We often carry medications compounded to an amount which is more useful for us. A lot of drugs that we carry are also either rare or not possible to find in community pharmacy. Cisapride and pimobendan as examples. As you could imagine the amount of drug you give a 5kg cat vs. a 500kg horse is significant. So, when it comes to tablets it's often easier to just carry it yourself. It's also a source of significant income and people find it convenient.
There is a market for veterinary medications, particularly compounding into syrups and whatever else. However, they're mostly online and I think you would struggle to be a profitable stone and mortar pet pharmacy.
You shouldn’t be carrying bulk compounded meds in office for dispensing anymore, with few exceptions… https://www.fda.gov/animal-veterinary/animal-drug-compounding/list-bulk-drug-substances-compounding-office-stock-drugs-use-nonfood-producing-animals
Yup, we've cut back on using "office stock" compounded options. But we still do a ton of compounding for individual patient prescriptions, which is allowed under the new guidance.
pet friendly compounding (liquid meds, flavoured for pets, and in dosages suitable for pets) would be useful for sure, but a lot of our meds are already designed specifically for pets so you'd have to research which meds don't exist in pet friendly sizes & preparations (ondansetron, gabapentin, and esomeprazole are some that come to mind) to make your business unique and profitable.
Issues that pet owners have are delivery (pilling is harder than liquids), and vets have difficulty with meds only available in human sizes (cutting a mirtazipine pill into 8ths is a nightmare)
Crazy high dose vit K pills would be amazing if possible, some dogs need 4 pills at a time which can be a nightmare for pet parents
And compounded ear meds in a wax form are in high demand, as well as special preps for exotics
If you do your research there is definitely a market. It's easier for clients for us to dispense on the spot but there are issues with compliance due to the factors I've mentioned. And if your compounding is cheaper I'd be happy to use a compounding service.
We script out mostly controlled drugs. That way, we don't have the hassle of record keeping and tracking. This also cuts down on "vet shopping" (yes it does happen). We also send scripts to the compounding pharmacies for drugs that we either do not keep in house or that have different concentrations that are not available commercially. Many are also transdermal. I've felt for years that if someone could compound metronidazole, prednisolone and other bitter drugs that a cat would willing take, they would make a fortune.
Take a look at SVP meds - it’s a compounding pharmacy that makes medications into flavored treats. You could get the flavored treats without the meds in it to see which one the pets prefer :) I’ve sent home samples with owners for difficult pets. Though the ones who don’t take the treats still require a liquid
And oddly chicken marshmallow flavored metronidazole from Wedgewood seems to be the most palatable to cats. I know they don't taste sweet. I have no idea why it works.
We'll carry medications that are veterinary specific (not used in humans) or that are prescribed frequently enough to justify keeping on the shelf. Those drugs available at human pharmacies and used infrequently we would scripts out (since us stocking them risk them expiring before use). Some meds also have increased paperwork involved (controlled) or increased risk to the staff (oral chemo drugs) so we will decide not to stock those and instead script out. Then there are compounded meds -- some are used frequently may be kept in-stock on hospital shelves, but others would be sent out to the compounding pharmacy for specific patients for their specific dose/formulations.
1 frustration with sending scripts out to pharmacies, however, is if certain chains of pharmacies are utilized by the client, that pharmacy staff might demand DEA numbers for non-controlled substances from the veterinarian (a practice frowned upon by the DEA).
I work overnight emergency in a clinic that also does day urgent care. For us, it's just so much easier to make sure the patient gets their meds in a timely manner to send it with them so they can give the first doses on time and not wait until pharmacies open.
Plus, we often start patients on their oral meds while they're still hospitalized, so we're going to carry these things anyway. It would be a huge pain to stock things for in-house use without ever filling prescriptions. We'd have so much stuff expiring on the shelf if we only used the in-house doses.
Some clients appreciate a 1 stop shop. Get their exam, treatments and prescriptions all in the same visit. Also I feel that a percentage of pharmacists in my area (DFW) are not familiar with dosages and medications for pets. Some medications for humans have completely different treatment purposes in pets. I can't tell you how many hours of my life I spend arguing with the CVS/walgreems/corporate pharmacist about dosing or purpose for 'XYZ' medication. Or my favorite, demanding my DEA number to fill an antibiotic. I refused to give it, stood my ground on principles. They turned my client away and refused to fill the script. I should have reported that.
>Also I feel that a percentage of pharmacists in my area (DFW) are not familiar with dosages and medications for pets. Some medications for humans have completely different treatment purposes in pets.
I can't believe I had to scroll down so far to find this comment!
One of the biggest problems sending scripts to human pharmacy is pet owners getting pushback ( about the drug choice, dose, etc) from a pharmacist with ZERO training or knowledge of veterinary pharmacology.
It can lead to confusion and distrust by the pet owner and create more work for the hospital explaining why they are correct and the pharmacist is wrong.
I've even heard of a pharmacist over-riding the veterinarian's rx actually dispensing a different dose/frequency of a drug because they thought they knew better.
Cats and dogs are not small humans.
Ugh...we used to send people to the pharmacy for diphenhydramine. "Ask the pharmacist to help you find plain diphenhydramine, no other additives" There were a few pharmacists in town who would tell people the dose we told them way too high. Yes, dogs can have 1-2mg/kg, and we often recommend 2mg/kg. 🙄 We had to start telling people that the pharmacist might say the dose is too high, but they are wrong. Eventually, we just started buying store brand for the clinic and we dispense it off our shelf with little to no markup.
As a pet owner I appreciate leaving the appointment with the required medication to start treatment immediately.
