Medication Dispensing

[Bellaboo]

My 5 year old Boxer Bella is on Vetmedin (for Cardiomyopethy) and they are amazing. She was diagnosed in Oct last year and they only gave her 6 to 12 months to live. It is nearly 12 months down the track now and she is doing so so well. She is almost symptom free. She still fatigues quickly and has a slight cough somtimes but the Vetmedin has been wonderful. She is on 2 a day and for 14 my vets charge about $35, but if I buy 28 they only charge me $54. They generally dont sell me more than the 28 (2 weeks) at once. I might ask them about buying larger amounts. She was on the Frudix for a while but is not on that any more.

They certainly arent cheap .... but for the results they have given us ... I would pay anything !!!

Edited September 28, 2008 by Bellaboo

[Miss B]

She is on 2 a day and for 14 my vets charge about $35, but if I buy 28 they only charge me $54. They generally dont sell me more than the 28 (2 weeks) at once. I might ask them about buying larger amounts. She was on the Frudix for a while but is not on that any more.

They certainly arent cheap .... but for the results they have given us ... I would pay anything !!!

You should ask your vet about purchasing Vetmedin in larger amounts to save on dispensing fees, it seems odd that they would only allow you to purchase two weeks worth at a time - especially as they are obviously aware that your dog will be on the Vetmedin long-term.

[Monah]

Neither my vet or doctor charge a dispensing fee although as a business owner I see nothing wrong with it and the costs must add up to a large amount for time, goods etc. I think a fee is a good idea.

[witheverythingiam]

The only way to stop having to pay a dispensing fee would be to get Dr in front of your name, specialising in animal health

$18 is a tad expensive though - usually it's only around $7, and the more you buy, of course the cheaper the medication end up being each.

-WithEverythingIAm

[witheverythingiam]

I think the more people that try to obtain scripts will find that Vet's will start charging script writing fees and so they should!! It costs me $70 for my doctor to write out 2 scripts for me each time. If you're going to use your Vet Clinic and expect to get in when you want, get the best diagnostics and phone support, then not buy the drugs from the clinic you'll find the goodwill will go out the window.

How very true. If I were a Vet, I'd be very hesitant to write out scripts willy nilly for medication to be bought at the chemist, unless we couldn't get that particular medication from our suppliers (very unlikely).

-WithEverythingIAm

[Staff'n'Toller]

Yep we have no problems writing out scripts for human meds that we can't get through the Vet Wholesaler, particularly if it means the client can get it quicker for their sick animal. We also have no probs writing out scripts for the compounding pharmacy.

Trying to get my boss to write out a script for a medicine that we stock on the shelves is like getting blood out of a stone. He actually charges a report writing fee already. Right or wrong I can't really argue...it's his choice as a Doctor. I think he also objects because many of his colleagues in the UK spend half their working day filling out insurance forms because everyone over there needs to have Pet Insurance.

I assume that the cost of writing out insurance claims is already factored into UK fees...so his objection to fee free script writing is probably connected to that.

Just FYI our dispensing fee is 17.00 has been for a while.

ETA: He is not a money hungry Vet either....he is far from it, he is away at the moment basically doing pro-bono work for a month.

Mel.

Edited September 30, 2008 by Staff'n'Toller

[sandgrubber]

Hi,

My dog needs to take life long prescribed medication from the vet. The medication is very expensive and I found out today the that vet charges me $18 everytime medication is dispensed.

My vet charges a dispensing fee on worming tablets . . . so I buy them 100 at a time in their original packing and on sell them at my cost to other breeders . .. . saves the vet from having to deal with lots of little transactions and gets the dogs wormed in a way that minimises handling charges. If your dog is on a medication for life, why not see if the vet will sell you dosage for several months at one hit. Btw, most meds have a very long shelf life (years) if kept dry and refrigerated.

[Mum to Emma]

This subject has always been a pet-peeve of mine (pardon the pun!)

When Emma was first prescribed Trental through by veterinary dermatologist, the specalist centre charged me $100 for 60 tablets. I didn't know anything about the drug at the time so didn't question the cost. However, when I did some research on the internet, I found that I could buy them at Chemist Warehouse for around $40 for 50 tablets! That's a 100% mark-up by the vet.

Now I would assume that the chemist is making his profit, so why does the vet have to double that? They gave me all sorts of excuses such as "Oh, we have to buy them through a veterinary wholesaler", blah, blah.

I'm all for vets charging the same consultation fee as GPs, BUT like GPs, they should NOT be able to dispense prescription medications - they should be forced to write prescriptions that can be filled by a third party ie a chemist. By directly selling expensive medication at such inflated prices, they only leave themselves open to accusations of over medicating our pets.

After speaking to Chemist Warehouse and being assured that they would fill a veterinary prescription, I insisted on receiving a prescription from the vet so that I could buy the Trental elsewhere, which they did give me - at an $11 fee on top of the consultation fee of $120 (again, WHY do vets charge to write prescriptions, yet GP's don't??)

[Staff'n'Toller]

My GP certainly does charge me for scripts and has for several years. If you see a bulk billing doctor for yourself then you cannot compare the two- it's called medicare- and you are paying a certain amount of tax to keep it going.

