Monday, October 13, 2014

The Fairness To Pet Owners Act

This article originally appeared in Dog News and is published here by permission of the author.

The Fairness To Pet Owners Act

Carlotta Cooper



Let me start by stating that, according to Govtrack.us, an online legislative tracking tool maintained by the government-transparency company Civic Impulse, LLC, this bill has zero percent chance of passage this year, so it's not something that either veterinarians or pet owners need to stress about at this time. However, it was originally introduced in 2011, and again this year. If it doesn't pass this year, it will likely be introduced again at some point in the future. This means that you should know about it.

The Fairness to Pet Owners Act in the U.S. House (HR 4023) was introduced by Rep. Jim Matheson, (D-Utah). The bill would require veterinarians to provide clients with written prescriptions for pet medications regardless of whether such a prescription is requested by the client. It would also prohibit veterinarians from charging a prescription-writing fee or asking clients to sign a liability waiver related to writing the prescription. Senator Charles Schumer (D-NY) and Richard Blumenthal (D-Conn) have introduced a companion bill in the Senate.

House version of the bill here: http://thomas.loc.gov/cgi-bin/query/z?c113:H.R.4023

Even though the bill may not pass at this time, Rep. Matheson thinks the Fairness to Pet Owners Act may raise public awareness about their veterinary-drug purchasing options.

“I think it’s important to have the issue out there and have people talk about it,” Matheson told the VIN News Service in an interview. (“Lawmaker behind proposed Fairness to Pet Owners Act aims to inform consumers,” March 14, 2014, Edie Lau.) “Even if the legislation were never to pass, I think consumers should be aware that they should at least ask for a prescription.”

Matheson originally introduced the legislation in 2011. That bill died in the House Energy and Commerce Committee’s Health Subcommittee when the legislative session ended in early 2013. Matheson reintroduced the legislation early this year. The bill is now with the Energy and Commerce Committee.

According to press releases from the American Veterinary Medical Association and an article in DVM360 Magazine (“Fairness to Pet Owners Act now brewing in U.S. Senate,” July 23, 2014, by Julie Scheidegger), the AVMA staunchly opposes the bills. The AVMA calls the act “burdensome and unnecessary.”

As dog owners, most of us have had experiences buying prescription medications from veterinarians. Opinions among owners and breeders seem to be sharply divided in the fancy over these bills.

Here are some of the pros and cons:

Pros
  • Veterinarians often mark up prescriptions 100 percent or more to help pay for some of their other services. Getting a prescription from your vet would allow you to buy the same medications cheaper elsewhere.

  • Some people are reluctant to ask for a prescription. If veterinarians are required to provide a prescription, you won't have to ask.

  • Some pet owners may not know that they can ask for a prescription or buy medication for their pets somewhere else. Automatically giving every client a prescription makes sure they know.

  • Vets would be prohibited from charging a fee for writing a prescription.

  • There may be less chance of a vet prescribing medication your dog doesn't really need.

The act would also:

  • Prevent vets from specifying from where clients must buy medications as a condition for receiving a prescription; and

  • Prevent vets from requiring clients to sign a waiver relieving the doctor of liability in the case of any problems with a prescription filled elsewhere


Cons
  • The AVMA says that clients are already free to purchase prescriptions from other sources. Some states already require vets to provide a prescription (two states). And vets are ethically obligated to write a prescription if you ask for one.

  • The AVMA says they have no data to show that this law would lower the overall cost of pet care.

  • According to the AVMA, there would be an “administrative cost” if vets had to automatically provide prescriptions to their clients.

  • According to the AVMA, it would be a burden on vets if they had to write a prescription every time they prescribed medicine for a client's pet.

  • Pharmacists are not well-versed in requirements for animal dosing.


Ashley Morgan, DVM, Governmental Relations Division assistant director for the American Veterinary Medical Association, says the bill is being presented “under the guise of saving consumers money on their pets’ medications.” Honestly, it's hard to see how pet owners would not save money if they bought their pets' medication outside the vet clinic. There are countless stories of pet owners who are able to save lots of money by having prescriptions filled at Wal-Mart or their local pharmacy. Just ask around and you can find owners who have paid a vet $30 for a tube of eye cream that is $4 at Costco. Or find someone whose vet made them pay to get a prescription – even if they were ordering something online and the prescription only had to be faxed. Lots of people use heartworm preventive that isn't carried by their vet but the vet will still charge for a prescription or refuse to write the script. In short, some veterinarians are not nearly as cooperative as the AVMA suggests and pet owners could save money.

