CMA Final Report

RE: CMA Final Report

Anthony Dennison — Mon, 20 Apr 2026 07:53:26 GMT

[quote userid="3169" url="~/f/non-clinical-questions/31331/cma-final-report/248594#248594"]They are not getting a script for an injectable with anaphylaxis and strict accidental self injection warnings on the data sheet, and I'm not injecting their Librela with sketchy cold chain. [/quote]

100% Agree on this. Sop many reasons not to provide these injectables to clients. There's a reason I have to write 'give by mouth' on probiotic paste...

RE: CMA Final Report

Clive Ansell — Thu, 26 Mar 2026 10:25:55 GMT

[quote userid="9239" url="~/f/non-clinical-questions/31331/cma-final-report/248596#248596"]

Clive Ansell said:
You can still decline as you are the MRCVS, nothing whatever to do with management.

Is this certain though? I guess sooner or later we will hear from the DC if this is the case or not, I'm certain that someone soon will complain about it.

[/quote]

The decision to prescribe or not, or whether it is appropriate to issue a written prescription, is entirely a matter for the individual MRCVS. In cases where I decline, either in part (reduced amount or time frame) or totally, I would enter my reasoning within the clinical notes.

One thing I do notice a lot, is where a vet has authorised a drug for the next 6 months, but the practice will only prescribe a month at a time and will charge a written prescription charge every month. I could see that generating complaints.

In the case of Librela I would only authorize a written prescription if the drug was being delivered directly to, and injected, in the clinic. My main concern here would be safety, but also is an owner going to store and inject it correctly, and can they legally and safely dispose of the used vial and syringe.

From data sheet

Special precautions to be taken by the person administering the veterinary medicinal product to animals

Hypersensitivity reactions, including anaphylaxis, could potentially occur in the case of accidental self-injection. Repeated self-administration may increase the risk of hypersensitivity reactions.

The importance of nerve growth factor (NGF) in ensuring normal foetal nervous system development is well-established and laboratory studies conducted on non-human primates with human anti-NGF antibodies have shown evidence of reproductive and developmental toxicity. Pregnant women, women trying to conceive and breastfeeding women should take extreme care to avoid accidental self-injection.

In case of accidental self-injection, seek medical advice immediately and show the package leaflet or the label to the physician

RE: CMA Final Report

Arlo Guthrie — Thu, 26 Mar 2026 08:29:12 GMT

Morning all. A few thoughts about why the CMA reforms may not stop the negative headlines about vets: https://www.vetsurgeon.org/b/veterinary-news/posts/veterinary-organisations-react-to-cma-s-final-vet-sector-reforms

RE: CMA Final Report

Dinu Catilina — Wed, 25 Mar 2026 20:21:12 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31331/cma-final-report/248593#248593"]

You can still decline as you are the MRCVS, nothing whatever to do with management.

[/quote]

Is this certain though? I guess sooner or later we will hear from the DC if this is the case or not, I'm certain that someone soon will complain about it.

RE: CMA Final Report

Michael Woodhouse — Wed, 25 Mar 2026 17:55:04 GMT

[quote userid="14693" url="~/f/non-clinical-questions/31331/cma-final-report/248588#248588"]Except clients will ask for a script for cytopoint/librela and do it themselves. Happens already and more time wasted doing forms to cover yourself in case they inject themselves or dont store it properly[/quote]

They are not getting a script for an injectable with anaphylaxis and strict accidental self injection warnings on the data sheet, and I'm not injecting their Librela with sketchy cold chain.

RE: CMA Final Report

Clive Ansell — Wed, 25 Mar 2026 12:17:24 GMT

[quote userid="14693" url="~/f/non-clinical-questions/31331/cma-final-report/248592#248592"]

I agree that it shd be clinic only but here we allow it

Even with forms to warn about self injection etc it gives me the willies if they end up losing a finger and sue that you still wont be covered. I never offer the option but often allowed by someone else and signed off by management

[/quote]

You can still decline as you are the MRCVS, nothing whatever to do with management.

