Control of medicines

RE: Control of medicines

Thomas Johnson — Mon, 05 Nov 2018 08:33:52 GMT

[quote user="Dinu Catilina"]

Well, for patients coming for their annual vaccination, they do receive a FOC health check. Wouldn't that suffice to allow dispensing 12 months of flea treatment and wormers? If we don't see the patient in the past 12 months, is it really under our care or just registered with our practice? Is there a difference?

[/quote]

When an animal has its annual vaccination a note is automatically put on its record along the lines of 'Okay to dispense flea and worm treatment for the next 12 months'. I agree that it's not ideal to give away free consultations for those clients we haven't seen for over a year, but most of them would otherwise buy their anti-parasite treatment at the pet shop so giving them the free 5 minute appointment does increase practice income, and it encourages them to come to us when their animal is unwell.

[quote user="Dinu Catilina"]I can't agree with giving reduced price consultations. The client pays for our time irrespective of why we see them. If you give someone a 5 minute consultation, what can you do with the rest of 5 minutes from a 10 minutes slot? [/quote]

Our computer system books appointments in multiples of 5 minutes, we normally book 15 minute appointments, but might book 10 minutes for a straightforward post-op check, or 20 minutes for a puppy or kitten 1st vaccine, so it generally all works out.

RE: Control of medicines

Iain Richards — Sun, 04 Nov 2018 22:41:34 GMT

[quote user="vs0u "]But in ruminant parasite control they are advising to treat only animals at risk of disease, leave 10 percent of the group untreated, and rotate products regularly.[/quote]

(Pedant alert, but it's important) Not quite. Products should not be automatically rotated. We advocate targeted selection for products as well as for timings of treatment.

RE: Control of medicines

Anthony Todd — Sun, 04 Nov 2018 18:28:54 GMT

[quote user="Allison Gleadhill"]

Had 3 people one week ringing asking for metacam for their dog. All came in. One was in connective heart failure, one had a liver tumour & the third had myasthenia gravis.....

[/quote]

Yeah, but I had a receptionist that just said " we don't sell it without an appointment, with the pet" full stop. end of everything.......

RE: Control of medicines

Anthony Todd — Sun, 04 Nov 2018 18:12:30 GMT

[quote user="Allison Gleadhill"]asking for metacam [/quote]

Be interesting to find out the sales of a POM via vets and via the on line pharmacies....

It seems, to me, that vets should fight back and attract clients [who may not ever have been to a vet apart from "spading"].

This should be even at a loss, but with the added value, to clients, of a free cursory exam ["a bit overweight"," "teeth need attention"] and not neccesarily at a profit.

RE: Control of medicines

Allison Gleadhill — Sun, 04 Nov 2018 17:13:52 GMT

Had 3 people one week ringing asking for metacam for their dog. All came in. One was in connective heart failure, one had a liver tumour & the third had myasthenia gravis.....

RE: Control of medicines

Chris Milligan — Sun, 04 Nov 2018 15:13:05 GMT

[quote user="Gillian Mostyn"]Playing devils advocate .. if the client had just been able to buy metacam from the pharmacy or vets, would this have happened?[/quote]

Just remembering how many clients I've seen with an old bottle of metacam that "gave a dose this morning, and another this afternoon 'cos the first one didn't seem to do much"

RE: Control of medicines

Dinu Catilina — Sun, 04 Nov 2018 14:54:54 GMT

I can't agree with giving reduced price consultations. The client pays for our time irrespective of why we see them. If you give someone a 5 minute consultation, what can you do with the rest of 5 minutes from a 10 minutes slot?

RE: Control of medicines

Thomas Johnson — Sun, 04 Nov 2018 09:37:48 GMT

[quote user="vs0u "]

[quote user="Anthony Todd"]What is a ball-park extra fee for the "animal under my care" requirement??[/quote]

Every practice that I've worked in does not charge for a check up for the purpose of flea/worming. Often these are done by a VN. Of course the product is still more expensive than it would be online though.

[/quote]

Practices I've worked at have also offered a free 5 minute health check to prescribe anti-parasite treatments, but always with a vet, these are POM-V products, can the animal be considered to be under the care of a vet if a vet hasn't seen it?

