An Ontario pharmacy owner claims veterinary drug distributors are restricting the supply of medication, which she believes is costing owners more money to treat their pets amid an absence of dispensing fee regulations.
Wendy Chui, owner of Toronto brick-and-mortar pharmacy Canada Chemist and online pharmacy store PetsDrugMart.ca, recently launched a complaint with the Competition Bureau claiming that drug companies are holding back supply to pharmacies, preventing licensed pharmacists from stocking certain animal medications.
She believes this is causing pet owners to pay significantly higher prices for those medications when they are exclusively offered through veterinarians.
“Pharmaceutical companies are trying to eliminate pharmacy dispensing of veterinarian-type prescription and medication,” Chui told CTVNews.ca in a phone interview. She calls the activity anti-competitive.
Unlike with human medicine, where a medical professional will often prescribe medication for a pharmacist to dispense, a veterinarian can act as both a prescriber and dispenser of animal medicine. Ontario veterinarians are required to fill out a prescription that can be filled elsewhere only if a pet owner asks to receive medications from another source.
Chui, who is legally permitted to dispense veterinary drugs and has been doing so since 2010, claims Veterinary Purchasing Co. Ltd. (VPCL), which is the only Ontario distributor for those drugs, has refused to provide her with stock for her licenced pharmacy since she opened for business. When she approached numerous pharmaceutical companies directly, her requests for distribution were also rejected.
CTVNews.ca reached out to VPCL for comment but did not hear back.
Chui turned to vets for supply, and had maintained her pet pharmacy based on this exchange.
She claims that in 2015 the VPCL and drug companies learned about her arrangements with veterinarians and stopped distributing to them. That same year, the College of Veterinarians of Ontario (CVO) amended its regulations to limit vets from supplying pharmacists with drugs for resale, she says.
In an email to CTVNews.ca, Jan Robinson, registrar and CEO of the CVO, explained that “Health Canada sets the approval, scheduling and distribution of all drugs in Canada, including the sale of drugs.”
Drug wholesalers or manufacturers are permitted to sell drugs to practitioners, such as veterinarians or pharmacists, for the purpose of dispensing, Robinson explained in the email.
“Veterinarians have the unique privilege to prescribe and dispense drugs to their clients, but they are not drug wholesalers,” she said.
Robinson added that only in emergency cases of low supply can a veterinarian provide a drug to another veterinarian or pharmacist.
“Prescribing and dispensing is at the level of the province related to professions that are licensed to do so,” Robinson said in a phone call with CTVNews.ca. “The majority of professions are generally able to do one or the other. They can prescribe or they could dispense.”
Veterinarians are the exception, Robinson explained. “They are the profession that has the drug therapy knowledge related to the application and outcome of the animal. So they have been given the privilege to both prescribe and dispense. That does not mean a pharmacist cannot dispense.”
Robinson explained that pet owners are permitted to ask for a prescription and take it to a separate pharmacy to be dispensed.
“Veterinarians can dispense at their own facility,” she said.
There are, however, no rules saying veterinarians must disclose to their customers that external dispensing options are available.
“Veterinarians are doctors. Their role is to prescribe and dispense for animals in their care. Their job isn’t about resale of drugs,” Robinson said. “They buy drugs [only] to be able to prescribe and dispense for animals within their care.”
The issue at hand here is the reselling of drugs, she said, which is only permitted in limited quantities under circumstances of supply shortages.
“It isn’t about the rules of the Veterinarians Act,” she said.
Chui says refusal to allow the distribution of these medications to her pharmacy is allowing veterinarians to have a monopoly on the sale of pet drugs.
“[Drug companies] want to trace who is prescribing,” she said. “So, when [they] do that, [they] are cornering the market and they know what to do to promote sales. [If these companies sell] to pharmacies, they have no idea who is prescribing. But if [they] have a direct channel of distribution going from drug manufacturing to distributor to only vets, then that’s [an] issue.”
As the Globe and Mail reported, Rich Verman, co-owner of another online pet pharmacy, ThePetPharmacist.ca, said that he has also faced difficulties with veterinarians willing to supply his store with requested medications.
According to the CVO professional practice standard, which says it abides by the province’s Veterinarians Act and regulations, “a veterinarian should acknowledge and manage the potential conflict of interest in assuming the dual role of prescriber and dispenser.”
Chui claims that this potential “conflict of interest” is being overlooked by the CVO, and she believes that pet owners could be paying more as a result.
She and her team gathered receipts from friends and colleagues who purchased animal medications from veterinarian offices and compared prices from these vets with their own. Chui submitted these cost comparisons to the Federal Bureau of Competition.
According to Chui’s comparisons, which were obtained by CTVNews.ca, certain medications were found to be nearly 25 per cent less expensive when purchased through her pharmacy service versus those purchased through veterinarians.
Robinson said part of the problem comes down to a lack of fee regulations.
There isn’t a regulator that I’m aware of in Ontario that actually is involved in fee-setting,” she said.
“Where you’ll see regulators, including ourselves, involved is when a client makes a complaint related to excessive fees,” she said. “If we received a complaint that a client felt a [medication] fee was excessive, we would take a look and investigate.”
Chui’s claims that her online pharmacy markups are significantly lower than those charged by vets to dispense, averaging 40 per cent less, and ranging from 20 per cent to 97 per cent in pricing differences.
Revolution Blue, for instance, a topical solution for the prevention of heartworm disease, roundworm infection and tick infestations with dogs, cost one pet owner $22.83 for one 0.75 milliliter tube, with the prescription including a total of six tubes, for a total cost of $137. According to Chui, her pharmacy charged $17.12 per tube (with six tubes costing a pet owner $102.72), and her pharmacy was not obligated to only sell in six-tube bulks if a pet owner only wanted to purchase individual doses.
Simparica Trio Dark Brown, a parasiticide for dogs, cost one pet owner $239 for six boxes of chewable tablets, according to receipt comparisons. Chui’s charges up to 50 per cent less for this medication, with their mark-up at $119.10 for six boxes.
Unaffordability of pet care is a problem that Humane Canada says is leading to longer animal shelter waitlists, which have shown record lengths since July.
Tara Hellewell, director of donor relations and national engagement for Humane Canada, told CTVNews.ca in a phone interview that much of the problem comes down to financial difficulties.
“Unfortunately, with the greater challenges of our economic situation, there are some folks who are really struggling to afford their [pet] bills. They’re being forced to surrender their animals because they can’t afford the cost of care.”
The Ontario Ministry of Agriculture, Food and Rural Affairs is currently reviewing the regulations associated with the Veterinarians Act, which was last updated in 1989.
Chui believes there should be regulations that restrict the mark-up fees established by veterinarians if they are both the prescriber and dispenser, and that there should be widened availability for pharmacists to dispense drugs to give pet owners a choice as to where they choose to purchase.
“It’s time to open up [the market] for more competition,” she said.