FTC workshop explores pet medications
How are consumers faring in the marketplace for pet medications?
That was the question during the Federal Trade Commission’s Oct. 2 workshop on trade restrictions in the distribution of pet medications to consumers.
The FTC began exploring the subject of pet medications in light of the introduction last year of the Fairness to Pet Owners Act (H.R. 1406), which would require veterinarians to provide pet owners with written prescriptions automatically and with written notification of the option to fill prescriptions elsewhere. The legislation had not moved out of subcommittee as of late October.
The AVMA Principles of Veterinary Medical Ethics state that veterinarians should honor clients’ requests for prescriptions in lieu of dispensing. Thus, the AVMA believes the federal legislation is unnecessary and burdensome.
The FTC workshop featured invited panelists and covered a wide range of issues, including consumers’ ability to obtain prescriptions from veterinarians, and manufacturers’ agreements to sell certain prescription and nonprescription drugs only through veterinarians.
Setting the stage
“An increasing array of options for consumers to purchase their pet medications has begun to lead, we believe, to lower prices and increased consumer choice, certainly in a few pet medicines,” said Jon Leibowitz, FTC chairman, in opening remarks. He argued, “While this market is becoming more competitive, it clearly has a way to go.”
Dr. Douglas G. Aspros, AVMA president, provided an overview of the veterinary profession. According to AVMA data, companion animal practices derive about a quarter of revenues from sales of prescription and nonprescription drugs.
“Please keep in mind as we go through this day that veterinarians primarily dispense drugs and pharmaceuticals to ensure the health and welfare of their animal patients,” Dr. Aspros said.
Dr. Paul D. Pion, president of the Veterinary Information Network, provided an overview of the pet medications industry.
Among the topics Dr. Pion discussed were manufacturers’ agreements to sell certain over-the-counter drugs only through veterinarians. The manufacturers state that only veterinarians have the expertise to dispense the products. A gray market has made many of the products available directly to consumers, however.
Drug distribution
The first panel delved into facets of the distribution of prescription and nonprescription pet medications to consumers.
Brad Dayton, senior director of pharmacy for the Ahold USA supermarket chain, spoke in favor of the Fairness to Pet Owners Act.
“I think pet owners should have the right to choose where they get their prescriptions filled, whether it be a retail establishment, a mail-order pharmacy, or their local vet,” Dayton said. “I believe that competition will only help price for pet owners.”
Mark Cushing spoke against H.R. 1406 on behalf of the American Veterinary Distributors Association. He said the bill is a solution in search of a problem, with veterinarians already writing thousands of prescriptions daily.
“You can get pet medications, both prescription and otherwise, OTC, from a host of sources all over this country—online, retail, veterinary, and otherwise,” Cushing said. “And it’s simply not correct to say that that marketplace is constricted and somehow works against the consumer.”
Prescription portability
Adrian Hochstadt, AVMA director of state legislative and regulatory affairs, gave an introductory presentation for the panel on portability of prescriptions for pet medications.
Hochstadt said 17 states require veterinarians to write prescriptions for pet medications on request, and a number of states have incorporated the AVMA Principles of Veterinary Medical Ethics into rules governing veterinarians.
The panelists generally agreed that veterinarians do honor clients’ requests for prescriptions in lieu of dispensing.
Dr. Race Foster of the online veterinary pharmacy Drs. Foster & Smith argued that prescription portability is meaningless when manufacturers sell certain prescription drugs only through veterinarians.
Nate Smith, a former Wal-Mart retail strategist, advocated for requiring veterinarians to write prescriptions automatically.
“That piece of paper lets the consumer know he or she has a choice,” Smith said. “It is the most effective, most efficient means of creating a consciousness of choice.”
Dr. Wendy Hauser, a small animal practitioner from Colorado, said she routinely offers to write prescriptions for pet medications if she is aware of substantial cost savings at human pharmacies. Nevertheless, she expressed concerns that the pharmacies might not fill the prescriptions accurately or provide appropriate counseling.
“I believe, if H.R. 1406 is enacted, that drug-induced adverse events will occur and will cause harm,” Dr. Hauser said.
Dr. Aspros said the AVMA is interacting with the pharmaceutical industry to determine how to train pharmacists on veterinary pharmacology.
Comparison with contact lenses
The final panel explored outcomes of the Fairness to Contact Lens Consumers Act, passed in 2003. The legislation required optometrists to provide patients with prescriptions for contact lenses.
Several panelists discussed and disputed research that found prices of contact lenses did not decrease after passage of the legislation and research that found a higher risk of certain adverse events occurs among consumers who purchase contact lenses from alternative channels of distribution.
Dr. Link V. Welborn, chair of the AVMA Veterinary Economics Steering Committee, said competition has driven down prices in the market for pet medications already. Almost every pet owner he sees is aware of alternative channels of distribution.
“Virtually every veterinary visit involves two different conversations, one about care and another about cost,” Dr. Welborn said. “Veterinarians help pet-owning consumers spend their money wisely, every day.”