Advocate without a prescription?

Re: Advocate without a prescription?

Andre Escudeiro-Vieites — Tue, 02 Nov 2010 21:24:13 GMT

I sent this letter to the BVA today by e-mail:

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Dear Colleagues,

I am writing to my representatives in the BVA to voice my concern (shared with many others in the profession) about some issues related to the rise in the sale of veterinary medicinal products through internet based companies.

There are a few points I would like to make:

1- The rise in this type commercial enterprise has been a direct consequence of the decisions from the Competition Commission.

2- If there was an unfair privileged position for Veterinary Practices in the past from a competition point of view, the new situation must be better in terms of fairer competition AND other paramount consequences derived from the lost of “control” of veterinary drugs by qualified accountable professionals (Veterinary Surgeons) must be acknowledged, monitored and addressed.

3- I have seen proof of VPOM drugs ranging from parasite treatments (Advocate) to immunosuppressant drugs such as cyclosporine (Opticare) being acquired through internet based companies without a prescription. This amounts both to a Public and Animal Health problem as well as a competitive disadvantage (a UK based Veterinary Practice having to compete in price with a drug selling company from, say, Barbados, that sells VPOM drugs illegally in the UK)

4- There is evidence in other countries that the quality and authenticity of the medicinal products sold on the internet needs to be monitored and internet accreditation systems are working in the USA. As published in the Veterinary Record on October 16^th the Veterinary Verified Internet Pharmacy Practice Sites Scheme is working in the USA and supported by the American FDA.

5- I believe it is the responsibility of Customs to police the import of drugs from outside the UK. Some of these responsibilities are sometimes shared though agreements with the transport companies that monitor whether imported goods comply with the transport and local regulations. Political pressure from our profession must be applied on these actors for a better control of the illegal import of veterinary products (without a veterinary prescription, etc)

6- I think the VBA as the voice of the profession with the capability to influence the appropriate bodies (VMD, Parliament…) must initiate a committee that looks into the consequences of this change in the way Veterinary Medicinal Products are being acquired by members of the public, not only in terms of Competition, but also as a Public Health issue and a risk for the Wellbeing of animals under our care.

Looking forward to hearing your comments on this letter,

Yours sincerely

Andres Escudeiro Vieites LV MRCVS

I would apreciate your comments( on the content and the purpose of the letter

Thanks

Re: Advocate without a prescription?

Mark Hedberg — Thu, 21 Oct 2010 09:27:56 GMT

As long as the dog isn't sensitive, 0.1 ml per 5kg of ivermectin once weekly for 4 weeks is a safe and effective dose, I've found.

Re: Advocate without a prescription?

Andre Escudeiro-Vieites — Thu, 21 Oct 2010 00:27:33 GMT

[quote user="Bob Russell"]Cyclosporin eye products have been on the market quite long enough to have recouped development costs and to have made a nice profit for the company involved.[/quote]

I have to admit I felt quite bad when I said to an animal assistant (on more or less minimum wage) that works at my Surgery that I wasn't prepared to do a prescription for the indian-non lincencenced in theEU- product that she coudl get on the internet that was equivalent to optimune, but that is altogether a diferent argument. I agree that the alowance that drug companies have to justify their investment in new drugs shoud be regulated a lot more closely and even that sometimes it is just regulations that make the whole thing more awkward ( I felt bad today when I had a 12 yo westie that had been treated fore atopy by other vets- no Hry of allergys till recently- and the owner was so worried and was thinking about putting her to sleep. I did a skin scrape and found plenty of demodex, and I had to give he some advocate although I am nearly sure that if if it is not working in 2-4 weeks I will feel brave enough to give her some Ivermectin, anyway...) what I mean is...I think I will compose a letter and send it to the BVA(Not now, I've just come from the pub and it is 12.25)

Re: Advocate without a prescription?

Andre Escudeiro-Vieites — Thu, 21 Oct 2010 00:08:22 GMT

[quote user="Evelyn Barbour-Hill"]Well, there's the Chinese method. Block the foreign sites, arrest and imprison anyone who contacts them.[/quote]

I have to admit that this is very funny, in a meaningfull sarcastic way!

Re: Advocate without a prescription?

Bob Russell — Wed, 20 Oct 2010 16:43:45 GMT

Where investigations of counterfeit human products has been carried out it seems that many of the medicines do contain the right active ingredients but often in wrong quantities and with high levels of potential contaminants. This is more a quality control issue.

The cost of manufacturing ingredients seems to be quite low so I suspect the counterfeiters may be interested in repeat business. A copy with no active ingredient is likely to sell once but if it fails to do its job there will be no follow up orders.

Indian 'optimmune' can be purchased (illegally) at £35 for three tubes delivered. I have no idea if it works but it is easy to see how clients could be tempted to try them.

The potential fines and criminal records are not set out in these sites small print!!!

This is going to become more of an issue as long as veterinary drugs companies charge excessively for their products. Cyclosporin eye products have been on the market quite long enough to have recouped development costs and to have made a nice profit for the company involved.

