Where to recommend patients fill pet prescriptions

[db8vet]

Hi! I was wondering, if you had a cost conscious patient who asked where he/she might be able to get pet medications filled for cheaper, where would you recommend they go and why? I can think of:

1. Pharmacies at Target, CVS, Wal-Mart: I think these only sell pet meds with human equivalents? Any guesses what percentage of commonly prescribed pet meds have human equivalents?
2. Online suppliers such as 1-800-Petmed or Drs. Fosters and Smith: not totally sure how prices compare to the Target/CVS pharmacies, and know that 1-800-Petmed had some issues with quality in the past that might have been resolved with the VET-VIPPS certificaton.
3. Vet that supplies through VetSource: not sure how they compare price-wise vs. #1 and #2 above?
4. Others?

Many thanks in advance for your help!

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[jmo1012]

I recommend people price shop in goodrx.com. only good for human drugs though

 

[CalliopeDVM]

Hi! I was wondering, if you had a cost conscious patient who asked where he/she might be able to get pet medications filled for cheaper, where would you recommend they go and why? I can think of:

1. Pharmacies at Target, CVS, Wal-Mart: I think these only sell pet meds with human equivalents? Any guesses what percentage of commonly prescribed pet meds have human equivalents?
2. Online suppliers such as 1-800-Petmed or Drs. Fosters and Smith: not totally sure how prices compare to the Target/CVS pharmacies, and know that 1-800-Petmed had some issues with quality in the past that might have been resolved with the VET-VIPPS certificaton.
3. Vet that supplies through VetSource: not sure how they compare price-wise vs. #1 and #2 above?
4. Others?

Many thanks in advance for your help!

I'm not in the US so I don't know what the specific retailers do, but in general I don't tell people where they should shop.....it would make me feel awful if I recommended some place and they had a bad experience (or worse, if there was an error). I will tell them that if they call around they can compare prices, but I don't recommend a specific place.

 

[LetItSnow]

I'm with Calliope.... I'd have them call around. They're the ones wanting a lower price, they can do the legwork. I don't have time - nor do my staff - to do that for them. I'm happy to give them a written prescription or call one in, but they're gonna have to tell me where.

And I suspect some drugs are going to be cheaper at one place and some at another. There's probably not a single pharmacy that's cheaper for everything.

 

[dyachei]

I tell them to call around but make sure it's reputable. The way 1-800-petmeds gets it's medication is through diversion. It's something the major companies crack down on. Most of them won't guarantee products bought from online pharmacies, and I tell this to owners. It's their decision. I will still sign Rx for them if asked. But we also price match so they don't have to choose between their wallets and their pet's wellbeing.

 

[nyanko]

I recommend people price shop in goodrx.com. only good for human drugs though

I've always done the same thing. I have had a lot of patients on expensive drugs like levetiracetam XR (which only recently has gone off patent) so this was the best way I found to make sure that people could afford their dogs' seizure meds every month.

 

[twelvetigers]

Walmart has a $4/28 and $10/84 list that includes meloxicam, cephalexin, cipro, and a few other things.

 

[DrinkandDerive]

Hi! I was wondering, if you had a cost conscious patient who asked where he/she might be able to get pet medications filled for cheaper, where would you recommend they go and why? I can think of:

1. Pharmacies at Target, CVS, Wal-Mart: I think these only sell pet meds with human equivalents? Any guesses what percentage of commonly prescribed pet meds have human equivalents?
2. Online suppliers such as 1-800-Petmed or Drs. Fosters and Smith: not totally sure how prices compare to the Target/CVS pharmacies, and know that 1-800-Petmed had some issues with quality in the past that might have been resolved with the VET-VIPPS certificaton.
3. Vet that supplies through VetSource: not sure how they compare price-wise vs. #1 and #2 above?
4. Others?

Many thanks in advance for your help!

