A turning point for onsite pharmacies arrives: e-prescribing for veterinarians

Veterinary practice leaders remember early in the COVID-19 pandemic when many clients turned to online sources to obtain veterinary medications and other products. And the growth of online purchases of veterinary medications has only accelerated since then. According to a 2020 report, online pet medication purchases increased by 13% that year, contributing to a growth rate of more than 9% in the past 5 years.¹

Rising competition from online veterinary pharmacies and large retailers seems inevitable with the lower prices they charge. Although veterinarians were still responsible for 72% of all medication purchases in 2020,¹ pharmacy competition has forced a turning point for veterinary practices with onsite offerings. Should these clinics maintain the status quo? Or should they think strategically about how to move forward with a business entity that may account for 20% or more of their costs² and take veterinarians and staff away from patients and clients in exam rooms?

The arrival of electronic prescribing (e-prescribing), which veterinarians have never had before, further complicates the issue. At first glance, e-prescribing may appear as a competitive threat. But this advancement, along with other changes in the industry, could help clinics operate more efficiently while improving pet health, client satisfaction, and clinician experience.

A long-debated issue

Although practices continue to fill most medications for their patients, the concern over pet prescription portability and competition has been debated for over a decade. In 2012, the US Federal Trade Commission (FTC) held a public workshop about the issue. It invited pet medication manufacturers and distributors, veterinarians, retailers, pharmacists, and consumer advocates representing a broad range of perspectives. The agency also reviewed over 700 written public comments submitted in response to the workshop.

One respondent, a former retail analyst and consumer advocate who spoke at the workshop, said pet owners “stand to save hundreds of millions of dollars annually if steps are taken to inject competition and choice into the marketplace for pet medications and specialty products.” Conversely, a companion animal industry lobbyist told the FTC that “we have a vigorous, highly competitive pet medications marketplace. The notion that consumers are trapped…it’s just not true.”

In a report about the issue released in 2015, the FTC failed to reach a definitive conclusion, stating “it is difficult to evaluate the effect of current practices on competition” and that stakeholders will likely “reevaluate and adjust their competitive strategies in light of consumer demand, supply conditions, and any legislative and regulatory developments.”³

Technology drives change

Indeed, consumer demand has been the biggest change in the decade since the FTC’s public workshop. The consumerization of health care—both veterinary and human—has changed consumer expectations about convenience, price transparency, and provider responses to their questions and concerns. Running cash-driven businesses not beholden to health insurance networks, most veterinary practice owners were ahead of the consumerist trend and in some cases have been more responsive to client expectations than human health care providers.

Technology continues to further drive this evolution. Approximately 90% of pet owners research a veterinary practice online before scheduling an appointment⁴ and 30% purchase pet food and supplies online.⁵ With the introduction of e-prescribing to veterinary medicine, price-conscious clients will certainly be excited, but practices, even those with onsite pharmacies, are likely to benefit as well.

For example, if a client wants to fill their pet’s prescription elsewhere, they need to call community pharmacies that fill veterinary prescriptions or search online for the most affordable option. Although this creates more work for the client, it also adds to the clinician’s burden because the clinician must confirm the prescription with the pharmacy and in some cases notify the client of the confirmation. If the practice fills the prescription with its online pharmacy, it requires the veterinarian or technician to enter data twice: once in the pharmacy online portal and a second time in the practice information management system (PIMS).

E-prescribing would eliminate these inefficiencies on both ends of the transaction. Instead of asking pet owners to find the most affordable prices for their pet’s medications, the veterinarian could share that information at the point of prescribing. Drug pricing information helps the pet owner, but it also supports the veterinarian with the onsite pharmacy by showing how competitively they price their drugs.

In some cases, clinics with onsite pharmacies may not need to lower their prices to compete with an online source, especially for medications that manage acute conditions. Many pet owners would be willing to pay more for a medication they can take home and give to their pet immediately as opposed to waiting several days for a package from an online pharmacy or driving to a community pharmacy.

Streamlining workflows

Likewise, for veterinary practices that want to eliminate the overhead of dispensing medications onsite (tracking inventory, adjusting for price fluctuations, disposing of expired medications, and complying with regulations), e-prescribing would offer an opportunity to phase out drugs that most patients prefer to buy elsewhere. For example, drugs for acute infections or pain may make sense to fill onsite, but chronic or preventive medications that pets need all year, such as those for arthritis or allergies, could be more affordably obtained online.

Opening veterinary medications to a competitive e-prescribing market encourages growth and competition for technology developers and pharmacies by leveling the playing field among all participants. PIMS companies, for example, are always looking for ways to distinguish their solutions in the market. With e-prescribing, PIMS companies or other software developers can create new solutions for veterinarian and technician workflows. With seamless access to processes and data they need to choose optimal medications, veterinarians could also answer clients’ questions and direct prescriptions to the most appropriate pharmacies based on clients’ convenience or spending goals.

Strengthening loyalty and care quality

Although some drug sales revenue would shift to third-party pharmacies, veterinary practices could increase appointment volume thanks to less time spent coordinating and communicating prescription information. These practices would also gain stronger client loyalty and trust. Loyalty is crucial given that 55% of pet dogs are 7 years or older, up from 45% in 2014.¹ Pet owners tend to want their older pets to stay with the same doctor and appreciate a veterinarian who helps them save money on care. More importantly, client loyalty and greater affordability can encourage improved adherence to preventive and follow-up care, yielding longer, healthier lives for the animals to whom veterinarians have dedicated their careers.

Lathe Bigler is vice president of clinical network services at First Databank (FDB) and general manager of FDB Vela, an e-prescribing network open to veterinarians.

References

1. Pet medications market thrives in wake of pandemic. News release. PR News Wire. June 8, 2021. Accessed August 9, 2022. https://www.prnewswire.com/news-releases/pet-medications-market-thrives-in-wake-of-pandemic-301308028.html
2. Crabtree A. How to organize and manage pharmacy and inventory. Veterinary Practice News. July 29, 2021. Accessed August 9, 2022. https://www.veterinarypracticenews.com/how-to-organize-and-manage-pharmacy-and-inventory/
3. Competition in the pet medications industry: prescription portability and distribution practices. Federal Trade Commission. May 2015. Accessed August 9, 2022. https://www.ftc.gov/system/files/documents/reports/competition-pet-medications-industry-prescription-portability-distribution-practices/150526-pet-meds-report.pdf
4. DeWilde C. How clinic clients benefit from technology. dvm360®. November 18, 2021. Accessed August 9, 2022. https://www.dvm360.com/view/how-clinic-clients-benefit-from-technology
5. US pet care: welcome to the petriarchy. Morgan Stanley. March 3, 2021. Accessed August 9, 2022. https://advisor.morganstanley.com/mcqueary-schumm-group/documents/field/m/mc/mcqueary-schumm-group/Welcome%20to%20the%20Petriarchy.pdf