In fact, if anything ever goes wrong, the buck stops with the MRCVS, not management.

[quote userid="14693" url="~/f/non-clinical-questions/31331/cma-final-report/248592#248592"]Even with forms to warn about self injection etc it gives me the willies if they end up losing a finger and sue that you still wont be covered. I never offer the option but often allowed by someone else and signed off by management[/quote]

I won't do it, and neither will the practice I'm currently working for.

Might be worth taking advice from the VDS?

RE: CMA Final Report

Lesley Strong — Wed, 25 Mar 2026 11:44:49 GMT

I agree that it shd be clinic only but here we allow it

Ironically when people kick off and tell you how much they save buying online I point out the pharmacy the are using is owned by the same corporate they are dissing in the consult room so they are still getting your money anyway

RE: CMA Final Report

Clive Ansell — Wed, 25 Mar 2026 11:20:15 GMT

[quote userid="14693" url="~/f/non-clinical-questions/31331/cma-final-report/248588#248588"]Except clients will ask for a script for cytopoint/librela and do it themselves. [/quote]

You can always decline if you feel it is inappropriate.

Where I am currently working we refuse to do this, we very rarely issue written prescriptions for injectables other than insulin.

I'm not sure if we should, or if we are even obliged too? as you say, how can you be 100% certain it is stored correctly or injected properly? Given the potential of the very severe possible consequence of accidental Librela injection, I feel it should be in clinic only .

RE: CMA Final Report

Clive Ansell — Wed, 25 Mar 2026 11:10:46 GMT

[quote userid="5408" url="~/f/non-clinical-questions/31331/cma-final-report/248586#248586"]I see that they order states that if a case is to be referred, the referring vet has to give the client an estimate. This will mean the referring vet asking for an estimate from the Referral practice. [/quote]

I already do this, but unless it is a fixed price procedure like a TPLO, then it would only be a rough idea of the initial consultation and investigation. Not possible beyond that.

[quote userid="5408" url="~/f/non-clinical-questions/31331/cma-final-report/248586#248586"]In dermatology it’s very difficult to give accurate estimates for cases such as pseudomonas otitis and with many cases the diagnosis has not been made and that’s the reason why they are being referred! ..do we quote for every possible diagnositic test there is? ! [/quote]

It is impossible in first opinion practice too at times.

I had an older aggressive dog booked for dental work yesterday, I could see a swelling that looked like a malar abscess at a distance, but no pre GA assessment was possible beyond that. Estimating for the work accurately just isn't feasible. The plan was to anaesthetise, descale, clean and assess the teeth, then telephone the client with an idea of the work needed. An estimate was produced on 1 hour of time for extractions, on top of the fixed anaesthesia and descale and clean charge. We were unable to contact the owner as agreed, telephone not answered 3 times, so we proceeded as agreed and extracted 11 teeth. Took 35 minutes, so the bill was actually lower than the estimate, everyone was happy, but it have just as easily gone the other way and taken much longer.

RE: CMA Final Report

Alistair Graham-Evans — Wed, 25 Mar 2026 10:25:30 GMT

Surely only one business will have to comply with “Pet health club” requirements

If they also appropriate the words Veterinary, clinic, practice all the recommendations may only apply to them.

Seriously - how has it taken 3 years to come up with this ?

I am celebrating my clinic sale that completed last week - to an independent group of young keen enthusiastic vets to continue and expand on our efforts. So there is hope but I’m glad to be out and can forget about employment law.

RE: CMA Final Report

Lesley Strong — Wed, 25 Mar 2026 08:54:30 GMT

Except clients will ask for a script for cytopoint/librela and do it themselves. Happens already and more time wasted doing forms to cover yourself in case they inject themselves or dont store it properly

All this thing will do it add more paperwork not improve things for clients or us

Fiddling with the deck chairs as the Titanic goes down

RE: CMA Final Report

Michael Woodhouse — Tue, 24 Mar 2026 22:57:43 GMT

"Potential savings from buying medicines elsewhere."

