Vet Monopolies

That's unfair. Whataboutery isn't helpful to anyone. Vets are very different to other jobs. Like all emergency professions, a mistake can be the difference between life and death. There's a hell of a lot of pressure. As a research scientist I was used to taking a lot of flack in the media, but that doesn't compare to Mr or Mrs Angry shouting in your face. When cuts are made, those on the front line take up the slack. A huge increase in the number of pets in recent years combined with a mass exodus of vets to other professions has led to a disastrous shortage. Most of the vets I worked with in teaching left because of the unbearable abuse and working hours. The profession has one of the highest rates of suicide.
I agree that many aspects about being a vet must be very hard. Not least because of a general deterioration in manners and so forth alongside high expectations. Also to point out that mistakes in some professions can result in multimillion £ claims against a practice and a long-fought for career down the drain.
 
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It is just a feeling that I have, but newer vets are being too cautious in their dealings with animals. They will not do anything without the tests. The older vets are more prepared to use experience and common sense.

Also I have never had a young vet ask permission to do a pm for their own interest/experience, with no cost to me, where the older vet, who treated the same animal did. A young vet did once offer to do a pm but wanted me to foot the bill. On that occasion I said that if they wanted to learn from my dog they could but I was not paying for them to do so as I did not need to know any more as the dog was now dead.
 
It is just a feeling that I have, but newer vets are being too cautious in their dealings with animals. They will not do anything without the tests. The older vets are more prepared to use experience and common sense.
very much this especially small animal vets. My young equine vets seem to have a lot more experience, possibly because several had ponies as kids and went through the whole horse performance and learnt different methods/things.

We have gone from experience to tests.
 
very much this especially small animal vets. My young equine vets seem to have a lot more experience, possibly because several had ponies as kids and went through the whole horse performance and learnt different methods/things.

We have gone from experience to tests.
If you're young, surely by default you're inexperienced....
 
If you're young, surely by default you're inexperienced....


In which case, mentoring by a truly experienced colleague, should be built into the working hours of young vets. I remember young vets telling me what their older colleagues had suggested by way of treatment but it seems that doesn't happen very often now in many of the practices being discussed on this thread.
 
It is just a feeling that I have, but newer vets are being too cautious in their dealings with animals. They will not do anything without the tests. The older vets are more prepared to use experience and common sense.

Also I have never had a young vet ask permission to do a pm for their own interest/experience, with no cost to me, where the older vet, who treated the same animal did. A young vet did once offer to do a pm but wanted me to foot the bill. On that occasion I said that if they wanted to learn from my dog they could but I was not paying for them to do so as I did not need to know any more as the dog was now dead.
I don’t think they have time to fit in PMs for their own experience even if they wanted to.
 
In which case, mentoring by a truly experienced colleague, should be built into the working hours of young vets. I remember young vets telling me what their older colleagues had suggested by way of treatment but it seems that doesn't happen very often now in many of the practices being discussed on this thread.

It usually is…..
My OH works for 3 practices managed by a big corporate *shock horror*. All of their younger vets are mentored by an experienced vet- it's very collaborative, they have a very active Whatsapp group with a lot of photos and videos shared. Even on OOH calls they are paired up with an experienced vet- the simple calls they will attend on their own, but more complex cases the more experienced vet will go too. Had it a few weeks ago when one of mine got kicked in the field- wound was initially managed by the experienced vet but he was explaining everything to the newer one throughout, and the follow up care was done by the newer one
 
And your off the record free post mortem then causes chaos if someone does decide to go for a true pathology post mortem. I’d never offer it, the risk of not finding the issue without a proper histology lab is too high. Most of our cases people want PM for is either to sue another vets or get the rspca involved. That needs a pathology report not the GP vet feels it’s likely XYZ virus or their surgery bled a bit but not a lot and it’s now all congealed. I generally expect to have a pretty decent idea pre-mortem what’s going on, technology has moved on fast.

The majority of my complaints (that arnt entirely financially driven- 4 of those came in via email last night to my practice) are for not doing the tests overnight, it’s very easy to get very cautious when the immediate knee jerk is that the vet didn’t do enough, and of course the companies don’t think of that lost revenue very highly either when they’re alerted to it. (Even when costs are already not being met and treatment plans don’t change regardless of the result…!).
 
