The Veterinary Pharmacy Wars
Do your veterinary clinics have a business plan for their pharmacy that factors in consumer preferences?
The veterinary pharmacy wasn’t always big business. But several factors led to its explosive growth, said Candise Goodwin, principal of Outlier Advisors.
First was the Minimum Advertised Price (MAP) policy. Before, manufacturers had little to no control over pricing or their brand equity in channels outside the traditional veterinary clinic pharmacy. With MAP, manufacturers now had skin in the game to monitor the channels and control the pricing of their products. Before this policy, it was challenging to get high quality products, even OTC products in different channels, Goodwin said. “There were a lot of products that weren’t the best solution for pet owners, but after MAP, pet owners now had access to these best brands, and manufacturers had the ability to control their brand equity.”
Manufacturers also began to both consolidate and release blockbuster oral flea and tick products around this time. Consumers already motivated to do the right thing for their fur baby now could purchase oral chews versus a sticky collar that they had to keep away from their child or worry about staining the couch.
Tim Lawrence, director of business operations at Patterson Veterinary, said the market has continued to evolve as distributors, manufacturers, veterinary practices, and retailers strive to deliver what consumers demand: convenience and value. “The veterinary pharmacy became significantly more valuable in the 1990s with the advancement of parasiticide preventatives and treatments,” he said. “Products like Program, Heartgard, and Advantage led the way and many followed. For a time, these products were only available at the vet practice … until they weren’t.”
Enter online retail companies such as PetMed Express, disrupting the market and paving the way for new companies like Chewy, Lawrence said. “COVID accelerated this trend and others wanted in, so we see Big Box retailers, major e-commerce players like Amazon, and countless boutique animal health startups fighting for a piece of the pharmacy pie, all promoting convenience and value.”
Suddenly, a modest category of veterinary medicine experienced explosive growth. For instance, when discussing one segment of the pharmaceutical space – the health dermatology market – Zoetis estimated it to be around $70 million in 2012. Today the market is $1.25 billion, with Zoetis products earning $1.2 billion of that segment. Indeed, the manufacturer boasts 15 blockbuster products (defined as products over $100 million) in seven therapeutic areas.
The rise of consumerization
Goodwin has had one of the most unique insights into market changes, having worked on the manufacturer side before moving over to the retail channel and helping some of the major players develop omnichannel strategies. During her 15-plus years of experience in the animal health world, she has launched numerous high profile industry changing growth initiatives at noteworthy companies including Merck Animal Health, Vets First Choice (now Covetrus), VIP Petcare (now a Pet IQ company), Petco and Petfolk. She got her start in animal health in 2010 as a field rep for Intervet Schering Plough (later acquired by Merck) before going over to the retail side with Vets First Choice in 2015 to help develop a solution for white label home delivery for veterinarians to compete with PetMed Express. Her job was to help educate the veterinary community on what home delivery was, why it mattered, what consumers expected, and how corporate veterinary clinics or independent veterinary clinics could participate in this shift. In her last corporate role before becoming a consultant, she oversaw the pharmacy and prescription diet business at Petco.
To Goodwin, the common thread in the veterinary pharmacy’s evolution is clear – consumer demands are changing the way products are purchased. The consumerization of healthcare is the broader trend happening based on a variety of things in the market, she said, like consumer expectations, pet parenthood, greater access to demographic information and even COVID, which created a rapid digital acceleration for the consumer. Things like QR codes, online purchases, pick-up in store, or curbside, created new avenues for retailers and veterinarians alike. They also created new headaches.
“These were things that we had to figure out very quickly,” said Goodwin. “A lot of companies innovated their business during this time, because consumers were ready and willing and needed, quite frankly, to adopt new solutions.”
Formulating a pharmacy strategy
Today, veterinary clinics that have successful pharmacies (online and in-store) have put a lot of thought into this part of their business and how it fits into the overall value chain from the consumer perspective, Goodwin said. First, they know who their customer is and what they want. They also know their market, whether it’s a mixed animal practice in a rural town or an urgent care clinic in a major metro area.
Indeed, the consumerization of the veterinary pharmacy has forced clinics and their owners to formulate a category strategy. Goodwin listed three common categories as examples:
- Acute medications, or medications that pet owners need right away
- Chronic medications for growing disease categories like dermatology
- Preventives for flea/tick and heartworm prevention
For each of those categories, understanding and knowing what products are most important from a medical perspective is critical for all types of veterinary clinics, be it emergency, urgent care, specialty, mobile or general practice. What medications make the most sense from a clinical and business perspective?
For instance, a lot of times a retail pharmacy can sell a generic product cheaper than a veterinary clinic. “If it’s a product used to treat something acute, veterinary clinics must ask themselves, do they care about that acute sale?” Goodwin said. “If you’re an urgent care clinic, do you care if you’re making a huge markup on a human antibiotic in your practice? Or is it better to send them to a retail pharmacy, because you know you’re going to keep that customer, and you’ve had higher transaction value based on the visit fee and the diagnostic fee?”