RE: Control of medicines

Evelyn Barbour-Hill — Sat, 03 Nov 2018 22:05:06 GMT

[quote user="Anthony Todd"]

The profession could do themselves a lot of good if someone reassessed VPOMs and changed the categories for flea controls and wormers, still vet only, but not with the "registered client, under vet care" restriction.

This now requires some cursory exam and a fee, which seems pointless and a con, particularly from the clients point of view!

[/quote]

It doesn't require a fee.

RE: Control of medicines

vs0u — Sat, 03 Nov 2018 15:35:52 GMT

[quote user="Bob Russell"]Irregular and incomplete treatment has to be a recipe for resistance. This may happen with all products over time but perhaps it should not have happened so rapidly as it did.[/quote]

It may be different for fleas. Not sure if the research has been done. But in ruminant parasite control they are advising to treat only animals at risk of disease, leave 10 percent of the group untreated, and rotate products regularly. I can't help wondering if we've fallen victim to clever marketing campaigns, and maybe should be a bit more targeted in prescribing flea control

RE: Control of medicines

Bob Russell — Fri, 02 Nov 2018 17:10:45 GMT

[quote user="vs0u "]

[quote user="Bob Russell"]The profession has hopefully learned a lesson regarding responsible use of parasiticides. Fipronil became almost useless on our watch because the profession failed to make sure it was used adequately.[/quote]

Interested to know what you mean by this...are you saying that if we used more fipronil that resistance would not have arisen? The current aim with flea products seems to be to sell as much as possible, especially with the introduction of the pet health schemes which encourage people to use it all the time. Surely indiscriminate use just makes resistance arise more quickly?

[/quote]

Not necessarily but when a product is used it should continue until the flea problem is properly controlled. For those continuously challenged on-going treatment makes sense.

I seem to remember figures being banded about that estimated of the pets being treated with Frontline the average number of doses given per year was between one and two. I am happy to be corrected if this was not the case.

Irregular and incomplete treatment has to be a recipe for resistance. This may happen with all products over time but perhaps it should not have happened so rapidly as it did.

i accept this is not based on research but seems logical to me.

RE: Control of medicines

Anthony Todd — Fri, 02 Nov 2018 15:36:09 GMT

[quote user="Richard Carter"]When Program flea control was launched in South Africa, it came with a 'vet only' POM category. Once the market had been well established, it was reclassified for sale in pharmacies as well. [/quote]

Yup, Hills did the same with their food.

Guaranteed vet only and forever!!!

Then, hello, for sale everywhere after vets did all the sale/marketing set-up work for them!!

RE: Control of medicines

Anthony Todd — Fri, 02 Nov 2018 15:32:53 GMT

[quote user="vs0u "]still more expensive than it would be online though. [/quote]

Does the practice still make a profit if they sold it for the on-line price?

If so I reckon it would be worth the smaller profit for the chance to gain a client for life??

RE: Control of medicines

vs0u — Fri, 02 Nov 2018 15:03:47 GMT

RE: Control of medicines

Richard Carter — Fri, 02 Nov 2018 14:54:56 GMT

When Program flea control was launched in South Africa, it came with a 'vet only' POM category. Once the market had been well established, it was reclassified for sale in pharmacies as well. Same thing with fipronyl. The parasite market is big - if only you can sell to more people without the hassle of having to see the vet!!

would not be the first time the rules were changed in favour of a big supplier. Anyone want to discuss the price differences of same flea products in UK and rest of EU??

RE: Control of medicines

vs0u — Fri, 02 Nov 2018 14:50:45 GMT

[quote user="Anthony Todd"]What is a ball-park extra fee for the "animal under my care" requirement??[/quote]

RE: Control of medicines

Bob Russell — Fri, 02 Nov 2018 12:11:22 GMT

My experience is that not that many pharmacists have a clue about flea products. If a flea product can be supplied by a pharmacist it can also be supplied by a SQP therefore readily available with minimal input via the internet. No different (or worse) than requiring a video consult with a vet.

The profession has hopefully learned a lesson regarding responsible use of parasiticides. Fipronil became almost useless on our watch because the profession failed to make sure it was used adequately.

Unrestricted supply should be for products that are low priority. Despite the comments from reps it is generally the manufacturers that decide to apply for their products to be reclassified. Perhaps Frontline sales in the supermarkets will degrade its apparent value.