Hi I am going to be a pharmacist (just waiting for my state to post the license on the website) and worked in a compounding pharmacy and I believe this is a great alternative. The compounding pharmacies usually do human and pet medications that cater to the individual. the only caveat is that it has to be a medication that doesn't already exist commercially for pets, so it has to be a different formulation or a mixture of of ingredients that doesn't exist yet. The prices will vary because it's usually family businesses that have to make sure they profit as well, so just make sure you price shop around. Usually the prices are very decent and the customer service is stellar for smaller independent pharmacies.

Secondly, the only medications I really see that can be used on pets as we use on humans is insulins. I don't see much other overlap in my experience.

Hope this helps.

 

[CalliopeDVM]

Secondly, the only medications I really see that can be used on pets as we use on humans is insulins. I don't see much other overlap in my experience.

And antibiotics. And anti-fungals. And seizure control medications. And corticosteroids. And narcotic pain relievers. And benzodiazepams. And gastro-protectants.

 

[DVMDream]

And antibiotics. And anti-fungals. And seizure control medications. And corticosteroids. And narcotic pain relievers. And benzodiazepams. And gastro-protectants.

Reasons why pharmacy schools really need to have courses on veterinary pharmacology. Pharmacists are largely clueless about vet pharmacology, not through any fault of their own. I only get frustrated when their cluelessness impacts my patients.

 

[twelvetigers]

And antibiotics. And anti-fungals. And seizure control medications. And corticosteroids. And narcotic pain relievers. And benzodiazepams. And gastro-protectants.

A whole lot of stuff that isn't cerenia, convenia, clavamox, vetmedin, or apoquel. Or anti-parasite, though I bet people get fenbendazole or praziquantel from time to time...

 

[DrinkandDerive]

And antibiotics. And anti-fungals. And seizure control medications. And corticosteroids. And narcotic pain relievers. And benzodiazepams. And gastro-protectants.

You're correct there aren't many courses for vet pharmacology. I didnt even have one at my school and I went to a pharmacy school in CA. People like me, who are passionate about animals, have to seek out information to learn. Keep in mind, I just passed my boards and so I'm a new pharmacist; seasoned pharmacists have much more experience but I don't see any of them responding on this thread. I responded to help as I myself thought a response from a pharmacist would be nice and helpful. My pharmacy is a compounding pharmacy so we mostly have patients who want specialized pet meds, this means we won't be filling commercialized medications For pets. That is why I said I did not see much overlap in commercialized drugs used for both humans and pets. Studying human adult pharm alone takes 4 years. Thus, for pet meds, they're mostly on their own. It doesn't stop me from learning though. Thanks for the info.

 

[jmo1012]

You're correct there aren't many courses for vet pharmacology. I didnt even have one at my school and I went to a pharmacy school in CA. People like me, who are passionate about animals, have to seek out information to learn. Keep in mind, I just passed my boards and so I'm a new pharmacist; seasoned pharmacists have much more experience but I don't see any of them responding on this thread. I responded to help as I myself thought a response from a pharmacist would be nice and helpful. My pharmacy is a compounding pharmacy so we mostly have patients who want specialized pet meds, this means we won't be filling commercialized medications For pets. That is why I said I did not see much overlap in commercialized drugs used for both humans and pets. Studying human adult pharm alone takes 4 years. Thus, for pet meds, they're mostly on their own. It doesn't stop me from learning though. Thanks for the info.

I dont think this is necessarily true - there are quite a few human formulations that don't come small enough for our pets that we frequently need to compound. Things like aspirin, clopidogrel, tramadol, gabapentin, and ursodiol immediately jump to mind. I work at a university where we have the ability to compound at our in-house pharmacy, however at my internship, we frequently called some of these things into local compounding pharmacies. A few of them we purchased in bulk from compounding pharmacies to dispense at our hospital (such as aspirin, tramadol, metronidazole, Keppra, etc.). Unless you meant you wont be dispensing normal formulations to people for their pets without compounding?

