Veterinary costs are very much under the spotlight in the UK at present. Costs are going up in nearly every area of our lives; so it’s no surprise that people are doing whatever they can to save money where their pets are concerned. One way to potentially do this is to request a written prescription from your vet and obtain the medication your pet needs from an online pharmacy. So how much does this cost and how does it work?

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Why are veterinary drug costs what they are?

As well as seeing things from a professional point of view, the majority of vets, nurses and practice staff own pets so we are all too aware of the rising costs of veterinary medications. Everything from routine flea and worming treatment, to painkillers, insulin or cancer medication has increased in price. One of the major findings of the recent Competition and Markets Authority (CMA) investigation is the concern that pet owners might be overpaying for medicines or prescriptions. The veterinary sector has welcomed this investigation in that it allows us to educate the public on why they may find the prices of veterinary medicines obtained directly from their vet higher than those available from online veterinary pharmacies or those that they may purchase for themselves. 

As vets, we are governed by laws set out by the Veterinary Medicines Directorate (the VMD); specifically, the Veterinary Medicines Regulations 2013. In addition, we are obliged to follow the guidance of our regulator, the Royal College of Veterinary Surgeons (RCVS). 

One of the main regulations we must follow is known as ‘The Cascade’

This is a set of rules which dictate how a vet must choose a specific medication for an animal. As the name suggests, it is a ‘cascade’ of steps. The top of the cascade being the first choice, the second step being the second choice and so on. 

Step 1 (first choice medication) – a veterinary medicine with a Marketing Authorisation valid in GB or UK wide for the indicated species and condition

If this is not possible, they may then move to step 2. If step 2 is not possible, then they may move to step 3 and so on. 

Step 2 – a veterinary medicine with a Marketing Authorisation valid in Northern Ireland for the indicated species and condition. But a Special Import Certificate is required.

Step 3 – a veterinary medicine with a Marketing Authorisation valid in GB, NI or UK wide for a different species or condition. For products not authorised in GB or UK wide a Special Import Certificate is required.

Step 4 – a human medicine with a Marketing Authorisation valid in GB, NI or UK wide OR an authorised veterinary medicine from outside of the UK. For products not authorised in GB or UK wide a Special Import Certificate is required. 

Step 5 – an extemporaneous preparation prepared by a vet, pharmacist or person holding an appropriate Manufacturer’s Authorisation, located in the UK 

So it is illegal for us to prescribe a cheaper human version of a product!

Put simply, vets’ hands are tied. We have to prescribe a licensed veterinary medication over and above a generic human form. Authorised veterinary medications tend to be more expensive. This is because of the costs of licensing them and the research that goes into it. We are also banned from using the price of the licensed medication as a reason not to abide by the cascade. We are able to take into account aspects such as the individual characteristics of the animal; treatment failure of an authorised product; unavailability of an authorised product and owner considerations. But if we choose to move down the cascade and use an unlicensed medication, we must be able to justify our decision to the RCVS and VMD if required. 

So why the difference between online pharmacies and veterinary practices?

Even if your vet has prescribed a licensed treatment for your pet, you may still notice a marked difference in price between buying it directly from the practice versus obtaining it online with a prescription. The reason here is a matter of numbers. Online pharmacies don’t have the same overheads as veterinary practices, not by a long stretch. They are also able to buy huge quantities of a medication from the manufacturers or wholesalers compared to what a veterinary practice will order. Both these facts mean that online pharmacies are able to sell the drugs at a fraction of the cost that a veterinary practice will have to in order to make any profit. Think of it as being like Amazon compared to a local corner shop! 

In addition, many practices will use the markup on medicines sales to reduce the cost of professional fees (e.g. consultation fees, or surgical time, etc). The argument is that reducing barriers to animals actually getting care is more important than reducing medicines prices, because there are alternative routes available to pet owners to obtain medicines with a prescription. 

In many cases, the amount a veterinary practice will pay for a product from their wholesaler will actually be more than an online pharmacy would charge a client. And what’s more, it’s illegal for a veterinary practice to buy a drug from an online pharmacy (at a lower cost) then sell it on to their clients. We are only allowed to purchase drugs from licensed wholesalers. 

The written prescriptions

Many owners are now turning to these online pharmacies to buy their pet’s medications. But in the case of veterinary prescription-only medications (POM-Vs), they will need a written prescription from their vet. A written prescription is an official document that will state the animal and owner details, the type, strength and amount of medication required, instructions on administering the medication and must be signed and dated by a registered veterinary surgeon. Typically a written prescription is valid for 6 months (and it cannot legally be longer). And it may be able to be used more than once; but this is at the discretion of the prescribing vet. Prescriptions for controlled medications, such as those used to treat epilepsy, are only valid for 28 days and cannot be repeated. 

If an owner requests one, a veterinary practice must provide a written prescription. And they are allowed to charge a ‘reasonable fee’ for the service. 

Currently, across the UK, the price of a written prescription varies between £12 and £31.09 with an average cost of £21.29 (data obtained from 1600 practices). Included in that cost is the vet’s professional time and expertise along with the act of putting their name to a formal document. This is a similar fee to a private prescription from a GP.

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As with many things online…

…it pays to be cautious. And it’s advised to only ever use veterinary pharmacies that are accredited by the Veterinary Medicines Directorate (VMD) as part of the VMD AIR scheme (and this will become a legal requirement later in 2024). Although many online pharmacies are part of this scheme and can be trusted to provide the service asked of them, there have been reports of fake drugs entering the UK from abroad which have gone on to be sold online. 

It’s worth bearing in mind also, that if you order an item that has to be stored in certain conditions; such as insulin which needs to be kept at fridge temperature. You must trust the courier to abide by these rules. 

Ultimately, in many cases, vets cannot compete with the costs offered by online pharmacies

We will always agree to help owners wherever we can but we are bound by strict laws. And our fees are a reflection of the rules we have to follow and the nature of our businesses. Written prescriptions can be a good way to ensure that vets are retaining ultimate care of their patients; but owners are able to reduce some costs associated with keeping their pets healthy.  

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