Goosemoose Pet Portal

I was reminded of this today as I called different places to fill out my pets prescriptions.  I got quotes from 20 to 65 dollars for the exact same medications!  :o  It really pays to shop around.

This info applies to both Americans and Canadians, but doesn't apply to those in the UK.

http://www.cbc.ca/marketplace/2007/11/28/cat_got_your_wallet/
I adored this segment of their show, I found it very informative, even though I'm an american!  They refeatured it this week and I don't know if it had been posted before.

We should write to the senators and such to argue for standardized prices of prescriptions.  It's ridiculous and I had vet-techs tsk me for not being will to pay such high markup.  Outrageous, that I should pay 5 times what the medication costs.  There's no excuse for this. 

Have you ever tried 1-800-PETMEDS?  I have always wondered about them... especially if they have medicine for small animals such as rats or if it is all just for cats and dogs.

Keep in mind - the online pharmacies may not be getting legal medications.  There are many reports of online places getting toxic chemicals for the flea and tick control.  Plus, Merial and Novartis do not send to the internet pharmacies - so how are they getting the medications?  Are they stored properly?  Are they current dated?

Baytril is NOT cheap under any measure.  Doxy and Amoxi are cheap.  If you are being charged an arm and a leg, get an rx and go to Walmart or whoever in your area has the $4 rx.

It's the same for people scrips - you have to shop around, different pharmacies charge VERY different prices. As soon as Walmart introduced their generics plan, a lot of others jumped on the wagon - but for my NON generics it can cost between 100 to almost 300 a month depending on where I go. If you asked those expensive pharmacies, of course they don't want me to know about the cheaper ones. It just seems like the show is making it out as if only vets markup their product. There are plenty of low cost clinics and there is pet insurance.

Vets are a bit different from other businesses because they have to CARE about their patient, but that doesn't mean the vets can't make money.

And what, the companies are going to tell a reporter they are having business trouble? Of course they will say they are doing well, they don't want to make it look like their product is bad!

The show also bugged me because of the way the announcer talks "where there's love...there's...opporTUNITY!"
Bah.

They also mocked products for separation anxiety, motion sickness and obesity - you go on a dog forum and see how many people have dogs with those problems. SA is a big deal and if it comes to it, why NOT use a product to help ease it? She gives her cat insulin because the cat needs it - it's her responsibility to shop around!

I have no problems paying for what a prescription is worth, what I do have problems with is being charge 20 dollars per bottle for "dispensing",(as one of the vets does) in addition to the cost. 

The difference between peoples and pets is that human prescriptions have some regulation to an extent. 

I've found that it's difficult to shop around.  2 places had to be faxed the prescription before they'd even give me a price quote.  My vet wasn't too happy about the extra effort needed. Maybe it depends on your area but I'm willing to put in the work and it's been very hard.   

I don't know what the fee is for, but it probably helps pay the tech's salary, proper storage for the drug, stuff like that. Yes, that sounds high.

What regulation in the US is on people prescriptions?

The show just sounded way too biased to be taken seriously. They started out with an agenda. They didn't go into it unbiased and therefore it's hard to watch it and really trust anything they say.

Wait.. so you can the RX from your vet and get URI meds from walgreens for a cheaper price? I'm taking my boys to the vet for URI and if I can get meds any cheaper i'm all for it.. /hack

I definitely agree that the show isn't perfect.  But until I had seen it a while back I had never even realized how much different dispensing fees were.


Regulation of human-medication dispensing fees (http://www.nacds.org/user-assets/pdfs/gov_affairs/issues/Medicaid/Medicaid_StateDispensing_100107.pdf)

It varies by state but in some a price-cap is approved by a committee.  According to several studies done by medicare, there are no fees over 11 dollars. One vet here charges 20.  There is legislation that is passing very soon that will regulate all dispensing fees with an over-all pricecap.

On the ethics of doctors selling/dispensing things to their patients directly from their practice (http://www.massmedboard.org/regs/pdf/05-01_sale_of_goods.pdf)

I am 100% for paying pharmacists a fair price for their time.  That being said, I don't consider the medications in the back to be a pharmacy.  Most vets here (I don't know other places, just speaking about here) fill their own prescriptions only.  Why should I pay for the techs salaries via the dispensing fees when I am paying 46-40 dollars per rat just for the appointment, then paying the cost and price-up of each test?  Just to be seen was 230 dollars for all of my girls for an appointment that lasted less than a half hour.  I love veterinarians and don't think it's great that they have the rap that they do, but in a world where my animal's life depends on me to be able to get them their medications regardless of whether or not it is payday I do feel that there is a problem.