Keyed in on client preferences
Veterinary clinics can determine what their customers want by asking them via online surveys, end-of-visit surveys, or even through simpler means. For instance, when Goodwin was part of the Bravecto launch, they asked if veterinary clinics would take a grassroots approach to better gauge pet owners’ interest by using a glass jar on the receptionist counters of veterinary clinics. If clients were interested in a three-month preventive solution, they could drop a plastic ball into one jar. If not, they could drop the ball in another jar. It wasn’t high tech, but it was one way the Bravecto launch team could garner enough feedback to see that the interest was high for a three-month preventive.
“The folks that have done their online pharmacy well are those that listened to their customers and actually asked their customers in a cohesive, unbiased way, what and how they want to receive these products,” Goodwin said. “And then, they put solutions in place.”
It’s not simply a matter of having an online pharmacy or launching one. Successful clinics have put themselves in the consumer mindset, and not focused on what they’ve always done. It may mean the addition of offerings such as curbside pickup, proactively calling people when they’re almost out of a medication, offering a concierge service, or building technology into a customer-facing app to request refills.
“You can’t get angry when consumers go to other channels, because we’re all consumers,” Goodwin said. “We all probably do the same thing, whether it’s picking up coffee based off rewards and service, or cashing in frequent flier miles on plane upgrades. The convenience factor is real. We’re all too busy and we all want our lives made easier and better. I think veterinarians have a huge opportunity, as well as the DSRs who help them, to do a real tactical analysis. Instead of fighting against convenience, how could you make your services more convenient for your customers?”
Distributor reps and the veterinary pharmacy
If all of this sounds complicated for veterinary clinics, then Goodwin has good news. The growth of the veterinary pharmacy can strengthen the relationship between distributor rep and veterinarians, like how their relationship dynamics have played out in the past. When Goodwin looks back earlier in her career calling on veterinary clinics as a manufacturer rep, DSRs were a vital piece of the ecosystem. “They played a really important role,” she said. “There weren’t a ton of other folks competing for the veterinarians’ and the owners’ time. I think that role is still really important today.”
A DSR first and foremost needs to seek to add value to their customers in a variety of ways, and pharmacy is one of those ways. Helping a practice owner think about what they’re doing, and how they might do it differently, has always been a big benefit DSRs can bring to their customers. “This isn’t a corporate program I’m talking about,” she said. “This is just really smart people that see a lot of veterinarians and have ideas and solutions on how to help them grow their practice or margin.”
While the pharmacy today may represent less of the total vet practice income than before, other income streams such as the surgical and dental suites have grown, said Lawrence. “Many practices have partnered with third party online pharmacies, allowing income retention, albeit at a reduced rate compared to an in-house pharmacy. Advancement in technology and competition ultimately makes us more efficient and consumer focused, and that’s not a bad thing.”
For the pharmacy specifically, Goodwin said it’s important for DSRs to understand who the practice serves and then what product categories within the pharmacy make the most sense. “One of the challenges that veterinarians face today is we have very big companies with very big voices that all want to help a veterinarian grow, but it’s all about their product,” she said. “That’s where distribution can really help.” Distribution can provide an agnostic value to the wide array of manufacturer offerings available to the veterinarian. Which makes the most sense for their patient base? Which holds the most potential for profit?
Opportunities created by value-seeking consumers
“Consumers want solutions,” Goodwin said. “So, if I’m a pet owner and I go in for an urgent care appointment, does the veterinarian have the best products that will solve my pet’s problem at an affordable price? Does the veterinarian have different pricing options? Because today’s consumer is very much a value-seeking consumer. That’s been a big shift over the last few years.”
The value-seeking consumer presents an opportunity for generics to come back into the fold, Goodwin said. “DSRs can help a veterinarian in understanding that it’s fine to carry the new big gun, but do you have value to folks that are seeking a more measured approach to some of their pet’s health issues? Distributor reps have a big opportunity there when they think about what’s in their bag versus some of these big gun products, because people want a variety of solutions.”
DSRS can help veterinarians to think about the real value their clinic can provide that other online players can’t. The pharmacy is just one part of the equation. Clinics can diversify their offerings and go deeper into the areas their customers want. For instance, if they have a lot of old overweight dogs, maybe they run a weight loss group and have a structured program where people can pay a monthly fee to get their pet healthy. Or, they could offer rehabilitation services and procedures such as laser therapy and shockwave therapy.
There are some great solutions (on top of an online pharmacy) that pet owners may want, Goodwin said. “It’s a category strategy where you can really serve your customers and make sure that they’re getting the best care that they can afford – and that they want – to provide to their pet.”
Putting it all together
The in-house pharmacy is still a significant percent of the total revenue at a practice, said Lawrence, noting that while pharmacy has changed, it has not caught up with the human medicine model where insurance is the norm and medication comes from a third party. “Clients still find it very convenient to leave the clinic after an exam with their pet’s medication in hand,” Lawrence said.
Distributors play a crucial role in supporting veterinarians and ensuring the overall health of their business. Depending on who you ask, the pharmacy represents 20-30% of the revenue at a practice, and a significant contribution to the bottom line, Lawrence said. “A great distributor is a true business partner, understanding the importance of the pharmacy to a practice, while helping the practice expand into additional revenue streams.”
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