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In which case, mentoring by a truly experienced colleague, should be built into the working hours of young vets. I remember young vets telling me what their older colleagues had suggested by way of treatment but it seems that doesn't happen very often now in many of the practices being discussed on this thread.
I remember when my daughter first graduated she specifically looked for a job where she would be mentored . It was surprising how many places weren’t prepared to offer that . You may recall she ended up at a mixed practice near you who were excellent at offering support when needed .
 
None of your replies answers the query about what reform you would like to see of CPD program?
? You have got the wrong end of the stick, it’s not what I might like to see, but what the cumulative evidence of submitted concerns to CMA show might be serious concerns about the sector, remembering that practising vets are among the many who have submitted those concerns.
Assuming the existing CPD undertaken fully updates and equips all vets with clinical developments, drugs practise, legislation and all the rest, then one glaring issue likely to be addressed is vet practices and individual vets becoming fully transparent in their explanation of procedures and treatments, and of cost. This is evidently a major concern for the majority of respondents - including many vets who complain they are pushed to upsell and hit ‘targets’ - which may have zero benefit to the patient.
Hopefully you’ve never done that, but it’s increasingly evident rather a lot of vets in small animal practice do, maybe some do not fully appreciate what they are doing in this respect, maybe some believe they already do adequately explain - in which case, that attitude or ignorance needs sorting out asap.
On a personal level, I’d like to see the RCVS properly investigating cases of poor / dangerous clinical practice, taking positive action to insist on re training or striking off offenders, instead of rushing to defend the clinical autonomy of crass vets - and there are some.
 
There’s very little reference to cpd in the 2x 340+ page documents! I checked as hadn’t seen it referenced re the CMA before. The only suggested reform re CPD is that vets tick a box for compliance at renewal rather than it being audited as it currently is, which is somewhat a box ticking exercise…! And 10.48 that makes reference to they’d expect CPD to cover the new competition elements of practice and new regulations, but proportional to professional need.


If you think it should feature more now is your chance to respond!
 
I still use the practice I've been with for many years, they were sold to IVC a couple of years ago. Things I have noticed since this happened, a sharp rise in costs, and an empty waiting room. It used to be heaving in there, but now there's usually no-one in there when I go in. The costs trouble me, but everything else has gone up too so it isn't just because of corporate greed, although it must be a factor. The clients are now supporting the corporate giant as well as the vet practice, so it adds a layer to the prices.
There are now some independents about but I have stuck with the same vet as I know them and they know me. Our horse vet from there is superb and I trust her implicitly. I feel for the vets there as I am sure they are expected to sell more tests/treatments, but it's no different from when I go to the dentist and they are always trying to get me to spend £££ on cosmetic dentistry. I am not ashamed to stand in the vet surgery and say that I'll struggle with that cost, can we find a less costly way of doing this? There usually is one even if it's not 'gold standard'.
I think one of the issues here is that vets in corporate practice (judging from some of their submissions to CMA) are actively discouraged, maybe even prohibited, from even mentioning the less expensive (sometimes less effective, but certainly not always) approaches to treating or managing whatever issue, and that is no longer going to be acceptable (altho I’m equally sure some will devise some semantic circumvention!)
 
There’s very little reference to cpd in the 2x 340+ page documents! I checked as hadn’t seen it referenced re the CMA before. The only suggested reform re CPD is that vets tick a box for compliance at renewal rather than it being audited as it currently is, which is somewhat a box ticking exercise…! And 10.48 that makes reference to they’d expect CPD to cover the new competition elements of practice and new regulations, but proportional to professional need.


If you think it should feature more now is your chance to respond!
Great idea, thanks for heads up, don’t all rush at once and jam the site!
 
In which case, mentoring by a truly experienced colleague, should be built into the working hours of young vets. I remember young vets telling me what their older colleagues had suggested by way of treatment but it seems that doesn't happen very often now in many of the practices being discussed on this thread.
We still have vet medicine undergrads doing a fortnight with the milk herd, not as frequently as in the past, but also senior vets in our (independent) practice might ring and ask if they can bring students to examine various cattle - not sick ones, just to improve students’ understanding and handling skills. Obviously we always say yes(!), occasionally those students ask to see horses, but focus is more on the commercial animals, and these are students rather than inexperienced vets.
 
I think a lot of vet practices - vets, receptionists, even management - aren't great at communication.

My equine vet happens to be really good at communication. They are good at laying out logical options, and a text or phone call is always welcome. They are certainly not the least expensive vets (private) that I could use but I'd happily pay more because I can always understand the value they bring, and I never feel like my horses are a number, and my business is tolerated rather than welcomed. I have felt that way with another vet.