In the human world, that actually pays for the pharmacist's time interpreting the prescription.  When you write your own, there is no interpretation needed. Secondly, it pays for the time spend on the phone with insurance companies.  Since most pet-insurance companies deal directly with the consumer though reimbursement, in the cases where a patient does have insurance it's rare a vet pharmacy deals with it.  In the human world, if a doctor offers for you to buy a prescription in his office, he is required by law to inform you that you can get it elsewhere. I personally had no idea you could do this until recently.  Most vets I've seen just rang it up with the bill.  Lastly, vet techs manning the counter aren't trained in the medications as a pharmacist is.  There are no regulations regarding this.  Recently, I had a vet tech tell me not to worry about dairy and antibiotics when dispensing me doxy, a drug that interacts badly with calcium.  I asked explicitly; she didn't even look at the label.  Every prescription for my pet lacks even basic information on the bottle and forget about getting a packet with it!  Every human prescription comes with at least a list of side-effects, interactions etc, and at a pharmacy there is a trained person standing behind the counter to ask questions to. 

If a human pharmacy whose SOLE job is to dispense medications does okay on less than 10 dollar dispensing fees (some as low as 1.97 :o), I'm sure that the veterinarians who dispense medications on the side of their practice, will be fine.  The reason that pet medications have yet to be regulated is that there is no huge insurance company paying the fees, it's out of owner's pockets.  Even in the case of those with insurance, it will only cover the drug and a small fee.  In some states people are required by law to have health insurance. 

I am lucky I guess because a visit for us is only $20, and often they don't charge me for the visit if other stuff is done. Just today I took Sadie (my American Eskimo Dog) over because she has a lump on her leg. They did an aspiration and only charged me for that part ($20). (She is fine, it is a benign tumor called a Histiocytoma). I also had Sadie spayed, vacc'd (the basics and bordatella) and microchipped in one visit, and it cost about $145. I think that is a good deal for all that stuff.

If I take two rats in at the same time, they usually only charge for one visit. The only time I have felt any medicine charge was high was when another vet was there and gave me a mix of baytril and doxy for Addie and it cost twice as much as the usual Baytril. I have never looked at the receipt closely enough to tell if they charge a dispensing fee.

The stuff I hate is the heartworm and flea prevention. That stuff is so expensive :(

I wish my doctor COULD fill my prescription - save me having to drive somewhere ELSE and wait (or drive back). When I have to go to 4 different doctors already it's a pain to have to remember which pharmacy I went to the last time because there are 4 grocery stores plus Walmart, and they all kept changing their prices. I have no idea where I got my last one filled. It'd be much easier if I could just get the drugs on my way out of the office. I can see how some people would get taken advantage of but if you have insurance, it doesn't seem like that big a deal.

(PS: I haven't visited the links you provided, I have to run but I will read them later).

I have never seen a "dispensing" fee on my bills but I wouldn't mind if they needed to charge one.  Vets do not have the governmental funding and support that hospitals and pharmacies have.  They are basically small business owners and pretty much everyone at a vets office is way underpaid.  What I find to be a shame is that vets can't get help from the government or other sources because they serve pets and animals are not worth it to our society. 
I would never go to a vet that doesn't care about my animals, but I haven't met many vets who don't truly care.  My wonderful vet who is three hours away (the only one I trust to do surgeries, etc on my babies) will call in prescriptions to my local vet or to the local compounding pharmacy.  She spent a lot of time calling around to pharmacies to see if they had the medication I needed.  And she will spend an hour on the phone talking to me about my babies because I live so far away... without charging me anything!  If that means I pay more when I go in to see her and get my scripts from her, then I'm certainly happy to do so.  I've had to look around, but I've been able to find vets who go above and beyond anywhere I live, and I'm willing to pay for that level of service and care, whether it is added to their office fee or their pharmacy fee. 
But I do get my dogs heartworm and flea/tick from 1800petmeds because we get a 15% discount. 

