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Discussion Starter #1
Hi, I am a new member and I have a question. Can I get a prescription ahead of time from my vet to fill at a human pharmacy rather than having it dispensed at her clinic? A website I recently visited, https://www.vets-on-commission.com stated that I can do this. It would be so handy to have such a prescription on hand at times when travelling. Is what is being said at that website accurate?

Namu
 

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I used to get my dog's thyroid meds from a human pharmacy because my vet doesn't keep them in stock (low demand). So long as there are repeats remaining any pharmacy should be able to fill a legitimate prescription.
 

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Yes, that is a thing that is possible if you live in the US or Canada and the drug is approved for use in humans, but it is up to the individual vet and probably depends on the drug, to an extent. There are documented cases of drug-seekers using their pets to obtain medications, either to sell or to use themselves because they have an addiction, so some vets prefer to fill rx themselves because it gives them better control/tracking over refills for medications that have the potential for abuse - for instance, opioids like tramadol or benzodiazapenes like xanax or valium.

Getting drugs from your vet instead of a human pharmacy also ensures that you're getting the usage information from the right kind of specialist - human pharmacists are not trained in veterinary drug usage and may not be aware of animal-specific side-effects, dosages, or drug interactions.
 

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Pretty common. For non-controlled medicines, my vets have often just asked right off what human pharmacy I would prefer (i.e. CVS, Walgreens, major grocery chain). Many of the major chains even carry common pet meds too or at minimum have filled pet scripts before. Its often cheaper to pay cash for human meds then fill via a vet pharmacy due to the generics available on the $4/$7 type lists.
Things like antibiotics mostly. Stuff with no real risk of human abuse.

Never opiates or similar painkillers (Tramadol for example).
 

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I have also found a number of vets online who are willing to do online assessments for prescribing medecines. I wont link here as I know it is forbidden, but a simple google search should point you in the right direction.
 

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I know when we had a Greyhound with Epilepsy, the Vet filled out a prescription so we could get the pills from a regular pharmacy as the ones he would have had to sell us for a dog were way more expensive than the ones prescribed for humans.
 

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Discussion Starter #8
Thanks for the update. Were you surprised to be offered a prescription for the Epilepsy medications or were you aware that a prescription was something that was available to you?

Namu123
 

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It has been our experience that vets sometimes 'forget' to explain that a prescription is an option, but it is - and it can be cheaper to fill it at costco than at the vet's front counter. Also, some eye drops and antibiotics are the same for dogs as humans, and are available over the counter (without a prescription) in some countries, like Mexico. Just saying.
 

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Discussion Starter #10
Hi Dalans,

Thanks for your feedback. The website that I had looked at and referenced in my original post also raised the issue of veterinarians being paid on a commission basis. Are you aware if that is a widespread practice in the area where you live or in other locations? If it is, it raises concerns in my mind as a pet owner about the issue of conflict of interest for veterinarians.

Namu123
 

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Honestly, I know most meds are slightly more expensive at my vet than at the human pharmacy, and I buy them there anyway. I don't see any reason to think he's price gauging - pretty much anything is more expensive at a small shop than at, say, Walgreens, because of selling at volume and the advantages a chain has with sourcing. Most vet clinics are on a pretty tight budget and I'm grateful we even have a competent vet in my small town, so I'm not about to penny-pinch with him. At the end of the day, Walgreens isn't going to be the one giving my dog an emergency gastroplexy or whatever.

If it was a long-term medication regime on a drug where the price difference was more substantial, I might feel different, especially if I had my own human meds to pick up on a regular schedule and it'd save an errand. (My pockets and my time have their limits, obviously, and sometimes what's best gives way to what's practical.) But I'm weary of this implication that independent shops and service providers are trying to rip you off just because they have to charge more than Amazon or Walmart.
 