Figgy's vet is great but I feel like they actually sell themselves short by not communicating as effectively.

An example being Figgy's after hours appointment at the vet hospital for cutting her back leg:

Out of hours appointment: £300
Suturing wound, up to 15 min: £250
Sedation: £200

Medications, consumable materials and clinical waste extra.

We were told when I called ahead that we must commit to the £300 or she can't be seen.

We were told there that treatment could cost about £1000, and we had to agree that before they admitted her.

These conversations felt very transactional and focused on the money. I know, intellectually, that this is about ensuring that there are no surprises for the owner and that the practice is trying to guard against owners getting their animals into treatment only to find it exceeds what they could afford.

However, the way it was communicated does feel like "we won't help you unless" and that I can understand would make some owners feel uncomfortable. We luckily do have the funds so it wasn't an issue for us to agree. But we are very lucky, and I know that.

What we weren't told:

The vets supported us through her entire recovery with both phone call advice and in-person follow up appointments, all of which were free of charge.

Removing the stitches was free of charge.

The meds included take home antibiotics for the week.

They didn't charge us for the appointment for her split stitches, only for the additional clean up materials and some extra antibiotics.

The service actually was end-to-end, but the presentation of the costs and service at that initial out of hours appointment didn't cover that. There was no indication of what was to come. There was no material which could be read through about that. It seemed like that money just bought that stitch up job in that moment.

So what felt like a very expensive 15 minutes at the time, was actually a very good value for money 3 weeks of follow up care.

Vets will be expected to be clearer about costs due to this investigation but cost is only one part of the equation. Value delivered is another. My suggestion to vets and those running practices is not to be shy about highlighting the value of the services they deliver, and to coach their staff on how to present their services in the best light.
 
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In which case, mentoring by a truly experienced colleague, should be built into the working hours of young vets. I remember young vets telling me what their older colleagues had suggested by way of treatment but it seems that doesn't happen very often now in many of the practices being discussed on this thread.
I wasn't over impressed by my last experience of a young inexperienced vet. Seriously ill old cat taken into their hospital as vet didn't know the problem, all fine to there. They did tests rang back and discussed conclusion at length. All fine. Put her on a drip would monitor overnight and duty vet would ring back in the morning with an update. That happened and all fine. Next evening the way forward wasn't clear. Vet advised one more night on the drip etc and we agreed (and it was put in the notes) that the following morning the duty vet would ring and we would make a decision based on overnight progress. This was crunch time, vet would either demonstrate the progress and hope and that it would be a good idea to take the cat home and see if it improved at home or would advise no progress, little expected and PTS then. Fine to there, It was clear to the vet I was quite pragmatic not an owner saying you must save my cat at all costs.

It was therefore expected the next morning's vet would have read the notes, understood the case and be aware this was crunch time and help would be required in making a decision. Finally got hold of vet. No progress. Reminded them of the previous night's conversation with their colleague would there be any point in taking home and seeing how it went or was PTS better. They didn't know, appeared to have no opinion at all. Discussed and stilll no help it was up to me. What was their medical opinion? they didn't have one it seemed, up to me. Pointed out hadn't seen the cat for 2 days, they had all the notes, they were a qualified vet what did they advise as a qualified vet. They didn't know.

I decided the only solution was to drive down, bring cat home and see what happened. Got there, vet still had no opinion, it appeared pretty clear from the cat that was it however having got that far decided to bring her home just in case she rallied. After half an hour at home, loaded her back up and PTS.

Looked up the vet who was clearly very inexperienced and that was the case. She was in a vet hospital, if she needed help she could have asked another vet, she could have contacted a senior vet, it was clear from the notes she was going to have to advise me.

Looked at the bill and the lack of help and professionalsim from this person was not reflected :rolleyes:

Either the vet in charge should have realised she needed help and supervised her or she should have asked for it. That was an independent practice.

I don't ever remember a time when a younger inexperienced vet said hold on I'm going to get some help with this case and consulted a colleague.

everyone has to learn, no problem with that but I am there to pay the costs for treating my animal, I can't afford on top of that to pay to give vets experience,

I've had students come out with horse vets, they are unqualified as such and I allow them to do bits under supervision (they are very far on towards qualifiying) but once qualified I get the impression that is it and they are left alone to get on with it. Obviously many small pet owners have little experience and don't realise this.

