if the licence will be for heartworm (as in mosquito transmitted) rather than lungworm (as in snail transmitted). If so, what a let down!

Re: Who is screwing us on drug prices?

Stephen Courtney — Sun, 03 May 2015 20:37:01 GMT

Sorry hadn't read Rob's post.

Re: Who is screwing us on drug prices?

Stephen Courtney — Sun, 03 May 2015 20:36:10 GMT

Given that praziquantel has an extremely short half life, why on earth can you not use milbemax weekly for 4 weeks? Same job gets done and a little unnecessary praziquantel will no no harm whatsoever.

and no hassle getting overpriced imported meds on special licence either!

Re: Who is screwing us on drug prices?

Rob Loxley — Sun, 03 May 2015 19:47:12 GMT

[quote user="Bob Russell"]Nexguard something[/quote]

NexGard Spectra?

[quote user="listhestar"]For treatment of Angiostrongylus vasorum infections, milbemycin oxime should be given four times at weekly intervals. It is recommended, where concomitant treatment against cestodes is indicated, to treat once with the product and continue with the monovalent product containing milbemycin oxime alone, for the remaining three weekly treatments.[/quote]

Which is not available in the UK, and given the very short halflife of praziquantel in dogs how much should we worry about this?

Re: Who is screwing us on drug prices?

Rob Loxley — Sun, 03 May 2015 19:40:16 GMT

[quote user="Bob Russell"]Bayer have insisted that they do not offer additional discounts to the internet sellers but something is clearly very wrong somewhere[/quote]

IME these kind of comments are weasly words from drug companies, as often small practices can never move the volume to get the same larger discounts?

[quote user="Arlo Guthrie"]Are you all members of a buying group, and is the problem hat the buying groups aren't getting enough of a discount?[/quote]

We find as a small practice that our discount from some manufacturers is zero to very little; we just can't sell the volume to get the offered better discount (that presumably the large corporates and online retailers can shift).

I would also suspect the online retailers run very very small margins on key shopped-for products?

[quote user="listhestar"]some much cheaper companies around for human generics - vast saving on NVS but just having the time to do the different orders[/quote]

Won't NVS negotiate on human generic prices?; Henry Schein will...

Re: Who is screwing us on drug prices?

listhestar — Sat, 02 May 2015 12:33:55 GMT

For treatment of Angiostrongylus vasorum infections, milbemycin oxime should be given four times at weekly intervals. It is recommended, where concomitant treatment against cestodes is indicated, to treat once with the product and continue with the monovalent product containing milbemycin oxime alone, for the remaining three weekly treatments.

In endemic areas administration of the product every four weeks will prevent angiostrongylosis by reducing immature adult (L5) and adult parasite burden, where concomitant treatment against cestodes is indicated.

For the treatment of Thelazia callipaeda, milbemcyin oxime should be given in 2 treatments, seven days apart. Where concomitant treatment against cestodes is indicated, MILBEMAX can replace the monovalent product containing milbemycin oxime alone. From NOAH, 2015

Lisa

Re: Who is screwing us on drug prices?

listhestar — Sat, 02 May 2015 12:31:10 GMT

[quote user="Bob Russell"] independent experts that were suggesting good efficacy at CPD I did 5 or more years ago![/quote]

Yes I have heard the same thing. Nexguard monthly vs 3 monthly bravecto.

Lisa