When I argue for regulation, I'm not talking about the good vets. Yes, there are many good ones out there.  Also, it just takes one good one moving in an area to drive the prices down.    Price caps wouldn't affect them, because they'd already be charging low prices.

However, telling those of us in areas where ALL of the vets DO charge ~$40 per animal that it's our fault and we need to shop around is a little ignorant (not saying that you are,but this is an assertion I've seen several times when people are attacking others about vet-costs; it's often the people with cheap vet care that attack others).  Not everywhere is blessed, unfortunately.  Where I am from, good vets don't come cheap.  I've called around the area, and am friends with a couple through work.  Even with that relationship I can only ask small advice matters and double check info; I cannot get my rats seen for free.  Only one vet in this area takes payment plans at all.  If you want a laugh, one need only look at his website on cat care. 

One gem:

He's a nice man though, and will give you prescriptions (that he writes) with almost no markup.  Nice isn't enough though; his information even in person is very VERY outdated. 

Regulation of dispensing costs would only affect the areas where dispensing fees are very high.  It wouldn't affect vets whose fees are already low.  It isn't true that all vets are out to overcharge, but it IS true that some vets and drug companies are taking advantage of an unregulated market.  Unfortunately, some medications need to be dispensed by a vet because most human pharmacies simply don't carry it.  It's not that the vets are evil, it's an inevitable problem when the person prescribing the meds is the same as the one (essentially) selling them.  Not all vets take advantage, but I can assure you that I've met some who do. 

ETA:

It's never listed separate, you need to ask what the fee is.  It's included in the medication charge.

I have to go to a special vet for my rats. The vet we visit charges $25 office visit for our cats and dogs but when I asked them if they could check my rats they kind of just sneered at me.. I wasn't very pleased. The place the rats go charges me around $50 a visit for EACH rat + the cost of meds for BOTH. It's not cheap. Jesirose, I'm jealous!  :BlueDumboSmileTongue: I wish I had a vet like that around here.  :crybaby2:

I'm not saying it's your fault - I'm saying that show made it sound like you should expect to get the best price on everything from your vet without bothering to look around. I'm sure there are areas where it's more expensive but if you (not YOU, the general you) never bother to look, you can't be upset about it. The show made it sound (to me) like they were upset that the vets weren't practically giving the medicine away and the vet should have told them it's X amount but if you go down to Joe he'll give it to you for half that!

Don't be too jealous of me, I had a nasty run-in with the reception when my flight got delayed and they were going to keep my dog for 3 extra nights because I couldn't get there on time :/ The vet is great but apparently someone was on a power trip that day and wouldn't let me even talk to them.

And you should definitely forward that website to the local animal services. Dumbass.

Not sure if all of you know this but you can't get Baytril from a human pharmacy.  It's strictly an animal drug and human pharmacies don't carry it.  But you can get doxycycline syrup for half the cost of the doxy solution, and it lasts twice as long too.  I was charged $40 for a bottle of doxycycline powder from my vet, and when I called a human pharmacy, I found out that I would have been charged $20 for the doxy syrup which would have lasted for a month (not two weeks like the doxy powder).

Deb

What some people don't realize is a lot of the difference in price doesn't just go into a vets own pocket. You have rates for the area, education loans to pay, employees to pay a decent working wage (and believe me, it never pans out to pay as much as you work. Being a receptionist and/or tech is brutal work). You have equipment loans to pay, you have to pay for stock, expensive test, sutures, utilities, etc. Some places have higher tech equipment they have to pay for so of course their exam fee isn't going to be $20. It really ads up to vets not making as much as their human counter parts and many burn out because they can't make enough to pay for their student loans!

So yeah, just because their office visit is $20 doesn't mean they are a good vet (and I'm not saying those who have vets with that price don't have good vets, I'm just saying there is more to that.) I'm saying a ton goes into vet care and it's more than meets the eye. Not all practices have the same bills to pay. And exotic care is more specialized and more specialized means more expensive equipment and tools. It's probably incredibly expensive to get a blood machine to do in house blood work that will read RAT blood right then and there not to mention all the other exotic animal blood.