I would happily pay more for my experienced horse vets some of whom are very young but very good but I am far from happy with the charges at the small vet side of the practice in relation to their service

maybe it is me but many more people seem happy with their horse vets and their charging than with small animal vets. That, to me at least, seems to be the area where many of the public are unhappy.
 
I'm actually quite astounded at my recent experience of getting pain meds for my dog. Requested a 2 week supply, and was charged almost £50 (onsior tablets in case anyone is interested). An online check seems to show that I could buy the same tablets for as little as 74p. I double checked with them that I hadn't been erroneously charged a consultation fee or some dispensing charge. Even with a prescription charge (currently 26.75!) I would have saved a chunk and if ordering a larger quantity it would be quite a substantial amount. I appreciate that vets have a lot of other costs but should it really be an extra £2 per day/tablet ? Over the course of a year the difference could be as much as £600 (assuming a few prescription charges in that period) for some people that might be the difference in being able to keep their pet pain free.

They were taken over by a large vet group a while ago and prices seem to be constantly increasing. I love my vet and she has been brilliant but I will definitely be looking at more affordable options.
 
I think a lot of vet practices - vets, receptionists, even management - aren't great at communication.

My equine vet happens to be really good at communication. They are good at laying out logical options, and a text or phone call is always welcome. They are certainly not the least expensive vets (private) that I could use but I'd happily pay more because I can always understand the value they bring, and I never feel like my horses are a number, and my business is tolerated rather than welcomed. I have felt that way with another vet.

Figgy's vet is great but I feel like they actually sell themselves short by not communicating as effectively.

An example being Figgy's after hours appointment at the vet hospital for cutting her back leg:

Out of hours appointment: £300
Suturing wound, up to 15 min: £250
Sedation: £200

Medications, consumable materials and clinical waste extra.

We were told when I called ahead that we must commit to the £300 or she can't be seen.

We were told there that treatment could cost about £1000, and we had to agree that before they admitted her.

These conversations felt very transactional and focused on the money. I know, intellectually, that this is about ensuring that there are no surprises for the owner and that the practice is trying to guard against owners getting their animals into treatment only to find it exceeds what they could afford.

However, the way it was communicated does feel like "we won't help you unless" and that I can understand would make some owners feel uncomfortable. We luckily do have the funds so it wasn't an issue for us to agree. But we are very lucky, and I know that.

What we weren't told:

The vets supported us through her entire recovery with both phone call advice and in-person follow up appointments, all of which were free of charge.

Removing the stitches was free of charge.

The meds included take home antibiotics for the week.

They didn't charge us for the appointment for her split stitches, only for the additional clean up materials and some extra antibiotics.

The service actually was end-to-end, but the presentation of the costs and service at that initial out of hours appointment didn't cover that. There was no indication of what was to come. There was no material which could be read through about that. It seemed like that money just bought that stitch up job in that moment.

So what felt like a very expensive 15 minutes at the time, was actually a very good value for money 3 weeks of follow up care.

Vets will be expected to be clearer about costs due to this investigation but cost is only one part of the equation. Value delivered is another. My suggestion to vets and those running practices is not to be shy about highlighting the value of the services they deliver, and to coach their staff on how to present their services in the best light.
Couldn’t agree more, vets do need more focus on communications training to be far more lucid and transparent, whatever is being charged for. Some of the European vets with thick accents are actually better in this respect - maybe because they really have to try in their explaining to clients.
 
I'm actually quite astounded at my recent experience of getting pain meds for my dog. Requested a 2 week supply, and was charged almost £50 (onsior tablets in case anyone is interested). An online check seems to show that I could buy the same tablets for as little as 74p. I double checked with them that I hadn't been erroneously charged a consultation fee or some dispensing charge. Even with a prescription charge (currently 26.75!) I would have saved a chunk and if ordering a larger quantity it would be quite a substantial amount. I appreciate that vets have a lot of other costs but should it really be an extra £2 per day/tablet ? Over the course of a year the difference could be as much as £600 (assuming a few prescription charges in that period) for some people that might be the difference in being able to keep their pet pain free.

They were taken over by a large vet group a while ago and prices seem to be constantly increasing. I love my vet and she has been brilliant but I will definitely be looking at more affordable options.
😕 CMA, submit your concerns….
 
