Regulators' clarification of California veterinary drug counseling law falls short
Following weeks of pleas from veterinarians for guidance, the California Veterinary Medical Board on Feb. 15 posted a document about the state's new law requiring veterinarians to counsel clients about the drugs they prescribe to clients' animals.
The two-page write-up misses the mark, however, a veterinarians' advocate says.
Raphael Moore, general counsel of the California-based Veterinary Information Network, an online community for the profession, said the document does not answer eight of the nine questions he submitted on behalf of practitioners at a Jan. 23 board meeting.
"It is a shame that the VMB did not take this opportunity to actually answer the substantive questions posed by the profession, leaving them unsure as to how to meet regulations that the board itself insisted on passing," Moore said.
Effective Jan. 1, the law — previously known as SB 1480, now folded into the state Business and Professions Code in section 4829.5 — requires veterinarians to provide to clients certain information about drugs they prescribe for the first time to the client's animal. The counseling is similar to that of a pharmacist's consultation with a human patient. The requirement applies to "dangerous drugs," which include all prescription drugs, under the state definition.
The mandate has generated numerous questions about exactly how to meet the letter of the law. For example, the first sentence of the regulation is, "Each time a veterinarian initially prescribes, dispenses or furnishes a dangerous drug, as defined in Section 4022, to an animal patient in an outpatient setting, the veterinarian shall offer to provide, in person or through electronic means, to the client responsible for the animal, or his or her agent, a consultation ..."
That passage alone has given rise to questions such as: Is it the offer of a consultation that shall be done in person or through electronic means, or the consultation itself? What are acceptable electronic means? An email containing all of the necessary information? A telephone call? Would providing a link to a searchable database fulfill the requirement?
Moore collected these and other questions raised by practitioners on a VIN message board discussion that ensued around a VIN News Service article published last month about the law. VIN is parent of the VIN News Service.
Moore submitted nine primary questions and several secondary questions to the board at a meeting one month ago. CVMB Executive Officer Jessica Sieferman replied that she and the board attorney would meet with legislative staff who were involved in developing the statute and would post information to the board's website shortly.
In an email to Moore on Feb. 14, Sieferman said the completed document "will not answer all of the specific 'open questions' you listed; rather, we addressed over all themed-issues and a few of our frequently asked questions."
She did not explain how veterinarians should handle their unaddressed questions. VIN News was unable to reach Sieferman for elaboration.
Of the questions from practitioners that Moore submitted, the CVMB document provides a direct answer only to the question: "Do refills of a prescription originally issued prior to Jan. 1, 2019, require a consultation?"
The answer: "SB 1480 was not applied retroactively. However, if you prescribed the dangerous drug prior to January 1, 2019, but are initially dispensing the drug after that date, you are required to offer the consultation."
Unanswered questions include whether the law applies to medications prepared by compounding pharmacies; whether the counseling duty may be delegated to any veterinary staff member, licensed or unlicensed; and the definition of "common" and "severe" adverse drug effects.