Basically what I am saying is you really have to look into the knowledge of the vet and the services offered (diagnostics as well as treatments and surgeries). Can they read fecals then and there? Can they do in house blood work? Do they have digital RADS or film? Do they offer high quality anesthesia? Do they properly sterilize their equipment? Can they do appendage amputations? If they can do all of that of course their office visit will be high (for the area), they have a high overhead!

I just get tired of these threads on vets trying to gouge clients. Seriously if they were in it to just make money they would of become a HUMAN doctor. Same amount of schooling, much higher pay.

Completely agree with you.  *points to top* the argument isn't about vet visits, it's about the dispensing fees of medications, a whole different story. 

Just like any small business, vets have to chose where they are going to make their money. Lots of vets use spays and neuters as "loss leaders"- they charge less than what it costs, or have less of a mark-up on it because they want people to get the surgery done and not be deterred by cost. (Heck- we did it in school- there was a flat fee for the surgery- around $150, but if you added the actual costs up, it would be closer to $400) You generally have to make that money up somewhere, so you up the cost of drugs, or another procedure. Sometimes you deal with drugs that are super expensive and have a short shelf life. If you can't use up the whole bottle before it goes bad, you lose money on it. So you charge enough that even if only half of it gets used, you still cover your costs of the drug. It does cost money to fill scripts- it takes the dr time to write it (and doctors time should be costly), techs time to fill it, the cost of the bottle, a computer to make the label, the dr has to have a license to dispense certain drugs, etc. etc. Vet costs do vary a lot- that is part of business. Poppyseed did an excellant job explaining things. Right now, I have a little over $70,000 in student loans- that is LOW- many of my classmates were over $200,000 when they graduated. And since I elected to take an internship to further my education, I am now a DOCTOR who is getting paid about $6.25/hr. (I have an annual salary, but I work 70-80hr/wk) It sucks, but I want to be the best vet I can be- and I'm willing to do it so I can better serve my patients. You can certainly bet that when I will charge appropriately for my knowledge, skills and supplies. Just because I love animals doesn't mean I should eat the cost of someone not being able to afford the pet they selected or live in debt all my life. No one seems to ask their mechanic to do things for free or cheap because they love cars...

Ya know if you expected to be able to hand out a bill for all your knowledge, skills and supplies and dont want people to piss and moan, maybe you should have become a MD and not a vet? I dont mind spending the money for my pets, I take it all as part of being responsible, but like healthcare in this country, things need to be affordable. Taking an animal to the vet shouldnt be a privelage to those that can afford it with little thought, services should be available to every income bracket/level.

Im not trying to be nasty, but I do see why people cringe at the cost of a vet visit at times. Its like social workers, they are horridly underpaid and severely overworked most of the time. Most of them do it why? Love of people and wanting to help. Am I suggesting you should live in debt or eat the cost for those not able to afford vet bills? NO, just dont expect to get rich.

anita did you see the part about 80 hour weeks for 6.25 an hour? Do you know how little money that really is? That is $12.50 an hour for a regular 40 hour week if you want to ONLY look at the money part. I made more than that working retail jobs in high school. I don't think Kati wants to get rich, but she DOES deserve to make a livable wage! I live in Texas where we have the lowest cost of living and I wouldn't attempt it to live off that.

I read somewhere that in any business if you don't have people complain about the price, you aren't charging enough. It's just part of business really.

It just reminds me of the saying "Can afford the vet, don't get a pet." I do cringe when my vet bill is $150, but what can I do? I keep my numbers low (I have 3 rats, and 1 cat) and I offer the healthiest environment I possibly can. But, I think it's fantastic that my vet can do xrays in house and I don't need to go to a special radiologist, and he can spay/neuter my rats, and whatever else I need him to. The things he's done for me and my furfamily, I'd rather pay a slightly higher price for a box of zithro at his office than get a script and go where-ever.

I'm a groomer and even *I* hear the bitching and moaning about prices. People have to pay me for my skills and my time, otherwise, don't book an appointment with me. I'm on the fairly lowend in my area, too.

