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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Pricey Pet Prescriptions: How to Get Your Vet to Help You Get the Best Deals on Drugs

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May 16, 2011 / (23) comments


Somehow this issue keeps on popping up on this blog: Pet owners who struggle to pay for their pets’ pricey products and prescriptions are always complaining that their veterinarians charge too much for them. So they want to buy elsewhere, but their veterinarian won’t play nice.

 

Plenty of my clients are perfectly happy to cough up the ten to thirty percent premium we veterinarians tend to charge on drugs and products. That’s the cost of convenience. Some, however, have multiple pets or tight budgets that preclude this luxury. Those clients require that I write a prescription so they can fill them elsewhere…

…and I happily will. But not all veterinarians feel the same way. Here’s why:

 

  1. Practice-owning veterinarians have historically enjoyed a sizable income from the "profit center" that is the in-house pharmacy. Selling pills, elixirs and products formulated especially for our pet patients was our exclusive purview. We were the only game in town.

    But veterinarians are feeling the economic squeeze acutely now that their pharmacy income has gone to the online folks (you know who they are). They’re struggling to maintain their incomes in light of a decreased demand for services and a diminished demand for products and pharmaceuticals in light of the proliferation of ready substitutes.

  2. Veterinarians are marketed to by drug and product manufacturers, who promise big income boosts with their recommendations. Some veterinarians still believe these tall tales are true (and in the tooth fairy, too). These earnings are possible, but it’s usually a short-term bump. They’re gone as soon as the online pharmacies out-maneuver brick and mortar veterinarians. And they always do. That’s their core business, after all.

  3. Plenty of veterinarians legitimately feel that the drugs and products you buy online might not be safe for your pets. We’ve all seen counterfeit products, so it’s no stretch for some veterinarians to put their foot down and say, "No way. I’m not endorsing that kind of buying behavior."

    But now that so many online pharmacies are certified by the National Board of State Pharmacies with VetVIPPS certification, safety is no longer the issue it may once have been. This good news, however, has not trickled down to all veterinarians.

    Problem is, it’s not always up to the veterinarian — not legally, anyhow. In about half of all U.S. states, veterinarians are required to write a prescription if a client asks for one. It’s an obstruction to the free flow of commerce to stand in a consumer’s way of a better deal. I mean, it’s not like it would be fair for your dermatologist to force you to get your antibiotics, sunscreen and face creams at the counter on your way out the door.

 

Still, old habits die hard. And while it may not be legal to challenge our client’s commercial choices, many veterinarians will. Sometimes that’s because they don’t know the law. Other times because, even when they do, they know that most clients will submit to their authority.

So what’s a cost-cutting consumer to do when their veterinarian won’t sanction their better deal via prescription pad? Here are my tips for getting your way (feel free to offer yours in the comment section below):

 

  1. Make it easy for your veterinarian to say yes.

    If you’re not sure where your veterinarian stands on this one, lob an easy shot across the bow first. Don’t ask while you’re checking out. Just order the meds and have the online pharmacy send its faxed prescription request. (Remember, there are plenty of reasons your vet can legitimately decline your request. Such as when you’re late for your annual labwork, etc.)

    Once you’ve been denied you can then call the staff and find out why.

  2. Appeal to the office manager.

    He or she will be able to describe the policy and offer any explanation. Your job is now to say that you’re a loyal client who pays a significant amount for vet services every year and that you have a safe option to buy drugs elsewhere that’s going to make paying for services more doable in the future.

    I would even go so far as to ask why Dr. X’s policy is different than Dr. Y’s policy down the street. You’re not threatening to defect. You’re just saying you’ve got choices.

  3. Make it hard for your veterinarian to say no.

    Armed with the knowledge that he or she doesn’t want you to get your drugs elsewhere, sometimes your best bet is to ask directly. Use the same tactic as with the office manager. Smile lots.

  4. Try the younger associate vet.

    A tip for the non-confrontational: Any younger veterinarian is probably uncomfortable with any policy that precludes writing a prescription. They aren’t likely to want to see themselves aligned with any sort of commercial undertaking outside the scope of their veterinary services. It’s a generational thing.

  5. When all else fails...

    …you can always explain the law, where applicable. Check out Scooter’s wonderful website to find out where your state stands.

 

***

 

OK, so now that I’ve incurred the wrath of a significant percentage of my fellow veterinary professionals, I think I’ll be lying low for a while. ;-)

 

 

Dr. Patty Khuly

 

 

Pic of the day: Meds For A Sick Ferret by Stacy Lynn Baum

 

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COMMENTS (23)
1
Scripts
by TheOldBroad on 05/16/2011 06:49am

I've not only never encountered resistance with a written script, my vet has even suggested less expensive alternatives.

What I did in the matter of Procrit was to get the first bottle at the clinic. That allowed us to get started immediately and to see if it was going to help. When Darlene's HCT increased, I called multiple pharmacies to compare prices and found that the compounding pharmacy already being used could provide a 6-pack for about half the price per bottle.

