April 29, 2016
Veterinary prescription practices reviewed by House panel
Lawmakers profess affection for pets, appreciation of veterinarians
By: Edie Lau
For The VIN News Service
The idea of compelling veterinarians to provide prescriptions automatically to pet owners to encourage shopping around for the best price was explored today by a largely skeptical panel of legislators in Washington, D.C.
VIN News Service screenshot
Dr. Kurt Schrader, a veterinarian and congressman from Oregon, challenged the need for a federal mandate on pet prescriptions during a hearing on Capitol Hill today.
A 90-minute hearing on “The Pet Medication Industry: Issues and Perspectives,” organized by the House Subcommittee on Commerce, Manufacturing and Trade, ended with no official action.
“Today, we’re here to listen; to understand what role, if any, the federal government ought to play,” said Rep. Fred Upton, R-Michigan. “I think we can all agree that the health and safety of pets is a top priority for folks … around the country.”
Upton chairs the House Energy and Commerce Committee, under which the subcommittee that hosted the hearing operates. The same subcommittee has been assigned a bill, HR 3174, dubbed the Fairness to Pet Owners Act of 2015, that would require veterinarians to provide prescriptions to clients in every instance that medication is prescribed.
The subcommittee has not considered the bill itself, and it is unclear when and whether it will do so.
An earlier version of the legislation, which was first put forth in 2011, prompted a look at the pet medications industry by the Federal Trade Commission, a pro-consumer, pro-competition agency. The FTC held a workshop on the subject in 2012, and issued a report last May.
At the hearing, Tara Koslov, deputy director of the FTC Office of Policy Planning, summarized the report findings and explained the agency’s support for a rule that veterinarians voluntarily provide prescriptions to clients.
Although 36 states and professional ethics oblige veterinarians to provide prescriptions when asked, “complaints persist that not all requests are honored,” Koslov said. “Also, many consumers still don’t know that they can ask for a portable prescription. Other consumers may know, but are uncomfortable asking, especially when their veterinarians require fees or liability waivers or make disparaging statements about competing retailers.”
Several legislators challenged Koslov’s stance. “These so-called complaints, you can’t verify where they’ve come from [or] who they’ve come from,” said Rep. Kurt Schrader, D-Oregon. “My guess is, they come from, frankly, the pet-med-type of distributors out there who are — their one, single motivation is to make money. I respect that. This is America, it’s a market system. But they do not have the best interest of the pet at all in their sights.”
Schrader, who is a veterinarian on the House Energy and Commerce Committee, also expressed offense at the tenor of the discussion.
“The tone a little bit is impugning my profession,” he said. “I’ve been a veterinarian for 35 years. I could have made a lot more money in a lot of other professions. I went to school for an exhaustive period of time … And I chose veterinary medicine because I love working with animals. The prescription piece is a small part of what we do. … It’s not about making a lot of money. It’s about providing the best health care to the pet.”
Other legislators also spoke passionately against mandating prescription writing.
“All it sounds like to me is just more regulation on an industry that is struggling,” said Rep. Markwayne Mullin, R-Oklahoma. “There is a shortage of vets, especially in rural America. We cannot find enough of them, and this is just another reason to keep people out of it.”
(Veterinarians widely see the profession as struggling, due in large part to crushing student debt, relatively low starting incomes and competition on multiple fronts, but assertions about a workforce shortage are controversial. A 2012 report by the National Research Council found no widespread shortages, although specific rural regions may have difficulty attracting practitioners.)
The subcommittee chairman, Rep. Michael Burgess, R-Texas, offered a personal anecdote in defense of medication sales at veterinary clinics:
His dog, Sammy, developed congestive heart failure last year at the age of 15. The situation looked grim, and the family veterinarian prescribed a drug that was expected to prolong the dog’s life by only a month or so. But 14 months later, Sammy is alive still.
“Every month, my wife goes back to the vet to get medications,” Burgess related. “Sure, we could get them online, and if I had any idea he was going to live this long, maybe I would have! But it’s also helpful. Because there’s this interaction that takes place: ‘How’s little Sammy doing? Is he looking good? Does he need to come in for a recheck?’ And several times, in fact, that recommendation has been made and followed, and a medication adjustment has been made…
“There is some value in the pet owner-veterinarian interaction that takes place,” Burgess concluded, “and I think that brings value to the transaction.”
Of nine legislators who spoke, nearly all mentioned by name a dog or cat in their home or workplace. Upton called his a “Nine-to-Fido office.” “Our beloved pets provide a constant source of joy and levity, as well as companionship and unconditional love,” he enthused.
Upton added: “I want to be clear that, just as our pets are part of our extended family, our vets are a trusted part, too, of that equation …”
No lawmaker spoke in direct support of federal prescription regulation, but Rep. Janice Schakowsky, D-Illinois, expressed doubts about the convoluted system by which pet medications sold by retail outlets may travel from manufacturer to pet owner.
Most pet pharmaceutical makers have policies of selling veterinary drugs only through veterinary clinics. Consequently, retail pharmacies and online vendors usually obtain veterinary medications through secondary distributors.
Nathan Smith, vice president of True Science LLC, told the panel that as a secondary distributor, his company obtains medications in a variety of ways: “Sometimes … we’ll buy excess inventory from veterinarians. Sometimes we buy straight from distributors, and at other times we’ve ... been able to source direct from manufacturers.”
Considering that a product might go from a manufacturer to a veterinary distributor to a veterinarian to a secondary distributor to a retail pharmacy before reaching the customer, Schakowsky said, “This does not seem to be an efficient supply chain, to me, in terms of best buy for the consumer.”
She wondered how moving through so many hands affects the prices of drugs.
Smith replied, “At prevailing prices, and we don’t know exactly, but you could imagine prices could fall an additional 15 to 30 percent based on the elimination of those extra steps in a supply chain.”
Also appearing at the hearing was Dr. John de Jong, chairman of the American Veterinary Medical Association board of directors. De Jong testified that legislation requiring automatic prescriptions is an unnecessary regulatory burden for veterinarians.
Schrader was of like mind. “I hope that this is the first and last hearing that we have on this sort of bill,” he said.
A video recording of the hearing is posted on YouTube.
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.
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