Thanks Jesi- yes I am HORRIBLY underpaid right now- but that is part of doing an internship! I do have classmates that are working more normal hours for $60,000/yr or so. Interns get the opportunity to work for crap money during long hours to get the experience. :)

I don't expect to get rich- never said I did. Never went into this career thinking I would. BUT- I do expect to make enough to support a family, pay for my own pet's medical bills, pay my staff a decent wage, pay for the equipment and supplies I need to provide the level of care I desire for my own pets, etc. And pay back my loans! Being a professional shouldn't make me poor. Seriously, why is it OK for doctors in human med to make so much but not me? I put just as much effort and work into it (if not more). I pay other professionals for their services and don't try to bargin or make payment plans (which most vets don't take because they have been burned too many times). Pets are a luxury, not a necessity. I wish everyone could share the love and joy of having a pet- but I am the one who has to hold that pet's head as I euthanize it when they didn't plan far enough ahead to afford to care for it. Most people on this board are ones I would LOVE to have as clients- but try to see your vet's point of view- it is hard when you cannot help the pet because of the owner. But when you start doing things for free here or cheaper there- you wind up broke and can't even practice anymore because you can't afford to pay your staff or pay the mortgage on your building. It sucks, but such is life.

IF it's a human drug, yes.  Amoxi and Doxy being the big ones for rats.  Baytril is NOT a human drug, and it's not cheap for the vet to buy either.  The markup on most heartworm prevention and flea and tick control is not that high, the drugs aren't cheap.  Then again, my opinion is if you think $150 is too much to pay for heartworm prevention, I'm going to have to ask you if you know the cost of the disease itself.

Of course I read that ::)

My whole point is that people will always piss and moan. of course she should be able to live decently and be able to pay her staff and whatnot.

Pets are a privelage, no doubt. I spend a great deal of money on the care of my own bunch.

I have a truckload of student loans myself, its the nature of a system that makes higher education of privelage, not a right.

Why are medical doctors able to charge so much? Likely because people value human life above that of their animal companions. Its sad that more people dont plan for the long term care of thier pets. I do, they are in many ways like my children and I have no desire to see them suffer.

Kati33, I hope nothing but the best for you. A thriving practice and everything that goes along with it.

I do understand how much it stinks even as a professional vet, believe me I do.  However, that STILL doesn't address my problem.

My problem is that as a system it is unethical for the person precribing the meds to make money off of them and to be the sole supplier, a case that is true for at least some areas.  And being the sole supplier, some DO overcharge.  I don't care that there is some markup, I expect that.  My problem is that there is no control over the markup and that some places do abuse the privledge.  I know it stinks being a vet, but that doesn't mean that it's okay for the few that do to gouge people who need to keep their animals healthy! It's difficult to even get a quote without having an appointment, many vets won't even give you that, so just to shop around you need to spend money!

My post isn't referring to the vets with a reasonable markup on medications.  Thats just fair.   My post is referring to those with an unreasonably high markup.  The cases that I point out have a high markup on ALL meds, regardless of cost.   Why not have it be a percent of the med cost, with more expensive meds having higher markup to help cover spoilage, etc?

Even better would be to have pet pharmacies entirely seperate.  That way we can ensure that the people giving us our meds are trained in the drugs, that we aren't getting prescribed things that we don't need, because there is no incentive.  It would also cause fewer spoilage concerns because if all of the vets in the area with different specialites had their animal-only prescriptions filled at one place, there would be higher turnover.  I would prefer this greatly. 

I'm not whining about high costs.  I understand that I am paying a professional for their services.   What I don't understand is why the distribution of medications doesn't work like human systems, keeping the costs reasonable for consumers. 

Here, I can shop around and get a quote at 95% of the vets.  That's NOT every area that you can't get a quote.  From working at a vet, when we got price shoppers, I knew to give them the FULL list of costs and explain our charges.


[/quote]My post is referring to those with an unreasonably high markup.[/quote]

Ok.  Amoxi (where I worked) had something like a 275% markup, but the average cost for the drug then?  $7.75 - the minimum cost of an Rx for us.  The minimum cost was figured by that for us, 90% of Rx were at least that much, and that makes sure that the cost of filling the Rx for us is breaking even.

Baytril?  53% markup on the 22.7 mg tabs.  A $30 dollar Rx was some days, not unreasonable (for cats, not rats).

Heartworm prevention and flea and tick control?  We didn't control those markups, Novartis and Merial told us what we were supposed to charge.  Same with the Science Diet and Prescription Diet we stocked.

So, which has the unreasonable markup?