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Discussion Starter #12
Dear Parus,

Thanks for your reply. The issue to me isn't about vets trying to rip off their clients. It is about consumers, including pet owners, being aware of the choice to obtain a prescription if that works best for them, rather than having medications dispensed to them without a choice by a veterinarian. I can fully understand wanting to try and support your local veterinarian especially if there isn't much of a difference in the cost between the medications you are being prescribed. However, I am now aware of situations where the difference in price for a month's supply of a single medication can be as much as $100 plus, between what a large human pharmacy may charge and what the cost is when that same medication is dispensed at a veterinarian's office. That is no small difference and even though I may like my veterinarian that doesn't mean I necessarily want to subsidize his or her income at my own expense. Choice is what I want pet owners to have. It is as simple as that and I am sorry if you are weary of hearing about this issue again.

NAMU 123
 

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However, I am now aware of situations where the difference in price for a month's supply of a single medication can be as much as $100 plus, between what a large human pharmacy may charge and what the cost is when that same medication is dispensed at a veterinarian's office.
That's a lot, yeah. Would you care to share these situations?
 

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One thing to keep in mind is that the vet knows what price they can fill a script for internally but unless a medication is on one of the well publisized $4 type generics lists AND the owner or vet takes the time to look it up, the vet has no way to know what the cash pay price is for any given med at a human pharmacy. That cash price can also fluctuate week to week or month to month. Human pharmaceutical prices are wonky due to insurance and middlemen (see Netflix show "Patriot Act with Hasan Minaj" episode on drug pricing for a quick and disturbing review).

If you or anyone is comparing vet clinic price to a copay or insurance price at a chain because that's what you remember paying for it for yourself/your kids, it will likely be drastically inaccurate.

Most pet owners and vets are also aware of the option of online animal pharmacy like PetSmart/Chewy as a third option.

I have never had a vet not willing to discuss upfront pricing options for any medication, procedure or test. They are all cash pay vs insurance like human docs so pricing doesnt end up varying from customer to customer for the exact same med.
 

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Discussion Starter #15
Thanks to Parus and Shell for their responses. I want to follow up in reply to Parus and her request for examples on the difference between the costs for medications dispensed at a veterinary clinic and the costs incurred at a human pharmacy for the same medication. I visited a dog owning friend yesterday and we discussed this topic of prescriptions versus dispensed medications. She told me she had something to show me. She went upstairs and came back down with two receipts for Tramadol that she had received in the past few months. One was from a large veterinary corporate practice where she'd been referred by her own veterinarian. She had been handed a bottle of tramadol by the vet tech at that clinic for her dog's pain at the end of the day and had paid her bill even before she received the medication. The veterinarian was not present when the medications were dispensed. There had been no discussion between the veterinarian and my friend about whether the Tramadol that was dispensed would be a generic or a brand medication and any cost difference that may entail. My friend was also not offered a prescription to get the medication elsewhere, but was simply given the already made up tramadol. She was not even aware at that time that a prescription was an option. The bill for those 80 Tramadol was $165.72.
A few months later she needed another round of tramadol and attended a different general veterinary clinic and the veterinarian informed her it was cheaper to have the tramadol filled with a prescription, and proceeded to give her one. After a visit to a local Costco pharmacy the bill for 80 tramadol came to $62. The difference to my friend was over $100 between the two bills.
Was my friend properly informed and did she make an informed decision regarding the medications she received? Did the fact that the corporate clinic where she went pays its associate veterinarians on commission influence how my friend was treated? If this scenario is repeating itself across this continent one has to ask how many pet owners is this happening to and in many cases are they even aware of the choice they were denied?

I'd be interested to hear what other people have to say about this issue.

NAMU 123
 

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80 Tramadol ?! Costco is well known for very affordable medication from their pharmacy (which in most, maybe all, states you do not need a costco membership to use) so the price sounds right but it is basically unheard of for any vet to prescribe 80 Tramadol at one time. Let alone a vet that does not have a very long standing relationship with the dog and owner.
Tramadol is abused by people and sold as a street drug so its fairly tightly controlled.

As an example, I had a dog have major knee sugery a few years ago. CCL repair with 20 staples kinda thing. He got 3 days worth of Tramadol (9 pills IIRC) and then it was on to a plain NSAID. If he had needed more tramadol, they would not even call another 3 day script into my regular vet for pick up but required another visit (no charge btw) with them and pick up in person. He did not need it and it often has problematic digestive side effects after a few days of use so 80 pills would be like a full month at full dose and that is rarely needed.

