What’s in Your Pharmacy?

The veterinary pharmacy is vital to a profitable practice, representing a double-digit share of gross revenue in the average small animal hospital. Inside that pharmacy are two categories of products: preventives and non-preventives. Preventives are, of course, heartworm, flea and tick products. Non-preventives include everything else, such as NSAIDs, supplements and anti-infectives.

To support their medical standards and promote best pharmacy practices, hospital teams must:

• Have systems in place to support pet owner compliance.
• Employ educated and trained team members.
• Maintain good inventory management.
• Brand an online pharmacy to the practice.
• Embrace the advantages of brand-name products.

Pet Owner Compliance

The adage “Simplicity is the ultimate sophistication” is a meaningful thought applicable to your efforts to get medications into patients. If your clients don’t purchase veterinary drugs and administer them properly, then all other points are moot. You can support pet owners in myriad ways to help them give medications to their cats and dogs.

Practice management consultant Debbie Boone said the first step is to “confirm that the client is willing and able to dose the pet.”

“Elderly, other-abled, frequent travelers or just busy clients may prefer long-acting injectables when available even though they are generally more expensive,” she said.

Additionally, some pets are difficult to medicate. Therefore, the simpler the plan, the better the odds of success.

Injections are an obvious solution when medically appropriate because they take the responsibility off the pet owner. They also support the practice’s financial health, as clients cannot easily purchase injections elsewhere.

With anti-infectives that need to go home in oral form for multiday administration, find the simplest dosing schedule. Reducing the burden on the pet owner cuts the risk of human error. Also, consider these questions:

• Can the drug be given only once a day?
• Can cutting or splitting pills be avoided?
• Will refrigeration or special storage be required?
• Will a compounded form make things easier?

For the same reasons that human pharmacies provide medication counseling and written handouts, veterinary teams should not rely solely on verbal education. Provide clients with written resources regarding their pets’ condition and prescriptions, and review the documents with them before checkout. While clients might say they understand the instructions, the reality is that many misread or forget what you give them. Expecting them to remember everything they heard is unrealistic.

Team Training

A well-trained veterinary team is part of a successful plan for well-managed medication protocols. Team training and protocols should be consistent across the practice to ensure every pet owner receives the safe dosing and dispensing instructions. Client knowledge of a pharmaceutical includes awareness of how it works and how to handle it safely and administer it correctly.

Unfortunately, veterinary teams sometimes substitute speed for safety, Boone said.

“We typically take less precautions with anti-infectives than chemotherapeutics, but even these benign medications have risks,” she said.

Anyone handling a medication should avoid skin contact with it for two reasons:

• Trace amounts of medication might cause a reaction in an allergic client or employee.
• Skin oils can damage a pill’s coating.

Accurate dispensing is vital for preventing harm to a pet. Consequently, create a protocol for double- or triple-checking prescriptions before you dispense them. Even the most well-trained and cautious veterinary professionals make honest mistakes.

“Selling” is a dirty word in veterinary medicine. But let’s be honest: Communication, reassurance, bonding, empathy, persuasion and influence are selling skills that teams should practice regularly. The better the veterinarian and support team can sell, the better the outcome for all involved. Remember this: Happy client, happy pet, happy team, higher profit.

Make sure your clients understand that buying from your veterinary practice is beneficial because you provide the most support. When they buy from a third-party pharmacy, they might save a few dollars, but they sacrifice your knowledge of their pet and its condition and possibly quality control. Train your team members to make those points in a professional, nonconfrontational manner.

Inventory Management

Ah, yes, inventory management — every practice manager’s nightmare! All veterinary hospitals have faced the stress of a mismanaged inventory, zero stock and back-ordered items. Those are the last things you want in times of broken supply chains and disrupted manufacturing.

The just-in-time method of inventory management has its perks but also shortcomings. Anti-infective medications are typically needed quickly, as active infections should not be left to brew. If you are ordering “just in time,” be sure to have standard operating procedures to avoid running out of a product. The risk of an empty shelf when a sick patient is in the exam room next door must be minimized. “We are out” is never what a pet owner wants to hear.

Good inventory management also means knowing a medication’s storage requirements. All team members who handle a drug must know whether it requires a specific temperature range, needs protection from light or has special handling instructions. Failure to treat a medication properly can yield a spoiled product.

Consistency in a stocked brand also helps avoid confusion and dispensing errors. Take notice of lot numbers and expiration dates, as they are critical in the event of a product recall or patient reaction.

Branded Online Pharmacy

In today’s landscape, every veterinary practice should have an online store. Consumers demanded e-commerce options before COVID-19, but since the pandemic, buying online has become a lifeline for many.

Your veterinary practice must remain competitive and relevant by providing online shopping opportunities, including home delivery. Doing that helps maintain client satisfaction with your practice and ensures that correct and properly handled medications find their way to patients. An online pharmacy also keeps you at the front of a client’s mind as a valued partner and resource.

While on-site dispensing of time-sensitive anti-infectives is important, don’t forget that some pet owners will insist on receiving them differently. If a drug is a refill or associated with a telehealth visit, the pet owner might not wish to pick it up at your practice. In those instances, be sure to offer home delivery, and remind clients that a veterinary office’s oversight of dispensing ensures quality, accuracy and safety.

Brand Names Versus Generics

Veterinarians prescribe some medications off-label because there are no other options. But when you stock a name-brand, FDA-approved, veterinary-specific anti-infective, choosing it over a generic is often the best medicine for several reasons, one of which is that it’s on-label.

While often more expensive than generics, branded products come with the manufacturer’s support. If the medication fails to work or has an unexpected side effect, you have access to a technical support team that can aid in many ways, including potentially assisting the pet owner with further veterinary care.

Stocking branded products maintains an open relationship between the practice and the manufacturer, allowing access to other benefits, such as team training and purchase promotions across the company portfolio.

Using veterinary-branded medications instills trust and confidence in the pet owner for two reasons. First, price is associated with value. Second, it suggests quality and efficacy. Both of those can improve client compliance, which is best for the pet and reduces the risk of drug resistance arising from unfinished prescriptions.

Remember when setting your fee schedule that in an increasingly competitive pharmacy landscape, your practice can choose to be highly competitive in pricing medications and make up for it in other ways.

All that said, know that not one size fits all. “Knowing your company brand and who your clients are helps determine if you need to find lower pricing for better compliance,” Boone said.

The management, handling, administration and dispensing of veterinary medications, from anti-infectives on down, is a significant feat. It consumes a good bit of time each day, but for a good reason: the health of the patient and practice. With suitable protocols in place, the process can be more efficient, less stressful for the team, and more convenient and safer for the pet owner and patient.

WHERE THE MONEY IS

According to the American Veterinary Medical Association’s 2023 Economic State of the Veterinary Profession report, exams and consultations make up the largest portion of revenue at all practice types. Pharmacies are No. 2 at about 14%.

TIMESAVER

Socially Acceptable columnist Dr. Caitlin DeWilde offers this veterinary pharmacy advice: “If you’re filling a prescription that would be better served by home delivery or auto-ship, consider adding a bag sticker or enclosing a small card that nudges clients to your online store. QR codes with the text ‘Scan to refill!’ also work great.”