Today's Veterinary Business

APR 2018

Today’s Veterinary Business provides information and resources designed to help veterinarians and office management improve the financial performance of their practices, allowing them to increase the level of patient care and client service.

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13 April/May 2018 • TODAYSVETERINARYBUSINESS.COM unauthorized gray-market aggrega- tors or diverters, and therefore we can't ensure the product's authentic- ity, nor can we ensure that products coming through that channel were properly stored or shipped." The latter point is important because improperly stored med- ications may lose their potency, rendering them useless. Not Against the Law Online and big-box retailers that sell veterinary drugs without permission are reluctant to discuss how they acquire the products. (PetSmart, PetMed Express Inc. and PetCareRx did not respond to repeated requests for comment.) However, PetMed Express, which operates, offered some insight in its 2017 an- nual report to shareholders, noting: "Historically, many of the major pharmaceutical manufacturers have declined to sell prescription and nonprescription pet medi- cations directly to us. In order to assure a supply of these products, we purchase medications from var- ious secondary sources, including a variety of domestic distributors." What is important to note, Leder and Dr. Catizone said, is that the un- authorized resale of veterinary drugs, while bad practice, is not against the law. However, the sale of prescrip- tion drugs to consumers without a prescription is unlawful, which is why the more prominent companies require a prescription from a veteri- narian before an order is filled. Manufacturers like Zoetis say they work hard to curb the diver- sion of veterinary drugs. "We have a number of things that we do internally in that regard, but it is proprietary information and I'm not at liberty to go into that," Leder said. "One thing I can tell you is that we regularly monitor our customers' ordering patterns, and when we detect anything out of the ordinary, we investigate to ensure that nothing irregular is go- ing on. We also have a responsibil- ity to alert veterinarians who may be providing pet owners with pre- scriptions to be filled outside their practice that Zoetis can't guarantee the authenticity or proper storage and handling of such products purchased by pet owners outside of the veterinary channel. "Moreover, we reserve the right to stop selling our products to a customer if that customer has been found to be diverting product to unauthorized resellers." Zoetis will not honor any guar- antees for products a pet owner purchases from unauthorized sourc- es and will not provide financial support in the event of an adverse experience or lack of efficacy. "In all incidents, Zoetis reserves the right to ask for verification of purchase from Zoetis or one of our four select authorized distributors," Leder said. Monitoring Orders Boehringer Ingelheim monitors sales and takes steps to control the diversion of its veterinary medica- tions, said Mike Hamby, head of the company's U.S. pet business. "The efficacy, safety and integ- rity of our products is of paramount importance to us and the veterinar- ians who recommend them," Ham- by said. "As the quality and efficacy of diverted products are unknown, we have established protocol in place to monitor for and address reported instances of diversion of our products. We encourage vet- erinarians to report any suspected diversion of our medications so we may take appropriate action." On the distribution end, Henry Schein Animal Health, which stocks pharmaceutical products from many different manufacturers, stated that it watches customer purchases for signs of diversion and acts accordingly. "We have internal controls in place that monitor customer orders to identify and prevent inappropriate controlled substance distribution," the company said in a statement. "These internal controls, which we have developed with ex- DEA experts, require all customers to provide detailed information about their practice to ensure that orders are appropriate for the scope of that practice. "As practices grow, we active- ly monitor opioid sales and adjust accordingly. When we find orders that fall outside what would be appropriate for the scope of the practice, based on the account history, size, and ordering pattern and frequency, we determine the acceptability for the completion of the order." Rogue Websites The National Association of Boards of Pharmacy is attempting to curb drug diversion by monitoring spuri- ous online pharmacies. "We have a team that searches the internet every day and identi- fies sites that we believe are operat- ing illegally or rogue sites for which we can't gather enough informa- tion and suspect are not operat- ing legally," Dr. Catizone said. "We publish that information on our website. Of the 14,000 websites we have identified, we believe around 95 percent are illegal or rogue sites. That's how large the problem is." In the past, the NABP issued a seal to be placed on the web- sites of accredited pharmacies that dispense prescription drugs and devices for companion and non-food-producing animals. But it recently stopped the program because unauthorized websites were taking the seal and using it without permission. Now the association issues a ".pharmacy" domain to sites that pass its vetting process. "The domain says that we have verified the website, who it is affiliated with, and that they are appropriately licensed and appear to be doing business properly," Dr. Catizone said. "Around 500 phar- macy sites, including a handful of veterinary pharmacies, use the .pharmacy domain." Veterinarians can help reduce drug diversion by purchasing med- ications directly from manufactur- ers or approved distributors, and explaining to clients why the use of unauthorized distributors may be dangerous, Dr. Catizone said. "I would also encourage vet- erinarians to do some research for clients and create a list of approved pharmacies or websites for the fulfillment of prescriptions outside the office," he added. "At least the veterinarian will know that the client is going to a legitimate site and will not be causing injury to their pet." Unauthorized drug distributors and sellers know what attracts customers and have become quite savvy at luring unsuspecting pet owners looking for a bargain. However, there are numerous signs that a website is illegitimate, said Carmen Catizone, executive director of the National Association of Boards of Pharmacy. They include: • The website contains no infor- mation on where the company is physically located. • The state board of pharmacy has no record of the website or can't find information for the website. • The website provides no contact information for an affiliated veterinarian or pharmacist. • The website does not require a prescription to fill an order. RED FLAGS " As the quality and efficacy of diverted products are unknown, we have established protocol in place to monitor for and address reported instances of diversion of our products. We encourage veterinarians to report any suspected diversion of our medications so we may take appropriate action." — Mike Hamby, Boehringer Ingelheim

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