I'm actually quite astounded at my recent experience of getting pain meds for my dog. Requested a 2 week supply, and was charged almost £50 (onsior tablets in case anyone is interested). An online check seems to show that I could buy the same tablets for as little as 74p. I double checked with them that I hadn't been erroneously charged a consultation fee or some dispensing charge. Even with a prescription charge (currently 26.75!) I would have saved a chunk and if ordering a larger quantity it would be quite a substantial amount. I appreciate that vets have a lot of other costs but should it really be an extra £2 per day/tablet ? Over the course of a year the difference could be as much as £600 (assuming a few prescription charges in that period) for some people that might be the difference in being able to keep their pet pain free.

They were taken over by a large vet group a while ago and prices seem to be constantly increasing. I love my vet and she has been brilliant but I will definitely be looking at more affordable options.
I was charged £11.50 for two sachets of Bute. They're about 70p each online.
Now the pony is on it every day I get a prescription & buy online, I do that for all the regular meds I have (I have a lot of elderly animals).
 
I'm actually quite astounded at my recent experience of getting pain meds for my dog. Requested a 2 week supply, and was charged almost £50 (onsior tablets in case anyone is interested). An online check seems to show that I could buy the same tablets for as little as 74p. I double checked with them that I hadn't been erroneously charged a consultation fee or some dispensing charge. Even with a prescription charge (currently 26.75!) I would have saved a chunk and if ordering a larger quantity it would be quite a substantial amount. I appreciate that vets have a lot of other costs but should it really be an extra £2 per day/tablet ? Over the course of a year the difference could be as much as £600 (assuming a few prescription charges in that period) for some people that might be the difference in being able to keep their pet pain free.

They were taken over by a large vet group a while ago and prices seem to be constantly increasing. I love my vet and she has been brilliant but I will definitely be looking at more affordable options.
I don't know how many times we have to explain this. Vets generally can't buy in for what the online pharmacies can sell for. Vets are legally bound to use specific wholesalers. They buy on an "as needed" basis, and only hold very small stocks of the most commonly used medications. Otherwise drugs are ordered in especially for the client. They can't bulk buy, many meds are relatively short dated, and generally vet practices are very limited for space.
Then generally there is a dispensing fee, which covers the time taken for a clinical, qualified person to check correct doseage/quantity, check that there is a current authorisation to dispense, to place the order, unpack the order, print the label or count out and package and label tablets, then let you know they are there, and then sell them to you via a receptionist.
Whereas an online pharmacy warehouse gets and checks a prescription (already produced by the vet), packages up the requested quantity of bulk-purchased-at-best-price meds and ships them, job done.
In our practice we always tell people when appropriate that online can work out cheaper, and offer written prescriptions. I do welcome a price cap though - our written prescriptions are currently too expensive IMO, but £16 may be a bit low as they can be quite time consuming to do for the vets.
 
I don't know how many times we have to explain this. Vets generally can't buy in for what the online pharmacies can sell for. Vets are legally bound to use specific wholesalers. They buy on an "as needed" basis, and only hold very small stocks of the most commonly used medications. Otherwise drugs are ordered in especially for the client. They can't bulk buy, many meds are relatively short dated, and generally vet practices are very limited for space.
Then generally there is a dispensing fee, which covers the time taken for a clinical, qualified person to check correct doseage/quantity, check that there is a current authorisation to dispense, to place the order, unpack the order, print the label or count out and package and label tablets, then let you know they are there, and then sell them to you via a receptionist.
Whereas an online pharmacy warehouse gets and checks a prescription (already produced by the vet), packages up the requested quantity of bulk-purchased-at-best-price meds and ships them, job done.
In our practice we always tell people when appropriate that online can work out cheaper, and offer written prescriptions. I do welcome a price cap though - our written prescriptions are currently too expensive IMO, but £16 may be a bit low as they can be quite time consuming to do for the vets.
I appreciate that has been written before and perhaps we should just accept that we no longer buy meds from vets. It will be just like the doctors, have your consultation, get your prescription probably electronically and off you go. That will save time and work for vet staff. It seems to be a lot of work for them and obviously they don't make any profit out of it having to pay a higher price. The only ones they will supply to are those who are insured and then they can mark it up however much they want as the insurance will be paying.

I've had 2 specific instances. First was with my previous equine vet, horse was on prascend. They would have preferred me to buy the prascend from them Their cost was horrendous. I advised them the online cost was X and their prescription charge was Y so if they could supply it for more or less that joint price I would buy from them. They decided they could and did. Prior to that I think they were charging around £1.68 for prascend and online was around £1.02.

