Diversion

So a few months back we initiated a policy change that has not been the most popular for some of our clients. Please know we do not make these changes, especially unpopular ones with clients, without good reason. There are only two main reasons here 1. Risk to animal health 2. Risk to veterinary licensure.

The change I am referring to is our outside prescription policy. Currently if a client wants a prescription from an outside pharmacy for an animal specific product a written script must be picked up at the clinic. Previously, we would sign fax request for these products and send the fax directly to the outside company completing the prescription electronically.

I realize this is a very annoying change, especially for clients use to the previous process. So let me take a minute to explain the reasons why, and as always, I digress to “story-time”.

So those of you that are into hair care and buy your products from your stylist or hairdresser may know that some products are “salon only”. These products are not directly sold to wholesalers, groceries, or big box stores. So where does the “Paul Mitchell” on the shelves at Walmart and Kroger coming from?….What a great question! These products are obtained from one of the following methods 1. Counterfeited 2. Stolen 3. Outdated (and then repackaged) 4. From over seas (and 1-3 apply). Big deal right? I mean it is hair product. Worse case scenario your scalp doesn’t’ get as clean (I realize I might be minimizing this). None of this is illegal. It is considered the “Gray Market”.

You may be asking, how does this apply to your pets medications. Well I am glad you ask…the same “gray market” exists with pet medications. They are obtained thorough the same manners 1.Counterfeited 2. Stolen 3.Outdated (and repackaged) 4. From over seas (and 1-3 apply). The only difference is the consequences are much larger than some frizzy hair. The most requested products are ones that carry expense, which is intuitive. The most common products are flea/tick, heartworm, NSAIDS (Rimadyl Galliprant ect), and Vetmedin. All of these products have deadly consequences if not the “real deal”. Heartworm and tick disease have previously been discussed in the last posting, If you want a refresher please revisit. NSAIDS don’t carry deadly consequence if not given (unless severe pain is is the issue) the side effects of these products if adulterated are potentially deadly. The last one on list, Vetmedin, is a heart medication that has been revolutionary in our field. It has increased survival times months to years for dogs in congestive heart failure. I am sure some readers with heart disease can sympathize.

You know what really “Grinds my gears”!?!? These outside pharmacies do not care about your pet! They care about profits and quarterly reports. If your dog dies of heartworm disease, congestive heart failure, adulterated product, or Lyme disease they are a number to them, not a patient. They also do not play an active role in education of why these products are importation, nor do the play an active role in describing side effects of the products. They are just there to collect your money and send you bogus medications. Even when buying from a brick and mortar pharmacy the same issues apply. Don’t be fooled, they get their products via the same sketchy means. Also, don’t be at ease because a real pharmacists is the one filling the order. I have a very close friend whom is recent graduate for pharmacy school. They do not get adequate education (or any at all) on veterinary medications. I challenge anyone who doesn’t believe me to ask the pharmacists what side effects they should look for in veterinary specific products…and ask them to do this on the spot without looking at the package insert (if there even is one). We recently had an encounter with client, who I assumed was a good friend from church. She was upset that we would not sign a Walmart script for a product. Her husband is a pharmacists and he “knows how these products are regulated” and has order these products from a “wholesaler”. The issue being the maker of this particular product, Zoetis, does not sell to wholesalers. See the issue???The company also put out a diversion letter stating as such. I emailed her copy, and have yet to hear back.

Finally my last point…Support your local businesses, because if not, the customer looses in the long run. Ironically, the “friend” I mentioned above has a small business we have supported in the past. Unfortunately, our clinic pharmacy is source of income, and it continues to dwindle even in the face of a growing client list. We still have growing expenses via natural inflation, as well as local staff that we support. This means eventually the cost of services must increase. We have done our best to minimize this to cost of living increases. We also have some things in the works to help make products more affordable. We are trying our best to do our part. Ultimately though we are very small fish, in a very big river trying to swimming up stream.

So those of you paying attention, may ask the following-If we know the risk, and is has been explained in detail, why won’t you sign fax request, and make this easy on all of us. That is a very good questions. There are two reasons 1. I don’t want my signature, or any of my doctors signatures, directly on a “gray market” product. We need that to be our clients choice so we are not held accountable if or when the product fails. 2. Some online companies are very unethical and will use our signatures to fill scripts on patients that are not ours, in some cases not even the same state. This is a huge legal liability. We do not want to get caught up a lawsuit and jeopardize our pharmacy license and/or possibly our medical license for something we have no control over. Anyone whom as dealt with the local or federal government know there is little margin for error and no sense of humor. If you have some free time to explore the google machine on the inter-web, google “Petmeds and lawsuits”. I will be the first to tell you not to believe everything you read on the internet, and actually it is the bane to my existence at times; however, there is a trend once you get to 14th “o” and get this message-“In order to show you the most relevant results, we have omitted some entries very similar to the 131 already displayed.” This is a company that has ethical issues! Bottom line and common theme to most of these blogs- Be nice! Don’t shoot the messenger! You can get your medications where you want, but we are going to inform you of the risks because that is job. Don’t get mad at your veterinarian because you can’t (or don’t want to) spend extra to ensure your pet is getting legit products. Sorry to offend, and if you are don’t keep reading!

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