We are changing our policies in regards to outside pharmacy vendors – and I would like to explain our rational to everyone for these updates. We at District Vet do everything within our power to ensure patient safety. Of recent we have had problems with a number of on-line and box store pharmacies dispensing counterfeit and / or incorrect medications to our patients. This has put their health and safety at risk.
First, box store pharmacies do not have pharmacists trained in veterinary medicine. They frequently make unsafe substitutions for our patients, giving them toxic ingredients, thinking that the medication is appropriate. They also may dispense inappropriate forms of medications or simply misread the prescription. This is all too common. When we dispense medications, one of our veterinarians personally inspects each drug that leaves our building. Our partner, Vets First Choice, does the same task.
Second, both box store pharmacies and on-line pharmacies such as PetMeds and Chewy (operated as PetSmart Pharmacy) do not obtain their pet medications from the veterinary manufacturers or licensed veterinary distributors. The question is, where do their medications come from? They will not disclose this information to anyone. They claim it is a trade secret. All I can say is that obtaining medications from the manufacturer is not a trade secret. I have inquired many times to certify where their medications come from, with their corporate entities repeatedly refusing to disclose their medications origins. Several pharmacists and pharmacy managers from these pharmacies have lied to me directly about their medication sources. I have it in writing. If it comes from the manufacturer, what are they hiding?
As a consultant in my past life, I worked for a pharmacy and learned where they usually obtain their medications: from shadowy entities that buy medications on the black market. Some are genuine, some may be counterfeit, some long expired, some from foreign countries. The entities try to get veterinarians to purchase extra medications then the entities buy the medications from them and through a cascade of hands, sell them to box stores and un-approved on-line pharmacies.
Why is this a problem? Quality of medications and the inability of the manufacturers to issue recalls. If a product is found to be defective in any way, manufacturers issue a recall to their approved distributors and the distributors then contact the veterinarians who have received the affected medications. They do this through knowing which lot numbers of medications were sent to the veterinarian. Chain of possession, known as a pedigree, is broken when medications change hands as described above. If the manufacturer does not know where the medications went, how can the pharmacy contact you about the dangerous medication? For human medication, the FDA requires that the pedigree not be broken, doesn’t your pet deserve the same protection?
But aren’t these pharmacies licensed and certified? Yes, Chewy, PetMeds, and others will tell you that they are Vet-VIPPs approved, but this has nothing to do with the origin of their medications or the knowledge of their staff. Vet-VIPPs has to do with their pharmacies being licensed, possessing licensed pharmacists, and passing a routine inspection. I have been through a Vet-VIPPs inspection before personally as a consultant – and I can tell you it does nothing to guarantee safety of medications. It is a sham.
Third, the guarantees on these medications from the manufacturers are not extended to outside pharmacies (Vets First Choice and a select few others excepted). Medication causes your pet to be sick? Got ineffective heartworm prevention? Tough luck if purchased from an unapproved pharmacy.
Fourth, manufacturer rebates are not passed on to clients by outside pharmacies, with exception of Vets First Choice and friends.
After much consideration, we have amended our outside pharmacy policies. If requested we will write written script only for clients to pick up. We will not fax back requests from these outside pharmacies or call in prescriptions to them. Our signature on their paperwork indicates our approval of their methods of operation. Since they keep their methodologies in the dark, we cannot place our reputation at risk for their mistakes and activities. We will also write on the prescription for pet-only medications that the manufacturer does not guarantee the medication. This statement must appear on the prescription label, and if it is not on the label the pharmacy must be reported to the board of pharmacy. Prescribers determine what goes on a prescription label, not the pharmacy. Your pets’ safety is our job.
We know that delivery of medications is important to many clients – we will ship it to you from our office and we do work directly with a pharmacy that ships pet medications to clients. It is called Vet’s First Choice. It is approved by the manufacturers of most pet medications, receives medications directly from the manufacturers, has intact pedigrees, and carries the manufacturers’ guarantees and rebates.
For food orders, several other outside vendors are approved by pet food manufacturers to deliver food. We will participate with these vendors as we know how they obtain the product and know that the food is guaranteed by the manufacturer.
After way too many problems over the past years, I have decided that we as a practice can no longer condone these unsafe practices. We pride ourselves on taking the best care of our patients as possible – and this extends outside of our walls, too.
Dan Teich, DVM