 

[DrinkandDerive]

I dont think this is necessarily true - there are quite a few human formulations that don't come small enough for our pets that we frequently need to compound. Things like aspirin, clopidogrel, tramadol, gabapentin, and ursodiol immediately jump to mind. I work at a university where we have the ability to compound at our in-house pharmacy, however at my internship, we frequently called some of these things into local compounding pharmacies. A few of them we purchased in bulk from compounding pharmacies to dispense at our hospital (such as aspirin, tramadol, metronidazole, Keppra, etc.). Unless you meant you wont be dispensing normal formulations to people for their pets without compounding?

Yes correct we don't really have patients who need already existing drugs manufactured by drug companies 🙂 they go to cheaper places for that such as cvs. I've compounded all those drugs you mentioned too for pets only if the dosage strength or formulation , etc doesn't already exist/trademarked by a company.

 

[DrinkandDerive]

To clarify for others:
I mean for my pharmacy only because it's a small family owned business, our prices for commercial drugs are higher. I am only speaking from my experience since I can attest to it. I am aware and know there are many overlap of human and animal drugs commercially available for humans. Many people will go to bigger chains like cvs or Walmart when they don't need compounded drugs at our store because our prices are higher.

I only responded on this thread to help and I believe dialogue between vets and pharmacists is important so we can help each other. At the end of the day, our goal is to help the patients.

 

[CalliopeDVM]

Studying human adult pharm alone takes 4 years. Thus, for pet meds, they're mostly on their own. It doesn't stop me from learning though. Thanks for the info.

Glad you're wanting to learn.......too many pharmacists feel they can give out (wrong) information about medication for their pets to clients even though they know nothing about it.

 

[LetItSnow]

I only responded on this thread to help and I believe dialogue between vets and pharmacists is important so we can help each other. At the end of the day, our goal is to help the patients.

That's cool. Just be forewarned you are going to meet resistance. There isn't a practicing veterinarian who hasn't had SOME bad experience with pharmacists. Typically it is a pharmacist refusing to fill a legitimate script or modifying the drug or dosing to something inappropriate, or a pharmacist inappropriately insisting on a DEA license (or an NPI number that vets aren't supposed to have).

The vet/pharm relationship is rocky.

I personally haven't had trouble with pharms changing my scripts - the only time it has happened was because I messed up and typo'd a tablet size that didn't exist - but even in my short time in practice I've gotten sick of them asking for my DEA license for scripts for which they don't have a legitimate need.

Our pharm school in MN does have at least one veterinary course, but last I heard it was elective. Was taught by the guy who teaches pharm in the vet school.

 

[dyachei]

Yes correct we don't really have patients who need already existing drugs manufactured by drug companies 🙂 they go to cheaper places for that such as cvs. I've compounded all those drugs you mentioned too for pets only if the dosage strength or formulation , etc doesn't already exist/trademarked by a company.

well, in the case of gabapentin...the solution form has xylitol in it, which is toxic, so we still compound it.

it happens kind of often. i also get certain sizes of meds compounded for pets.

 

[CountBy5s]

I am a pharmacist who loves animals. I actually started my health related career at a vet tech but my growing cat allergy exploded during undergrad. Then back surgery sort of steered me into a different career.

Anyways... I would love some advice/recommendations on a great veterinary pharmacology reference. I would like to study more on my own so that I can be more useful in this area.

I personally am guilty of asking for a DEA number ' but I explained it was just to find the doctor in our computer system. Sometimes names and phone numbers don't bring up anything especially for providers from another geographical area. However DEA number usually finds the provider pretty quickly. Things get busy crazy around the pharmacy and finding the provider in 3 seconds vs 3 minutes can really save a pharmacists sanity.

 

[CalliopeDVM]

I am a pharmacist who loves animals. I actually started my health related career at a vet tech but my growing cat allergy exploded during undergrad. Then back surgery sort of steered me into a different career.

Anyways... I would love some advice/recommendations on a great veterinary pharmacology reference. I would like to study more on my own so that I can be more useful in this area.

I personally am guilty of asking for a DEA number ' but I explained it was just to find the doctor in our computer system. Sometimes names and phone numbers don't bring up anything especially for providers from another geographical area. However DEA number usually finds the provider pretty quickly. Things get busy crazy around the pharmacy and finding the provider in 3 seconds vs 3 minutes can really save a pharmacists sanity.