Dr. Morgan admits that there may be instances of veterinarians declining to provide prescriptions, but not enough to justify a law.

“Our understanding and belief is that it’s not a pervasive problem,” Morgan said. “The AVMA's Principles of Veterinary Medical Ethics states that a veterinarian should honor a client's request. If there are veterinarians not providing prescriptions, hopefully they have a medical or ethical reason for doing it and are communicating that to the client.”

As far as it being a burden for veterinarians to have to write prescriptions or requiring an “administrative cost,” how are M.D.s able to write prescriptions for people without suffering these problems? When you go to see your doctor you don't have to buy your prescriptions from him or her. You expect to get a prescription so you can go out and have it filled. You are free to shop around for the best price if you like. Perhaps at one time you bought your medicine from your doctor when he made housecalls and carried a doctor's bag to your house but those days are gone. It seems silly for pet owners to have to go on purchasing over-priced prescriptions from veterinarians while the cost of pet care rises dramatically every year. Pet owners have access to cutting edge treatments that are similar to the same treatment given to humans these days – and we pay similar costs for it. Shouldn't we be able to save money where we can on the cost of prescriptions?

Rep. Matheson also sees the similarity between physicians and vets. “In the case of human doctors, they can’t dispense medication,” he said. “We’ve made a decision that that is a conflict of interest. I’m not raising that issue right now (for veterinary medicine), but I could.”

Will there be a backlash from veterinarians? Possibly. If this bill passes at some time in the future, we could see other pet care costs rise as vets try to make up the loss of income from prescriptions. Ethical? Not really. But it could happen. Many vets already charge for an “office visit.” What's that about? What does that cover? I suppose it allows you and your dog to sit in the lobby for a few minutes.

The one con for the bill that seems like a realistic concern is that pharmacists are not well-versed in dosing for animals. If you take your vet's prescription to your local pharmacy to be filled, your pharmacist might not know about possible substitutions or how they would affect a dog. He or she might not know if it's okay to sell you a different size pill and tell you to cut it in half, and so on. Will your vet be cooperative if the pharmacist has to call to get information?

Other people believe that this bill is a bad idea because they think that the marketplace should sort things out. More laws, even to protect pet owners, would only interfere with the rights of veterinarians to practice and charge what they want.

I was curious about who was supporting this bill and eventually found a group called APAW – Advocacy for Pets and Affordable Wellness. APAW describes itself as “a national coalition of pet owners and advocates dedicated to promoting the health and well-being of America’s pets and empowering pet owners everywhere to demand affordable, quality health care and medicine for their animals.”
On its website, which focuses on the proposed legislation, APAW has a page titled “Where to buy meds” that displays the logos of 45 retail supermarkets and pharmacies. The stores are, or are owned by, Wal-Mart, Costco, K-Mart, Target, Albertson’s, Kroger, Bashas’ and Brookshire Brothers. Also in the listing is one online pharmacy, PetCare Rx. Founded by a petsitter and dogwalker in Huntington Beach, CA, the coalition is made up of politicians, veterinarians, retailers, product companies and shelter groups.

Obviously, these retailers have something to gain by supporting the legislation, but it's good to know who is backing the bill. According to APAW, on average, pet owners can save up to 80 percent on their pets' medications by buying from non-vet sources.

Rep. Matheson also co-sponsored the Fairness to Contact Lens Consumers Act of 2003. This act, which passed, requires eye doctors to provide patients with prescriptions that allows them to buy their lenses somewhere else. There are a lot of similarities between this law and the Fairness to Pet Owners Act.

I don't usually like more laws and regulations but this time I think pet owners are over a barrel when it comes to prescriptions. If you need medication for your dog, you don't have options. You have to use a vet. After much thought and consideration of the pros and cons, I think the Fairness to Pet Owners Act is a good idea for pet owners. I think that vets should provide us with a prescription so we can buy medication for our pets anywhere we like. While veterinarians have a near monopoly on selling pet medication, the prices remain high. Giving pet owners more information and options about where they can purchase medication for their pets should help lower costs.

Rep. Matheson is not running for re-election and it is doubtful that this bill will pass during what remains of this Congressional session. However, we can expect to see the Fairness to Pet Owners Act again in the future so remember the pros and cons. As costs for pet care rise, this bill to save pet owners money on prescriptions will probably look better and better.

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