Second is vets buying meds in. I had 2 horses on prascend with my current independent vets. They e mailed my 6 m prescription, I got prascend around £1.08 online. Then one day head horse vet told me they could supply it (it had changed it's name to pergoquin, different product/same stuff) and this would negate the prescription cost and it would be £1.01.

We chatted about vets buying drugs v the public buying online and the cost difference. Asked how his practice had managed this. They had "joined up" with other similar practices, presumably independents, and with their now very large buying capacity they had got the costs down.
 
When my old vets went through a phase of price matching to online + script fee it was to improve the turnover just prior to being sold out. The maths didn’t actually work out but it was the daily takings she was trying to up to get the best price….!
 
Thing is, I do want vets to keep some stock and happy to pay a premium as sometimes you do want/need meds now rather than once I've got them delivered.

I do agree with LG's point about them not always communicating what is included procedure wise re ongoing care and selling themselves short a bit on what they are actual providing within a quote.
 
When my old vets went through a phase of price matching to online + script fee it was to improve the turnover just prior to being sold out. The maths didn’t actually work out but it was the daily takings she was trying to up to get the best price….!
interesting. The vet in my post 144 matching the online price was a partner so stood to benefit and this was pretty soon before the practice went to CVC (I think it was)
 
I appreciate that has been written before and perhaps we should just accept that we no longer buy meds from vets. It will be just like the doctors, have your consultation, get your prescription probably electronically and off you go. That will save time and work for vet staff. It seems to be a lot of work for them and obviously they don't make any profit out of it having to pay a higher price.

The problem with prescriptions in a practical sense is they actually take longer to write, print out, sign, scan back in and email to a pharmacy (we're not *supposed* to give them to the client - and we have had several attempt to fraudulently edit theirs, so try to send to the pharmacy where possible) than it does to book the meds out directly. Then the pharmacy might ring up to ask if they can give out apple flavoured Equipalazone because I haven't specified that, despite that being the only equipalazone they make any more. So then I'll have to phone them back and be on hold for 45 minutes to say 'yes, give them that'.
Plus if I'm out on the road I can phone up the office and say 'please put up 20 x pergoquin for Mrs Paddy with Pony, he has one tablet daily, shes going to collect them later', whereas a prescription I have to be physically in the office.
I'm very open with our clients who are on long term danilon in that we cannot compete with that price wise, in which case they are best off with a prescription, but for all other drugs we do try (independent practice but a big one, and part of a buying group, so we probably get a better price than many smaller practices).

The saddest part of the CMA recommending prescriptions is that the corporate groups will be the ones who profit out of this - they own the pharmacies! And lost drug revenue will have to be made up elsewhere, such as an increase in consult fees.

I don't know what the answer is, but I'm not convinced this is it.
 
The problem with prescriptions in a practical sense is they actually take longer to write, print out, sign, scan back in and email to a pharmacy (we're not *supposed* to give them to the client - and we have had several attempt to fraudulently edit theirs, so try to send to the pharmacy where possible) than it does to book the meds out directly. Then the pharmacy might ring up to ask if they can give out apple flavoured Equipalazone because I haven't specified that, despite that being the only equipalazone they make any more. So then I'll have to phone them back and be on hold for 45 minutes to say 'yes, give them that'.
Plus if I'm out on the road I can phone up the office and say 'please put up 20 x pergoquin for Mrs Paddy with Pony, he has one tablet daily, shes going to collect them later', whereas a prescription I have to be physically in the office.
I'm very open with our clients who are on long term danilon in that we cannot compete with that price wise, in which case they are best off with a prescription, but for all other drugs we do try (independent practice but a big one, and part of a buying group, so we probably get a better price than many smaller practices).

The saddest part of the CMA recommending prescriptions is that the corporate groups will be the ones who profit out of this - they own the pharmacies! And lost drug revenue will have to be made up elsewhere, such as an increase in consult fees.

I don't know what the answer is, but I'm not convinced this is it.
I can see the problems from the vet side. My indep sends the script in an e mail to me and I send it on to animed who I used in my case (until the vet came up with better prices) they used to send me a paper copy as well but I told them to stop as it was only costing them more money.

the additional cost of 20 x pergo for Mrs Paddy with pony at vet's prices is negligible but Mrs Paddy has 2 horses and the pony all with PPID so drug costs are important to her. :D
 
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