Chemist Warehouses buy drugs in huge bulk amounts and distribute those between all of their franchised stores. It's a little bit like Bunnings and then your little hardware store down the road having entirely different prices. The small fries just cannot compete with the bulk buyers because we can't negotiate huge discounts like they can. It's pretty simple to understand.

You're paying $120 for the Specialist Vet's expertise, they do many years of extra study. When your Vet refers you to one it is because your dogs' issues are out of their area of expertise.

If everyone starts demanding scripts, then down the track we might end up like the UK, you see the Vet (for double what you're paying now b/c they will need to cover overheads to make up for loss of income from drugs) and they don't stock meds at all anymore.

Mel.

[Mum to Emma]

If everyone starts demanding scripts, then down the track we might end up like the UK, you see the Vet (for double what you're paying now b/c they will need to cover overheads to make up for loss of income from drugs) and they don't stock meds at all anymore.

Mel.

Well, by saying this you're supporting the argument that pets are prescribed medications unnecessarily in order to increase their profits. If vets don't stock meds, they won't prescribe them unless it's necessary. Vets should give people the option to buy, for example, cortisone eyedrops directly from them at $20 a bottle, or from the chemist at $10. The fact is, they don't even give people this option, nor let them know that it is available. And - be honest - writing out a prescription is no more onerous that writing out an invoice.

I am free to shop at Bunnings OR the local corner store. One offers price, the other convenience. Either way, the choice is mine.

BTW, it was anticipated that Emma would be on this medication for life. By buying the meds from the vet, I would have been unnecessarily supporting his profits to the tune of an extra $292 a year, in addition to the annual revisit.

Edited October 5, 2008 by Mum to Emma

[WalandLibby]

For drugs that they prescribe relatively small numbers of it's not surprising that a vet will have to charge a higher price.

My dog has been on huge amounts of medication (at one point, more than 10 doses a day, fortunately we're down to 4 doses a day now) and I've found the specialist extremely happy to write scripts, in fact it was her who suggested that I buy what I can from the pharmacy. I have never found vets to act as though they don't realise that ppl often struggle to find the money for vet treatment, and to do what they can to reduce that burden. But maybe it does come down to finding a vet who you feel comfortable with, who respects you (and you respect them), and asking them about it when you're not happy with something.

Edited October 5, 2008 by WalandLibby

[Staff'n'Toller]

I'm not sure, mum to emma, why you have such a huge chip on your shoulder, but nothing I wrote suggests that we over-medicate animals. What I said was that in the future Vets won't stock medicines AT ALL and you may have to go to the chemist for everything. Kindly refrain from putting words into my mouth.

Your insinuations that Vets put out medications unnecessarily "just because they can" or "just because they want to boost profits" is complete and utter hogwash.

If you were aiming those accusations at a Vet in particular you would be taken for defamation...think about what type before you type it.

What most lay-people such as yourself don't understand is the real cost of medications because all of yours are probably on the PBS.

No-one would believe that we keep $15000.00 worth of meds on the shelf FOR EACH VET IN THE PRACTICE at any one time, most people wouldn't believe that either, I do the stocktake though, I can tell you it's absolutely true.

It sounds as though you are quite upset that a) you had to pay to see a specialist and b) you are also upset that your dog needs to be on life long medications. Neither of which is my problem.

Edited October 5, 2008 by Staff'n'Toller

[Staff'n'Toller]

Rappie may also be able to tell us more about the costs of having medications approved for animals, and what sort of recourse there is if say...your dog is on a human medication from the chemist and they have an adverse reaction?? My bet is that if you were to ring the manufacturers they wouldn't want anything to do with it because chemist meds are not approved for animal use.

I think there's a huge minefield there, especially if your dog has a serious adverse reaction and dies...

[WalandLibby]

the costs of having medications approved for animals, and what sort of recourse there is if say...your dog is on a human medication from the chemist and they have an adverse reaction?

Most of what my dog's been on has been off-label use, I thought that was pretty common for medications for animals (at least those with rarer conditions) whether you buy from a vet or not?

What most lay-people such as yourself don't understand is the real cost of medications because all of yours are probably on the PBS.

I so agree - I think has a lot to do with how we feel about paying for general veterinary treatment too. If we were faced more often with the real costs of providing our own health care, I don't think we'd think as often that vet care is expensive. Edited October 5, 2008 by WalandLibby

[Miss B]

I actually took a phone call at work the other week and was asked, "Oh hi... just wondering if you bulk-bill?"

[dougal]

I was placed in a similar position many years ago, my boy was on daily (very expensive) medication for 14 years. Over the years I used a range of strategies to minimise the cost - at one time I was importing directly from the US which worked out much cheaper than purchasing through the vet. I also shopped around vets and negotiated a cheaper price as they knew I would be a regular customer. One vet charged me wholesale. I also purchased through pharmacies - again negotiating directly with the pharmacist. Good luck!