A fairer price and I suspect many more dogs would be on eye medication for dry eye!

Re: Advocate without a prescription?

James Allsop — Wed, 20 Oct 2010 16:32:29 GMT

A client of mine was getting generic optimmune on the internet without prescription for around £12 per tube, she told me about it to see if I might be able to get it from there as well and reduce my costs. I reported it to VMD and again they knew all about it but as it was not a UK site (even though it ended .co.uk) they were powerless to stop it, they have to contact the local government of the country the company is based in and request that they intervene - needless to say this doesnt work well. My client only realised there was a problem when she couldnt read the data sheet, the company was apparently based in Trinidad. She now has a prescription and uses a UK based site and gets real optimmune.

Re: Advocate without a prescription?

Gareth Dowdeswell — Wed, 20 Oct 2010 16:29:47 GMT

Thanks for all the replies, just wanted to check it was as illegal as I thought it was. Unfortunately I didn't find out the name of the website but will make more effort next time!

[quote user="Gillian Mostyn"]

There is nothing to say this was actually the genuine product anyway.

Different product, but a client of ours swore she was able to buy her prescription diet online at a fraction of the cost. At our request she brought a bag in. The packaging was identical. But the kibble inside was completely different.

[/quote]

The packaging did indeed look authentic, and the dog didn't have any fleas, so hopefully it was an authentic product. Guess that's another reason why medications without prescription would be a bad idea.

Re: Advocate without a prescription?

Evelyn Barbour-Hill — Wed, 20 Oct 2010 16:18:35 GMT

[quote user="Colin Cameron"]But what can anyone do?[/quote]

Well, there's the Chinese method. Block the foreign sites, arrest and imprison anyone who contacts them.

Re: Advocate without a prescription?

Colin Cameron — Wed, 20 Oct 2010 13:43:52 GMT

[quote user="Utlendigur"]There was a site called petcaremart.co.uk that was selling advocate [/quote]

I did report this site ( petcaremart.co.uk) to VMD ( they know all about it) but as it is based outside the EU it is beyond their control. Apparently the penalty for being caught importing from this and similar sites is up to £5000 per offence! This information soon brought the client to their senses and off they went clutching some legal Advocate! This website has now been modified and does now say that a prescription is required for Advocate, so someone has had a word in someones ear! The whole internet pharmacy/retail market for POM-V will, in my estimation, become a bit farcical unless something is done to stop this sort of activity. But what can anyone do?

Re: Advocate without a prescription?

Edward Jones — Wed, 20 Oct 2010 11:38:02 GMT

[quote user="Martin Atkinson"]After all its less likely anyone could harm a pet with Advocate[/quote]

How about a small/puppy collie being given the wrong dose (or licking it off the coat) and a milbemax at the same time? That might be interesting...

[quote user="NOAH Compendium"]When 40% of the unit dose was given orally [to ivermectin-sensitive Collie dogs], severe neurological signs were observed.[/quote]

Re: Advocate without a prescription?

Hannah Wynne Richards — Wed, 20 Oct 2010 10:16:31 GMT

Definitely one for the BVA to take up

Wynne

Re: Advocate without a prescription?

Andre Escudeiro-Vieites — Tue, 19 Oct 2010 13:44:05 GMT

[quote user="Tim Mainland"]

It Is so important that such information relating to any POM-V products is reported to VMD. The scenarios described are illegal.

[/quote]

I don´t really think the VMD has the will (or maybe the means) to act on this. It would take a couple days labour from a clerical employee to do internet searches and find every product likely to be sold illegaly in the UK.

The problem has to be the will or the means to enforce or police these sites.

I don´t think that they need to rely on Vets or mebers of the public reporting dodgy sites.

Maybe we should do something else about it, like asking the BVA to take this issue as a representative body to the VMD, rather than individual vets reporting ilegal sites.

What do you think?

Re: Advocate without a prescription?

Bob Russell — Tue, 19 Oct 2010 12:30:21 GMT

Most prescription diets are available on-line, much cheaper and delivered free. Same stuff according to Royal Canin. I think it is time to lose the term prescription diet which by definition needs a written authority from a vet or SQP or anyone the VMD considers sufficiently trained to ''prescribe'' medication nowadays (a weeks training has to be as good as five years at University doesn't it).

Perhaps 'therapeutic diet if you chose the right one' would be more appropriate.

Re: Advocate without a prescription?

Gillian Mostyn — Tue, 19 Oct 2010 11:49:45 GMT

There is nothing to say this was actually the genuine product anyway.

Re: Advocate without a prescription?

Bob Russell — Tue, 19 Oct 2010 09:17:56 GMT

[quote user="Laurence Webb"]

[quote user="Bob Russell"]

I did report various flea products being sold on ebay and the VMD informed me that an arrangement was being introduced to stop imports of POM-V products that way. As expected from the VMD nothing has been achieved and Frontline Combo is freely available without prescription. It arrives in a bottle and has a dropper to apply!!!!!