The clinic has always been helpful with written scripts, called in prescriptions and, if possible, generics.

2
lots of medicine
by wickets on 05/16/2011 07:18am

doesnt even need a animal freindly online pharmacy...costco, walgreens, cvs etc are all easy places to get filled. A lot cheaper to. Vets take advantage of the panic you're in when you visit....the last thing you're thinking about while they fix that bleeding leg is the cost of an antibiotic/pain med and its always after the fact that you say, "damn thats expensive stuff!" bottom line though, when its my money i dont need to be nice about saving it with anyone....this business of negotiating with office managers etc is BS and the more people that stop doing it the better off we will all be. thanks for great posts lately

by annet on 05/16/2011 09:13am

My Costco recently got a large new sign for the pharmacy counter reminding customers that they can/will fill veterinary prescriptions.

So far I've gotten lucky but my cats are only 4.5 so I've been happy to pay the premium because the few times have been single course antibiotics/eye drops.

by 4_Fab_Felines on 05/16/2011 08:33pm

Agreed on price-scouting at local pharmacies instead of immediately opting for a vet-specific one. The veterinary compounding pharmacy I dealt with last year was incredibly pricey. (To add insult to injury, as it turned out, the cat was sensitive to the costly antibiotic, and we ended up having to pitch it and go with a cheap locally-sourced alternative anyway. FAIL.)

I know that my cat's insulin is far cheaper at some pharmacies than others (I'm talking close to half the cost), as are his syringes. Antibiotic prices can vary wildly from one place to another as well.

3
by wikith on 05/16/2011 08:12am

I write scripts when asked, and even sometimes offer to spontaneously if a client is having trouble affording my treatment plan. My big reservations are:

1. A LOT of them never get filled... or get filled a week later. Drives me nuts. The extra step in getting the meds seems to be a big stumbling block in the pet getting the meds started.

2. I feel this will have negative repercussions on vet prices overall. Traditionally the markup on meds has been high and the profit from services low in many practices. Profit is needed to keep the practice going, so the prevailing wisdom in the vet field seems to be to cut available drugs in inventory (reducing what is available for the people who DO want the convenience or for in-house use on hospitalized pets) and increase prices on services. I'm no economist, but what this seems to say to me is that in the long run consumers will actually pay more and sacrifice convenience. Maybe I'm wrong on this.

Honestly, I'd like to see more brick and mortar pharmacies carry animal medicines and keep pharmacists with veterinary training on staff. Lots of meds just shouldn't wait for shipping. In the end, though, these are my client's choices so I still write the scripts when requested.

by Dr. Patty Khuly on 05/16/2011 09:32am

"A LOT of them never get filled... or get filled a week later. Drives me nuts. The extra step in getting the meds seems to be a big stumbling block in the pet getting the meds started."

Yes, yes, yes! I hate this. It's an inevitable down-side of scripting out an antibiotic, for example. Drives me batty that people wouldn't fill something like that ASAP.

4
Scripts
by Elizabeth and The Lab Crew on 05/16/2011 09:17am

10 to 30% markup... not where I live. The regular markup for drugs is 125%, if they have to special order a drug like percorten then the markup is 150%.

I would never order online if the markup was as low as you seem to think it is. I know a few Vets in the US who give drugs like percorten at cost to their regular loyal customers. I see people from all across North America in the Yahoo Support Group for Canine Addison's ( we have 4500 members )and the markups I see are generally beyond 30% that is for sure.
When you have a dog who needs life long medication that is expensive a markup of 125% is not fair..

by Dr. Patty Khuly on 05/16/2011 09:26am

Oops, sorry. I meant that my markup is probably only 10%-30% higher than the pharmacy's markup. In other words, If mine is 100% the pharmacy's is more like 75%. But you're right, this will vary widely from practice to practice and from one geographical region to another.

by Dr. Patty Khuly on 05/16/2011 09:30am

And you're right, 125% is not right. Especially if you have another option that's being denied. Which is why people really need to know what their rights are in these cases so that their pets can get the meds they need. I've seen too many pets suffer from a lack of client compliance due to med cost.

5
Online Rx
by WOWHAVS on 05/16/2011 09:36am

Years ago my vet warned me about one well-known online pharmacy, saying their scripts were often expired when they arrived. He said the other pharmacies seemed to be fine. Dr. K., could this still be an issue with pharmacies belonging to the groups you listed, or just those that are not members?

6
Best Deals
by Springer Mom on 05/16/2011 09:43am

I was a pet parent to three dogs up until 8 weeks ago when I lost my beloved 13 year old Maggie. I had 2 dogs on pain meds for health problems and the first prescription I received of Tramadol from the vet was $40. Before I needed a refill I found out Tramadol can be filled at a regular pharmacy AND it is a generic so the cost was only $4.00! I really wish my vet had told me this was possible in the beginning. Now before getting any refills I check to see if they are available at my local pharmacy. Having multiple geriatric pets is a very expensive endeavor and I love my vet, but I lost some respect for her when I'm spending $300-$600 per month in treatments and meds when she could have informed me of my options.