My first thoughts, and I'll have to run some figures, is just to change my pricing so that I charge a typical internet price for everything and make my injection or dispensing fee £21. I'm going to make so much more money on every bad eye, ear, injection that the losses on the expensive, ongoing meds are more than compensated. Therefore there are no savings to be had and I don't need to tell them something that isn't true.

"we regularly price match our medicines, including prescriptions fees to internet retails to keep our costs fair"

Now 1ml of dex, injected costs you £4.80 (inc), it will be £21.16

Bottle of Canural 15ml, now £32, after this £37.48

Tube of Chlorampenecol eye ointment, now £18.66 after £25.59

Bottle of 10ml Loxicom £23.20 after this, £30.78

A large Bravecto based on buy 3 get 1 FOC costs an average of £40 each from me, online (unless you want to pay for 4 at once and almost no one does) £43.74 each.

Just need to get as many arthritis cases onto Librela, skin cases on Cytopoint etc

I'll almost be embarrassed selling a 1ml of amoxicillin, costing me 7p at £21.12, but that's what they have done to me. Madness.

RE: CMA Final Report

David Bentley — Tue, 24 Mar 2026 22:26:16 GMT

I see that they order states that if a case is to be referred, the referring vet has to give the client an estimate. This will mean the referring vet asking for an estimate from the Referral practice. In dermatology it’s very difficult to give accurate estimates for cases such as pseudomonas otitis and with many cases the diagnosis has not been made and that’s the reason why they are being referred! ..do we quote for every possible diagnositic test there is? ! For me, trying to give estimates for CO2 laser surgery is also very difficult without seeing the case. it will just end with me quoting the maximum price it could be, which could end up being well off the mark. Animals aren’t cars or pieces of electronic equipment. You can’t give an estimate for a job on an animal like you can for a job on a car. This CMA order is just going to add to all the other bureaucratic crap that we have to put up with nowadays and suck out what little joy there is left in the job

RE: CMA Final Report

Cinzia Gandini — Tue, 24 Mar 2026 17:36:03 GMT

[quote userid="2131" url="~/f/non-clinical-questions/31331/cma-final-report/248582#248582"]hoo-ha[/quote]

hoo-ha is a go

RE: CMA Final Report

Clive Ansell — Tue, 24 Mar 2026 17:26:45 GMT

[quote userid="2131" url="~/f/non-clinical-questions/31331/cma-final-report/248582#248582"]As soon as my official governing body and regulator has the courtesy to inform me directly about all this hoo-ha or whatever it is, I shall start to do something about it.[/quote]

That sounds like a good plan to me.

It's not going to affect me, as a locum, a great deal anyway.

RE: CMA Final Report

Evelyn Barbour-Hill — Tue, 24 Mar 2026 17:07:08 GMT

As soon as my official governing body and regulator has the courtesy to inform me directly about all this hoo-ha or whatever it is, I shall start to do something about it.

RE: CMA Final Report

Cinzia Gandini — Tue, 24 Mar 2026 16:10:34 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31331/cma-final-report/248579#248579"]Here you go everyone[/quote]

Fantastic report, I love it. it should be made more visible. Reading the CMA report over and over, you know what it looks like? It seems more like a reform tailored to corporate clinics rather than to private practices. Though private providers may ultimately bear a greater share of the impact.

RE: CMA Final Report

Cinzia Gandini — Tue, 24 Mar 2026 15:28:44 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31331/cma-final-report/248577#248577"]There are only 5 there[/quote]

RE: CMA Final Report

Arlo Guthrie — Tue, 24 Mar 2026 14:47:14 GMT

Here you go everyone, I came at this trying to summarise what vets and practices will have to do, and by when.

A 'to do' list, if you like:

https://www.vetsurgeon.org/b/veterinary-news/posts/new-cma-transparency-rules-could-cost-vet-practices-several-thousand-pounds-to-implement

I can see several thousands of pounds worth of work, time and expense in the list.

I'm really sceptical about the price comparison thing providing anything much of real value to consumers directly, but it might focus minds in practice.