[/quote]I didn't belive you but yes, there it is - 32 months supply of Frontline Plus for £36.19 plus 62p shipping (it's large dog stuff an you break it open to measure out smaller quantities for cats).

Does ebay not have some responsibility for allowing UK buyers to import medications illegally, although probably unknowingly? They take commission so presumably this makes them legally involved in these transactions

EDIT - I've also found some that boast 'no expiration' Surely they're breaking the law in the US by advertising this, as the FDA would require an expiration on this by law?

[/quote]

When a product is being supplied illegally this sort of detail is not particularly important to the suppliers. It is the person importing the medicine i.e. the e-bayer that is committing a criminal offence without knowing it!!!

E bay did promise to block this - having said this I have not tried to order it - there may be a pop-up warning that it is an illegal to buy this in the UK.

Re: Advocate without a prescription?

Utlendigur — Mon, 18 Oct 2010 21:50:14 GMT

There was a site called petcaremart.co.uk that was selling advocate (and other things) without prescription. It appeared to be a UK site from the website details, but was actually based in Barbados, so outside of UK law apart from the customs side of things. I've just tried to find it again now and it appears to be gone so hopefully it's been taken down. I had heard that customs were looking for imports from it and stopping them.

As far as the VMD website goes, wouldn't it be nice if there was an obvious link somewhere on the main page saying "report fraud here", and an easy way of doing it. I may have just been thick but it took a lot of searching to find the enforcement contact details, and then I had two emails bounced back because the addresses provided were out of date.

Re: Advocate without a prescription?

Tim Mainland — Mon, 18 Oct 2010 19:48:28 GMT

It Is so important that such information relating to any POM-V products is reported to VMD. The scenarios described are illegal.

Re: Advocate without a prescription?

Laurence Webb — Mon, 18 Oct 2010 19:08:53 GMT

[quote user="Bob Russell"]

EDIT - I've also found some that boast 'no expiration' Surely they're breaking the law in the US by advertising this, as the FDA would require an expiration on this by law?

Re: Advocate without a prescription?

bob lehner — Mon, 18 Oct 2010 18:05:28 GMT

[quote user="Camilla Edwards"]

So quite possibly you've stumbled accross an illegal website, not sure what you're meant to do about that? Maybe contact the VMD?

[/quote]

I agree - if you can find out more details about the site then the VMD should be the ones to take appropriate action to close it down (if it is UK-based).

Re: Advocate without a prescription?

Bob Russell — Mon, 18 Oct 2010 18:05:11 GMT

Bob Martin branded 'Advantage' is available in Morrisons - small cat was around £8 for four doses from memory. As certain 'gentlemans' medication is available on-line after a 'consultation' with an on-line doctor (and no I have not had such a consultation!!!) perhaps there is an on-line vet trying to do something similar.

If you get the website information send an email to the VMD they will claim to take action if the site is in the UK. I did report various flea products being sold on ebay and the VMD informed me that an arrangement was being introduced to stop imports of POM-V products that way. As expected from the VMD nothing has been achieved and Frontline Combo is freely available without prescription. It arrives in a bottle and has a dropper to apply!!!!!

Re: Advocate without a prescription?

Martin Atkinson — Mon, 18 Oct 2010 17:27:35 GMT

[quote user="Gareth Dowdeswell"]

[/quote]

Hmmm...good point, I concede on that and don't condone the fact it can be obtained without a prescription the but the second sentence illustrates my point that 25-40kg Advocate would probably do less harm on a tiny dog than Bob Martins dog flea treatment on a cat.

Re: Advocate without a prescription?

Camilla Edwards — Mon, 18 Oct 2010 17:16:17 GMT

This is according to the online NOAH compendium

http://www.noahcompendium.co.uk/Bayer_plc/Advocate_Spot-on_Solution/-38251.html so Advocate's legal category is POM-V, which,

http://www.noahcompendium.co.uk/Compendium/Overview/-42802.html stands for prescription only medicine - veterinarian. ie. it needs a vet's prescription to get it.

So quite possibly you've stumbled accross an illegal website, not sure what you're meant to do about that? Maybe contact the VMD?

Camilla

Re: Advocate without a prescription?

Gareth Dowdeswell — Mon, 18 Oct 2010 17:04:06 GMT

[quote user="Martin Atkinson"]

Is this any worse than prescription diets being available over the internet? After all its less likely anyone could harm a pet with Advocate than they could with the wrong flea product from a pet shop but they could feed entirely the wrong diet to their pets.

[/quote]

I've never tried putting 25-40kg Advocate onto a tiny dog, perhaps that might do some harm? Given that owners can mix up Bob Martins Dog and Cat treatments, it wouldn't be beyond the realms of possiblity. I'm really more interested in the fact that Advocate is a POM-V and appears to have been obtained without a prescription, regardless of if Advocate should be a POM-V or not.

Re: Advocate without a prescription?

Martin Atkinson — Mon, 18 Oct 2010 16:59:01 GMT