And if anyone considers a $30 fee for a months worth of antibiotics - call around and ask the human pharmacies what the cost is for 2 weeks with of Augmentin without insurance.  You are at a minimum in most areas of $45.  For people.  I have an inhaler that's 228.99 without insurance.


That implys the system works for people.  It doesn't work.  It only works with insurance.  Those without pay an extremely high premium for the medications that they need.

Pet insurance sucks btw - when last I knew, the idea was it ran for one year, then you renew.  However, if your dog got diagnosised with something on day 364 of 365, the treatment had to be complete by day 365, or it wouldn't be covered next year.  Plus, it's a reimbursment system and they aren't required to reimburse you if they decide it's not covered.

Most vets around here (Southeast Michigan) are pretty forthcoming if you call and ask for pricing information. The prices will vary wildly. I have been told an office visit is $40 per animal, expect to spend $80 for two of the boys to be seen and then be charged 34.00 plus the cost of meds. I paid $30.00 for the last bottle of baytril I needed, 12 and some change for the doxy..not bad IMO

I definitely hate how the pet-insurance works.  I'm looking to get my cats insured now, while they're still young.  I wasn't aware it only worked on a 365 day basis, thank you for that info.


 Medications are all expensive =/.  This I know.  The thing is, although that inhaler would cost that much, only 10 dollars or less is fees from the pharmacist. I just don't understand why you are paying for expertise when you are buying a product. Especially since many times the person behind the counter isn't trained in medications except maybe the basics.  When I pay a pharmacist a dispensing fee, it includes the time I take to ask questions.  At the vet, when I ask questions of a staff-member dispensing the meds I don't always get an educated response.  Vets aren't as trained in drugs and drug interactions as a real pharmacist.  I don't expect them to be either, nor would I expect a human doctor to know everything about every drug.   I don't see why this type of system doesn't work?  Isn't that how it worked for people before insurance existed?   They have input a similar system in the UK:

Here is the initial report, discussing the monopoly-like effect of having the same system that is currently in the US: (http://www.competition-commission.org.uk/rep_pub/reports/2003/478vetmeds.htm)
 a statement on the report (http://nds.coi.gov.uk/content/detail.asp?ReleaseID=57067&NewsAreaID=2&NavigatedFromSearch=True)
 
 
 and the results:
 A discussion of the laws right after their creation (http://www.cr-law.co.uk/articles/viewarticle.asp?articleid=1507)
 the law in question (http://www.oft.gov.uk/shared_oft/monopolies/veterinary.pdf)

It's too soon for there to be good relevant studies discussing the after effects of the laws, but clearly from the legal action taken, economic experts felt that the situation in place was a volatile one.

I didn't mean that you can't get a quote in every area.  I meant that there were a couple places where it's harder, making the statement "shop around" seem like just words to a few of us.  Are we the majority?  No. But we are still relevant.  I find that vets act similar by region, probably a result of competition?  Here the prices are all the same for exotics, and many vets work on the same philosophies.  Where I used to live the prices were different, as was the "feel". Also, many places don't have transparent fees, nor do they publish them even on the invoice. 

Edited for neatness in the URLs.

I will NOT guarantee that is how it currently works.  That is what I knew, but I've not kept up to date because I find it easier to save up for emergencies.


Ok, from the vet side.  I've got to potentially mix up the medication or count out pills, type up a label, use a bottle, explain to the client how the drug works, what side effects might they see, how to give the medication - both schedule and how to get it in their pet, and then do follow up to make sure the medication is working and they don't have questions.  That's not including how much any medication itself costs.

If I talk to a pharmacist - yes, I may get a good answer.  If I just talk to staff behind the counter, HA.  I honestly think half the time I may know more than they do.  Including having, more than one time, not have the staff behind the counter at a human pharmacy not know that doxy can't be taken with dairy or calcium inriched products.

Most of the vets here (and all that I like) can tell you about a drug they are going to prescribe.  Can a tech or assistant?  Not always, but most of us could tell you on the 30 most common drugs we use.

Besides, your pharmacist won't be there to show you how to force a pill down your dog (if you get the prescription at the area pharmacy).  Your vet, or the techs/assistants, should be.  They'll be there to show you how to put ear meds in.  And if you think that should be free or cheap - try putting ointment in the ear of a snotty Cocker with an ear infection.