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Bill requiring veterinarians to script out strikes nerve

AVMA expected to oppose congressional measure

April 27, 2011 (published)
Dave DeKok and Jennifer Fiala
A federal bill that forces veterinarians to issue prescriptions to pet owners so they can bargain hunt in pharmacies or online for their pets' medications is generating flak from those who believe the profession is being unfairly targeted.

The Fairness to Pet Owners Act of 2011 calls for veterinarians to write prescriptions for pet medications or notify clients of the option even if the owner does not ask. Sponsored by Rep. Jim Matheson, R-Utah, HR 1406 stipulates that veterinarians may not refuse to write a prescription or charge a fee for it.

The nation's economic downturn spurred the bill's creation, explains Alyson Heyrend, the communications director on Matheson's staff. HR 1406 was referred to the Energy and Commerce Committee on April 6, and Heyrend expects that lawmakers will take a look at it next week when Congress is back in session.

"I don't think there was one standout anecdote that was the impetus for this," she said. "The congressman certainly talked with constituents about the need for this bill. I think that the more ways a pet owner can care for their pets is a good thing, especially in these tough economic times."

In a statement to press, Matheson said: “Family budgets are tight and every opportunity to save matters. This bill simply gives pet owners the same right to shop around for the best prices on the medications they buy for their pets as they have for products they buy for themselves.”

The American Veterinary Medical Association (AVMA) has not yet taken an official stance, but its Board of Governors is expected to soon put the final touches on talking points designed to stamp out HR 1406. Heyrend reports that veterinarians already have been lobbying against the bill on Capitol Hill. Meanwhile, the AVMA's leadership is urging members to write their elected officials in opposition to the measure.

Why? Because what the bill requires is "onerous, burdensome and unnecessary," according to Dr. Mark Lutschaunig, director of the AVMA's Governmental Relations Division in Washington. He insists that the AVMA's stance is not fueled by any potential loss of revenue to veterinary practices but by the volunteer councils and committees within the AVMA that have studied the bill's potential impact.

Their consensus, Lutschaunig said, is that it's "inappropriate to prohibit any business from charging for the delivery of a service" such as writing a prescription. Additionally, it would place clients in the “uncomfortable and untenable” position of policing their veterinarians and create unnecessary work for practitioners, in the process.

The AVMA already has adopted an ethics stance that calls for veterinarians to provide prescriptions to clients who ask for them, free of charge. The Principle of Veterinary Medical Ethics of the AVMA was revised in 2008 to address client prescription requests in an attempt to fend off federal mandates like what's proposed in HR 1406. Though the AVMA's stance is a guide that carries no legal or regulatory teeth, licensing boards in some states have adopted it as part of regulatory code that requires veterinarians to provide their clients with prescriptions upon request.

“It’s not wrong for clients to go elsewhere if they want. But there are better ways to go about it,” said Dr. Maria Gonzales of San Antonio, Texas, speaking of HR 1406. With concerns that some online pharmacies sell drugs of uncertain quality, Gonzales fears that HR 1406 would preclude veterinarians from advising clients on the safest places to buy their pet medications, which could include their own veterinary practices.

HR 1406 has garnered attention on the Veterinary Information Network (VIN), an online professional community where response to the bill has been predominantly negative. The bill's mandates rub salt in the wounds of veterinarians who have for a decade seen their once highly profitable in-house pharmacies lose business to a proliferation of online drug sellers and brick-and-mortar pharmacy chains. Additionally, the bill puts a crimp in how some veterinarians have fought the loss of revenue, especially since the emergence of the online pharmacy PetMed Express — by charging prescription-writing fees or refusing to script out altogether.

Even so, many veterinarians already script out free-of-charge and view withholding or putting a price tag on prescriptions as bad for client relations. Moreover, small animal veterinary practices aren't known to be cash cows, and the idea that veterinarians are needlessly squeezing clients is considered by some to be insulting.

“We don’t gouge the client,” said Dr. Mark Pirrung of Mesquite, Texas, who is opposed to the bill and has tried to alert other veterinarians to its provisions. Like many of his colleagues, he's priced his in-house medications and pet parasiticides to be competitive. “Most of our prices are less than PME (PetMed Express)."

The Fairness to Pet Owners Act is modeled after the Fairness to Contact Lens Consumers Act, passed in 2003, which gives contact lens wearers a right to a written copy of their prescription. That bill was a reaction to optometrists who required patients to buy contact lenses from them at higher prices and refused to hand out prescriptions so that patients could shop elsewhere when contact lens discounters came on the market.

Some veterinarians suspect that PetMed Express is behind the Fairness to Pet Owners Act, but the company and Matheson's spokeswoman Heyrend dismiss the idea. “We have not heard about this bill and therefore cannot comment on it,” said Bonnie Levengood, PetMed Express' marketing director.

Nevertheless, there is a connection. PetMed Express CEO Menderes Akdag is the former CEO and president of Lens Express, Inc., now known as 1 (800) Contacts — the company that helped usurp the contact lens-selling business from optometrists by selling direct to consumers. Under his direction in the late 1990s, Lens Express' annual sales increased from $10 million to $48 million, largely due to the business gleaned from optometry practices.

HR 1460 stands to boost the sales of PetMed Express and other online pharmacies if more pet owners buy their medications outside of veterinary practices. Based on comments posted by veterinarians in a VIN discussion, some are having a hard time believing that the Pompano Beach, Fla.-based company is not somehow connected to the measure.

Pirrung, the veterinarian from Mesquite, Texas, said it would be burdensome to write prescriptions for every medication prescribed, whether requested by the owner or not. For his trouble, he sometimes deems the extra time spent justifies charging owners $10 to write a prescription, a practice that the state's regulatory code allows. In addition, he believes that pets with an immediate medical need for a drug will suffer if an owner without access to a retail pharmacy carrying the medication waits to get the prescription filled online.

San Antonio's Gonzales is more accepting of bills like HR 1406 because they could aid consumers seeking better prices, and greater access to medications could lead to healthier animals.

The American Society for the Prevention of Cruelty to Animals (ASPCA) is endorsing the measure for the same reason. According to a spokeswoman, the ASPCA believes that the bill could alleviate the suffering of some animals — a concept that's core to the organization's mission — by giving owners access to more affordable pet medications.

A statement to the VIN News Service reads: "It is the ASPCA's position that prescription portability will bring more convenient and affordable prescription fulfillment options to pet owners as a means to better care for their pets and help to alleviate disease, pain and suffering where cost or convenience is a factor. ... The ASPCA believes that broader fulfillment of prescription pet medications will lead to more pet owners receiving access to regular wellness and preventative care for their pets."

Lutschaunig, head of the AVMA's Washington division, counters that the bill could have "unintended consequences," including prescription fraud and delays in pets receiving medications. Additionally, because most pharmacists cater to human needs, there are “potentials for prescriptions to be filled by someone lacking expertise and knowledge of animal physiology and drug interactions,” he said.  




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 news@vin.com.



Information and opinions expressed in letters to the editor are those of the author and are independent of the VIN News Service. Letters may be edited for style. We do not verify their content for accuracy.



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