I totally understand the vet pricing thing but this is hard times for all of us. I also starting using an online pharmacy for our other meds that was saving me another $25 a month. I certainly feel it pays to shop around.

by kmdvm on 05/16/2011 12:49pm

It is too bad that you lost some respect for your veterinarian for not offering you a script for someplace cheaper. I will often offer a script - if I think about it and I think a client will appreciate it. I have had a client come back in and chew me out because I said this was a $4 script at WalMart or HyVee and he went to Walgreens and had to pay $10. I have had many clients say they would rather just get it here.
I buy my medications at the local pharmacy - knowing I pay more - but I want to support their business so when I need them for something urgent - they are still there . . . and I don't expect them to tell me at my local pharmacy that I could get this script cheaper down the road.

7
2 sides to script prices
by psproat on 05/16/2011 09:54am

As an operations professional in the industry I find your comments insightful, especially the proposed solutions to clients. Understand that there are multiple sides to the coin. There are just many pressures on the owner to markup the meds such as salary, benefits, taxes, and capital investment to name a few. It is good to see in writing what the clients are being coached on so the clinics can better prepare their responses. Also, at least 2 if not 3 of theses solutions would be career altering to para's and associates if implemented without consent. I would challenge any practice to develop clear standards and responses to these client solutions. Everyone needs to be on the same page including the soft-hearted and compassionate owner. Continuity is the key.

8
Vet price not always more
by Brrnese on 05/16/2011 11:07am

I've learned not to assume that the veterinarian office is always more. I generally do the following:

1) if pet is sick and starting meds now is important we generally get the intial Rx filled at the vets

2) If it will be a long term medication then I go home and see if there are alternatives for purchase. I have used the Walgreens Rx card for a number of prescriptions - $12 for a 90 day supply. I had one of my Berners on metronidazole long term and Costco was by far the most cost effective. Same Rx was $23 at Costco, $210 at Longs/CVS and somewhere in between at my vets.

3) My youngest berner has had chronic UTI's and is now starting long term antibiotic RX - cost for Zeniquin at my vets is half of what I can find anywhere else

4) I also discovered petmedcard.com and have set up cards for both of my girls. A $34 metronidazole RX at Walgreens on my Walgreens RX card would be $11 there with the petmedcard.

by CP on 05/16/2011 02:49pm

Is there a fee for the petmedcard?

by WOWHAVS on 05/16/2011 03:00pm

You can also get a CareCredit card at Carecredit.com to use for yourself and your pets' medical bills for services.

by julesb4isu on 05/16/2011 05:46pm

I have nothing against CareCredit, but you just need to be sure before you sign up that the clinic (or service) you are using will accept it, as not everywhere does.

by Brrnese on 05/16/2011 10:42pm

No - there isn't a fee - they have quite a bit of info on their website - http://petmedcard.com/access/index.cfm? -

9
Match Price
by Gretchiesmom on 05/16/2011 02:46pm

I don't go outside for my prescriptions, but may shop around in the future determining the need (emergency or ongoing). Some of my friends have just found out the costs online and asked their vets to match the price, which the vets did--sort of a win-win, I guess.

10
Pet med prices
by Ruthcatrin on 05/16/2011 05:41pm

It depends on what it is for me. An antibiotic, or something similer that needs to be started right away? THAT I'm going to get from my vet. It might cost me more, but I can start it right away. For a long term maintnence med (one of my cats is on methmozole, sorry if I spelled that wrong, for her thyroid). First fill from the vet, with a request for a seperate script to take home so I can get the refills from elsewhere, but I also advise that if the price difference isn't that much (and sometimes it isn't) then I'll bring it back to them to be filled afterall. So far both vets I've seen in the last few years have pretty much offered the seperate script for me to take to my local pharmacy or the like so its never been an issue for me.

11
Thank You!
by Tripawds on 05/16/2011 06:25pm

Thanks for this! More great information we'll be sharing with Tripawds members, who regularly face huge pharmacy bills during amputation recovery and canine cancer care.

We're always looking to find and share coupon codes and promotions for saving on prescriptions online, but always strongly urge people to only purchase from Vet-VIPPS certified pharmacies.

You may have miffed fellow vets, but it's posts like this that keep us on the other side of the counter following along.

12
Vets and Prescriptions
by whitedogresq on 05/17/2011 08:03am

Many vets in our area WILL have the last word on the subject: they charge $5 - $20 to write a requested prescription.

13
New Pet Pharmacy
by WOWHAVS on 05/18/2011 12:10pm

Dog.com has a new pet pharmacy with FREE SHIPPING

http://www.dog.com/pet-pharmacy/see-all-pet-pharmacy/1537/

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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