RE: CMA Final Report

Arlo Guthrie — Tue, 24 Mar 2026 12:50:44 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31331/cma-final-report/248577#248577"]There are only 5 there[/quote]

Typo in report by the looks of things.

RE: CMA Final Report

Clive Ansell — Tue, 24 Mar 2026 12:13:39 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31331/cma-final-report/248575#248575"]

Prices for the relevant treatments and services need to be provided in relation to 6 standardised pet characteristic and weight categories:

Pet	Weight
Cat, small dog	<10kg
Medium dog	10 to 25kg
Large dog	>25 to 40kg
Extra-large dog	>40 to 60kg
Giant dog	>60kg

[/quote]

There are only 5 there

RE: CMA Final Report

Clive Ansell — Tue, 24 Mar 2026 12:12:27 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31331/cma-final-report/248573#248573"]according to the 6 standardised weight categories[/quote]

Where I am working we have 4 weight ranges for routine dog neutering and for anaesthesia. ( <10Kg. 10-25Kg, 25-40Kg and >40kg) Surgical and dental procedures are priced by 5 minute time blocks.

RE: CMA Final Report

Arlo Guthrie — Tue, 24 Mar 2026 12:11:43 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31331/cma-final-report/248574#248574"]Whatever they are? [/quote]

Prices for the relevant treatments and services need to be provided in relation to 6 standardised pet characteristic and weight categories:

Pet	Weight
Cat, small dog	<10kg
Medium dog	10 to 25kg
Large dog	>25 to 40kg
Extra-large dog	>40 to 60kg
Giant dog	>60kg

[quote userid="5012" url="~/f/non-clinical-questions/31331/cma-final-report/248574#248574"]What is a compliant estimate?[/quote]

For treatments within a FOP, a treatment pathway means all diagnostic tests and/or treatments which a veterinary professional has already provided, and may provide, at the FOP, or for which they may make a referral to a professional within the same FOP, and which the professional recommends for the purpose of diagnosing and/or treating what they think the animal’s medical condition is reasonably likely to be.

It covers such tests and treatments for up to 12 months from the point at which the written estimate is provided and may encompass several stages of tests or treatment. It may cover one or more options for treating the pet, depending on what the veterinary professional judges the pet’s medical condition is reasonably likely to be.

The estimate can be given as a range or a specific figure, or a combination of the two. When giving a range, the vet should provide an indication of where in the range the cost is likely to be, and which factors would affect this.

When the treatment will be given outside the FOP (for example at a referral centre), the veterinary professional should give an estimate of the likely treatment costs to the best of their ability or an indication of what it would typically be expected to be.

The price indication that the business is required to give will depend on the circumstances. If, for example, the veterinary professional knows that the referral provider charges a fixed price for any diagnostic tests and/or treatments which are part of the treatment pathway, the written estimate must include these. In other cases, it must be an indication based on the relevant vet’s judgement and knowledge of the market. In these cases, the veterinary business which provides the written estimate will not be required to provide an update should the estimated costs increase.

RE: CMA Final Report

Clive Ansell — Tue, 24 Mar 2026 12:00:15 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31331/cma-final-report/248573#248573"]

I wonder what percentage display everything required by the CMA, and according to the 6 standardised weight categories?

I wonder what percentage of practices already give compliant estimates too.

[/quote]

Whatever they are? not read the detail yet, so cannot answer accurately.

What is a compliant estimate? as oppossed to a non compliant one?

RE: CMA Final Report

Arlo Guthrie — Tue, 24 Mar 2026 11:25:32 GMT

I'm trying to calculate the cost of implementing the reforms.

So far, I am arriving at an initial cost of up to £10K to the practice depending on the degree to which they already comply. Then £500-4.5K per annum thereafter.

[quote userid="5012" url="~/f/non-clinical-questions/31331/cma-final-report/248570#248570"]Already display a list of fixed price procedures and commonly dispensed medicines[/quote]

I wonder what percentage display everything required by the CMA, and according to the 6 standardised weight categories?

I wonder what percentage of practices already give compliant estimates too.