Plumb is probably the most widely used drug formulary and reference, in Canada and the US at least.

http://www.wiley.com/WileyCDA/WileyTitle/productCd-1118911938.html
https://www.plumbsveterinarydrugs.com/#!/home

 

[JaynaAli]

[QUOTE="CountBy5s, post: 18419277, member: 785260"

I personally am guilty of asking for a DEA number ' but I explained it was just to find the doctor in our computer system. Sometimes names and phone numbers don't bring up anything especially for providers from another geographical area. However DEA number usually finds the provider pretty quickly. Things get busy crazy around the pharmacy and finding the provider in 3 seconds vs 3 minutes can really save a pharmacists sanity.[/QUOTE]

I second the Plumb's recommendation. It's really the vet go-to.

Also, I understand that it's easier for you if we give you a DEA number. But we aren't required to have a DEA number for non-controlled medications and many vets don't have their own DEA license at all. I didn't have my own when I was practicing and still don't. I just didn't call in controlled substances. Also, as vets we are not legally allowed to have an NPI number which is usually what pharmacists ask for when I say I don't have a DEA number. And then they spend 3 minutes arguing with me that we have to have a DEA or NPI number when we don't. I wish there was an easier way but some of us just don't have the things you want. It gets frustrating having the same argument every time you try to call something in to a new pharmacist.


Sent from my iPhone using SDN mobile app

 

[CountBy5s]

Reasons why pharmacy schools really need to have courses on veterinary pharmacology. Pharmacists are largely clueless about vet pharmacology, not through any fault of their own. I only get frustrated when their cluelessness impacts my patients.

You will be happy to hear that the national pharmacy board exam (NAPLEX) will now include vet pharm starting I believe in 2017...: ). Our school offered vet pharm. but the class size capped out at 15 students. : ( ... but the interest is growing. : )

 

[CountBy5s]

[QUOTE="CountBy5s, post: 18419277, member: 785260"

I personally am guilty of asking for a DEA number ' but I explained it was just to find the doctor in our computer system. Sometimes names and phone numbers don't bring up anything especially for providers from another geographical area. However DEA number usually finds the provider pretty quickly. Things get busy crazy around the pharmacy and finding the provider in 3 seconds vs 3 minutes can really save a pharmacists sanity.

I second the Plumb's recommendation. It's really the vet go-to.

Also, I understand that it's easier for you if we give you a DEA number. But we aren't required to have a DEA number for non-controlled medications and many vets don't have their own DEA license at all. I didn't have my own when I was practicing and still don't. I just didn't call in controlled substances. Also, as vets we are not legally allowed to have an NPI number which is usually what pharmacists ask for when I say I don't have a DEA number. And then they spend 3 minutes arguing with me that we have to have a DEA or NPI number when we don't. I wish there was an easier way but some of us just don't have the things you want. It gets frustrating having the same argument every time you try to call something in to a new pharmacist.


Sent from my iPhone using SDN mobile app[/QUOTE]

I can totally understand that. Sometimes i go crazy calling other pharmacists. Pharmacist should know you don't have a NPI though. It think it can be a limitation of the way pharmacy OS handles new searches. Especially if they are not previously registered with that specific pharmacy location. : /

 

[CountBy5s]

Plumb is probably the most widely used drug formulary and reference, in Canada and the US at least.

http://www.wiley.com/WileyCDA/WileyTitle/productCd-1118911938.html
https://www.plumbsveterinarydrugs.com/#!/home

Is there a mobile app version other phone apps you use regularly.

 

[CalliopeDVM]

Is there a mobile app version other phone apps you use regularly.

Yes, if you're an on-line subscriber (the second link I posted), there's a matching app for your phone. I don't have an online subscription for it, as it's included in my VIN membership (but that's veterinarian- and veterinary student-only website).


Other phone apps I use regularly: Mostly the Compendium of Veterinary Products (CVP Vet) -- essentially, it's like a PDR for veterinary products -- and apps for converting units (as I discuss cases with Canadians and Americans).