[Rappie]

The exact circumstances under which a dispensing fee is charged and how much it is, is something determined by the individual practices. Under most circumstances, a dispensing (or injection) fee will be applied to prescription medicine ie. S4-S8 drugs. Those drug schedules are the same used in human medicine. In most of the practices I have worked in, a vet is responsible for the intial prescription as well as checking the patient record again each time that a refill is required - to monitor the efficacy, any side effects, whether any adjustments need to be made to dosages, whether a blood test is due (for drugs such as phenobarbitone). That all takes time, training and expertise.

It's very very costly to get a new medication registered for veterinary use. There are also guidelines for the off label use of medications and whether or not it's an appropriate option depends on the patient, the drug in question, costs etc. It's generally expected that if there is a specific veterinary preparation of a particular drug then that is the one that should be prescribed - this applies even to drugs that are labelled for specific species. Veterinary drugs go through the same sorts of testing as human drugs - so things like bioavailability, tissue concentrations, adverse effects - in the appropriate species. Any off label use needs to be fully described to the client and any adverse effects discussed - this applies to things like using ivermectin off label to treat mite infections, or for human medications. Some drugs are fine to substitute - frusemide is one of those, some eye medications are another. Other times there is no registered veterinary equivalent - such as tramadol or diazepam, or the medication needs to be specially compounded. In these cases, these drugs can be prescribed if there is sufficient, well accepted, published information to support their use. There is no back up using drugs off label - if something goes wrong, the companies aren't likely to be interested and it is "normal" for owners to want to blame someone. It's not as simple as just asking for the cheapest option. Whether or not your vet is prepared to write a prescription for the cheapest option depends on a lot of factors, not just whether they are "trying to rip you off".

ETA: there are also some drugs where even though there is a registered veterinary generic, it just doesn't seem to work as well as the "real" one. If cost is a significant issue then a vet might prescribe the generic, sometimes at a higher dose. The fact that there are two types, and your vet prescribes the more expensive may not have anything to do with practice income.

Edited October 5, 2008 by Rappie

[Mum to Emma]

I'm not sure, mum to emma, why you have such a huge chip on your shoulder, but nothing I wrote suggests that we over-medicate animals. What I said was that in the future Vets won't stock medicines AT ALL and you may have to go to the chemist for everything. Kindly refrain from putting words into my mouth.

Your insinuations that Vets put out medications unnecessarily "just because they can" or "just because they want to boost profits" is complete and utter hogwash.

If you were aiming those accusations at a Vet in particular you would be taken for defamation...think about what type before you type it.

What most lay-people such as yourself don't understand is the real cost of medications because all of yours are probably on the PBS.

No-one would believe that we keep $15000.00 worth of meds on the shelf FOR EACH VET IN THE PRACTICE at any one time, most people wouldn't believe that either, I do the stocktake though, I can tell you it's absolutely true.

It sounds as though you are quite upset that a) you had to pay to see a specialist and b) you are also upset that your dog needs to be on life long medications. Neither of which is my problem.

(a) Trental is not on the PBS

(b) I most certainly am NOT upset that I had to see a specialist. Vet's (like GPs) are inclined to shoot in the dark when something more obscure comes along . Specialists are most certainly worth the double consultation fee because they diagnose more conditions immediately, which means quicker resolution and less stress for the pet. Oh, and my vet has 25+ years experience and is highly regarded in the profession. But there's just some conditions that they just don't see ...

(c ) You still haven't given me a good argument why pet meds should be marked up 100%. Yes, vets have overheads - so do GP's. The consultation fee is the same. My GPs doesn't charge for a script if it's given to me as part of a consultation. Nor does my regular vet. But the vet specialist DOES.

(d) Don't put words into MY mouth either. I said dispensing meds left vets open to the accusation of over medication - just as it would some GPs if they did likewise. I didn't say it happened at all vets - but I'm sure that in a small number it does.

(d) I would be very happy to go to chemists for everything IF it meant I got a fair price.

What upsets me is that some pets will suffer because their owners can't afford the medication. Some will immediately be put to sleep beacuse their owners are horrified when given an estimate of the cost to treat them. I'm sure we're all aware of situations where that has happened.

Pet care shoudn't be a privilege of the wealthy. But while vets don't do everything to minimise cost, that is what is happening. And that is very sad.

Edited October 5, 2008 by Mum to Emma

[stormie]

Owning a pet shouldn't be a privilege of the wealthy, no, but people should be aware of and prepared for possible costs of veterinary treatment before they take on a pet. And there's also plenty of pet insurance companies out there who cover costs of medications.

I don't see why vets should have to discount medications for people. It's like asking the vet to pay for your treatment. My loves cars, but he doesn't fix my car for free or cheap.

[witheverythingiam]

What most lay-people such as yourself don't understand is the real cost of medications because all of yours are probably on the PBS.

Yes, and we all know the PBS is NOT for animals, but for humans who need medication. I'll bet this person would kick up a stink like the ones in the newpaper on Sunday who are outraged by the fact a Vet was doing business after hours with a human chemotherapy hospital in Vic, because it was cheaper for the animals' owners.

Wanting the rules bent, to suit oneself.

-WithEverythingIAm