But really, if cost matters, ask about it along the way. That is kinda for anything in the consumer world.

At a more typical prescription level for say, 10 tramadol, the difference in price would be more like $12 at costco and maybe $18-20 at the rate you describe from that first vet. Mos people aren going to make a separate trip to costco for 10 bucks savings. Especially since Costco might be 45 minutes away for many people.
 

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Discussion Starter #17
Hello Shell,

The prescription from the corporate clinic was for post procedure pain. My friend used 6 tramadol before discontinuing it. Her geriatric dog died a week later. She had never met this veterinarian before the tramadol was prescribed. She donated the left over tramadol to a pet rescue society whom she had fostered for. A few months later she went back to her regular vet clinic and saw a locum who gave her a prescription for the other 80 tablets of tramadol for her second dog who had started to develop arthritis. Needless to say she wished she had kept the tramadol she had donated earlier! However the cost difference between the two sets of tramadol was over $100. Each set of medication contained eighty, 50 mg tablets. I suspect most folks won't quibble if the cost difference for a medication is a few dollars, as the convenience of having the medication dispensed on site at the vet's office is useful. However this was certainly not the case her. I would agree that like all consumers pet owners need to ask questions, but to ask the right questions they need to be informed and hopefully this is what this thread may do for anyone reading it. I encourage people to become informed and to ask questions. I found the website that I mentioned in my first post, https://www.vets-on-commission.com has a realm of information that will make pet owners aware of the changes occurring in the pet world and how they may navigate that world safely and effectively.

NAMU 123
 

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a large veterinary corporate practice
Well, assuming your story is accurate, there's your first problem.

I have to take your commentary with a grain of salt. Where are you located? Here, the human pharmacy likely would have questioned or rejected the prescriptions due to checks put into place due to the opioid addiction crisis. I have trouble buying a vet writing a script for that much tramadol for post-procedure pain (why would the pain be expected to persist that long?) and it'd be a weird choice for early stage arthritis, I think.
(Side note: tramadol might not do much for pain relief in dogs at all, and appears ineffective against arthritis in particular. Here's a recent study and some commentary on it:
https://avmajournals.avma.org/doi/abs/10.2460/javma.252.4.427?journalCode=javma&
https://vetgirlontherun.com/tramadol-work-dogs-chronic-arthritis-vetgirl-veterinary-continuing-education-blog/
http://veterinarynews.dvm360.com/study-shows-tramadol-has-no-effect-osteoarthritis-pain-scores )

You've made a point of linking that website at every opportunity. The site doesn't seem to identify a publisher or author, so I don't think it's a good use of my time to read through it - anyone can toss anything up onto the internet.
 

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So yeah, here we have a user named NSA123 promoting the same site.
https://www.vetratingz.com/reviews/2576/Veterinary-Clinic-Ladysmith-Animal-Hospital.html
https://www.vetratingz.com/reviews/39217/Veterinary-Clinic-Island-Veterinary-Hospital.html
https://www.vetratingz.com/reviews/41254/Veterinary-Clinic-Callander-Animal-Hospital.html

NAMU123, why not just start a thread about corporate veterinary practices and commission pay? Why the pretence that you were asking a question you didn't know the answer to? It's a legitimate topic and concern, but you're behaving like a spammer, which doesn't do your cause any favors.
 

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I don't even know if my dog's prescriptions would be cheaper at a human pharmacy. I have a friend who is a pharmacy tech and from our discussions, the human medications that my dog is on are about the same price per pill as what I'd be paying if I had it filled at the pharmacy where she works. Since one of my dogs is also on medications that aren't prescribed for humans, it's just one less top for me to only go to the vet.

There is something very, VERY fishy about a vet prescribing 80 x 50mg tramadol to someone who they do not have a standing relationship with. My vet, with whom I have a very good relationship and have been going to for almost a decade, will not prescribe more than 30 at a time for my palliative care senior (a cost of ~$10, for me).

Many vets charge a prescription fee for writing a script to have it taken elsewhere (human physicians paid on a fee-for-service model generally charge a similar fee as well, but in Canada at least, it's billed to the public system so the patient never sees it).
 
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