RE: Control of medicines

Anthony Todd — Fri, 02 Nov 2018 11:52:05 GMT

[quote user="Bob Russell"] Altering the category to allow any vet to prescribe flea products would allow the internet suppliers to do exactly what they want already - supply without seeing.[/quote]

AFAIK, and in my recent experience, some products require the public actually to transact only through a pharmacist and, again in my recent experience, the pharmacist takes the patient through the use of the drug with appropriate advice and caveats, which would be relevant for flea products.

What is a ball-park extra fee for the "animal under my care" requirement??

Of course some of the preps seem to be available under another name and unrestricted totally, which adds to the illogic of the classification!

RE: Control of medicines

Bob Russell — Fri, 02 Nov 2018 10:57:21 GMT

We do 'free' five minute consults for non-registered or lapsed clients one afternoon a week. Five minutes, full charge if the client has other issues.

Conversion rate back to active clients make it viable. A nice service to offer but obviously some try to take advantage so we do enforce the 'rules' strictly.

Altering the category to allow any vet to prescribe flea products would allow the internet suppliers to do exactly what they want already - supply without seeing.

RE: Control of medicines

Martin Atkinson — Fri, 02 Nov 2018 10:41:54 GMT

[quote user="Niall Taylor"]There is a reason that some people are vets and others aren't and we should stop being bashful about that fact.[/quote]It never ceases to amaze me how little knowledge the general public have about their own bodies let alone their pets' or even medicines. Did no-one else do biology at school?

RE: Control of medicines

Anthony Todd — Fri, 02 Nov 2018 10:04:06 GMT

[quote user="David Mills"]I'm not sure pharma are that bothered with the vet market to push this. [/quote]

This now requires some cursory exam and a fee, which seems pointless and a con, particularly from the clients point of view!

RE: Control of medicines

Thomas Johnson — Fri, 02 Nov 2018 08:31:59 GMT

[quote user="Sammy82"]I don't find it unreasonable to ask if the dog needs a higher dose when it gets worse. At least they asked![/quote]

Absolutely, I can completely understand why they asked, it just makes me concerned about how people might use these medications if they were more freely available.

RE: Control of medicines

David Mills — Thu, 01 Nov 2018 22:36:14 GMT

[quote user="Richard Carter"]My feeling is there is some pharmaceutical company who is fed up trying to get pharmacists selling flea products and wants available to all. As flea/worm products account for 2 staff salaries, does that mean 2 people out of a job in future??[/quote]

I'm not sure pharma are that bothered with the vet market to push this.

However it would suit some of the bigger players in our industry.

OOH providers currently struggle with conversion of calls to consults. So offer a video consult first for, say, £40, refundable if deemed necessary to attend the hospital.

Similar the bigger chains and the "just after advice" calls. A vet may call you back in a few hours or pay £10 for an online consult, refundable if you attend the practice.

Access to veterinary services, except the far reaches of the Highlands, is not an issue in the UK, far from it.

Worrying. Very, very worrying.

RE: Control of medicines

Sammy82 — Thu, 01 Nov 2018 21:46:05 GMT

I dread to think that these same clients are trusted to dose Calpol etc for their baby correctly (human, not fur baby). And how many give them Metacam because that's what they had in the house at 3am?

I don't find it unreasonable to ask if the dog needs a higher dose when it gets worse. At least they asked! After all we usually dose painkillers for ourselves depending on severity of pain, eg. milder headache 200mg Ibuprofen will do, more severe pain might require 400mg or more up to max safe dose? So maybe we should do the same and not always put dogs the full dose straight away? I often feel that the human medicine control is so much laxer, our animals are much better protected. This makes it harder for owners to understand why we can't just sell them Metacam etc without seeing the dog, when they can buy similar for their children off the shelf without speaking to anyone, and why it the costs 10x as much on top of the consult fee.

RE: Control of medicines

Utlendigur — Thu, 01 Nov 2018 21:05:01 GMT

[quote user="Thomas Johnson"]I have had several clients whose dogs have been on Metacam for arthritis for some time ask if they should increase the dose or give it twice daily when the arthritis gets worse.[/quote]

Or add some ibuprofen because that's a painkiller aswell innit..

Or the client who gave her cat Calpol, for 3 days (because it wasn't getting better after the 1st or 2nd day), at the dose it said on the bottle for "over 12s" - because the cat was over 12 years old