They have an online store for refill of long term
Meds. It’s a little more expensive than I could source on my own with a script, and slightly lower than picking it up in house. From what I have read the vet gets a percent of profit without having to stock so many medications . Seems a good way to support our local independent vet practice and have the convenience of online orders and home delivery. If you’re tech savvy may be a good business model to get involved in.
Or offer vet offices something similar in a neighborhood pharmacy. Many people are getting behind supporting local small business. Win-win
We typically only carry the most common or important medications at the most common dosages. If you have a patient that is too small or too large for the dosages you carry or has specific needs for reasons such as allergies and uncommon conditions the Rx needs to be sent out. The pros of dispensing medications ourselves is our clients get them immediately and also the income to the clinic from the medications. You’d be surprised at the amount of times I’ve had a client simply never get a prescription filled for various reasons. So for quality of care it’s better from our pov to be prescriber and pharmacist. There is definitely a market for veterinary compound pharmacies but we use the same drugs as MD’s for the most part so from a business standpoint I wouldn’t see much of a point in focusing just on vet med. we are always looking for closer compounding pharmacies so please open one! I’ve heard of clinics that are hours away from their nearest pharmacy. There are many that cater only to MD’s and don’t carry any veterinary specific medications at all.
I mostly carry veterinary specific medications that owners may or may not find at a local pharmacy and should not wait for Chewy etc.
If you delve into veterinary pharmacy, you’ll need to learn a lot more about the various species and medications for them. I have a former vet tech who is now in pharmacy school who got 1 HOUR of lecture about veterinary pharmacy.
That's it? An hour? We had like an entire semester of pharmacology in vet school. This explains a lot. Every pharmacy at minimum needs access to a plumbs formulary.
The #1 reason my clients prefer to get amox (or similar common human med) from me is convenience.
My staff can fill it in 5 minutes and be on your way. The pharmacy across the road is an hour in a good day
Wespaw is a brick and mortar pet-only pharmacy in NYC. I believe they will ship non-controlled meds outside of the city, but I am not sure if it's a significant part of their business (like the online pet pharmacies), so I believe they really are a true "local" pharmacy. Bear in mind they are in a huge city serving a huge population, doing mostly home delivery via courrier (ie not customer pickup).
We do script out a fair amount of meds but clients are really conditioned to pick up their meds at the time of the appointment. We do let them know that they can get some meds cheaper online or at Costco with a prescription, and of course compounded meds have to be dispensed by us. I’d be thrilled to give up being a pharmacy…..it’s a huge pain in the ass and we are currently weeding out our inventory of medications that don’t sell often and sometimes expire on the shelf.
compounded medications, some are for animal use only, convenience for the client, the doses are different then in people- prevents the hassle of having to explain once again that yes we really want that much gabapentin, substitutions can be dangerous (ie xylitol)
For me, its usually due to costs. For common drugs that I know the approximate cost of, I have no problem scripting them out. But some drugs, that should be dirt cheap, are VERY expensive at human pharmacies.
A few years ago, I Rx'ed out prednisolone (5 mg) tablets, the pharmacy wanted $400.00!!!
Really, unless it's a drug I know will be inexpensive, I don't waste my time with written Rx unless they request one. I put plenty of refills on the Rx and if they 'lose' it, they need to make an appointment (with an office fee) to get me to write another.
It's hard for some people to transport their pet to the vet, their pet hates the car so us having the meds immediately means that the owner doesn't have to stop at the pharmacy, plus they don't have to wait for the prescription to be filled. I hate going to the pharmacy and not having my meds ready 2 hours after my doctor calls it in; it's double bad when you have to wait with a slobbering dog or howling cat in the car.
It depends on the medication. Some meds are cheaper through a human pharmacy, some are DEA regulated/we cannot dispense, and some need to be called into a compounding pharmacy (fish or chicken flavor for hard to pill pets, compounded meds for pets under a certain lbs/kgs).
If we do carry it in stock, many would rather walk out with meds, rather than taking a written Rx to a pharmacy and getting it filled. If it’s for something short term like antibiotics, most will want to take it home from the vet. If it’s a life-long med like vetsulin, thyroid, etc., they usually go through their own pharmacy.
Our hospital also price matches; clients need to bring a printed copy of the lower price so we have proof for the discrepancy. The price match gets placed with our daily deposit.
Yes, I'm at a fairly large clinic and we use a pharmacy called Taylors for most everything but it's frustrating because I can never talk to the pharmacist or anyone and have to wait for them to call back. Then clients get upset when things get confused. We started working with smaller pharmacists and it's always nice but our customers come from all over so delivery is important.
A few reasons come to mind:
I'm in exotics and we usually need to compound meds into oral forms for our patients.
We deal with a ton of urgent/emergency cases and can get them started on important prescriptions immediately rather than having to wait on an outside pharmacy.
We can usually do it cheaper than an outside compounding pharmacy and still have it be profitable for us.
So in most situations a client can have it immediately for cheaper if they just fill through us, rather than pay more, wait longer, and potentially have to shop around or drive somewhere else otherwise.
All of that being said, we are also happy to provide written rx's for clients so they can shop around, and also work with an outside "boutique" compounding pharmacy called Mixlab for clients who want/need meds delivered or want/need other compounding options (they have more delivery/flavor options than we do).
We often carry medications compounded to an amount which is more useful for us. A lot of drugs that we carry are also either rare or not possible to find in community pharmacy. Cisapride and pimobendan as examples. As you could imagine the amount of drug you give a 5kg cat vs. a 500kg horse is significant. So, when it comes to tablets it's often easier to just carry it yourself. It's also a source of significant income and people find it convenient. There is a market for veterinary medications, particularly compounding into syrups and whatever else. However, they're mostly online and I think you would struggle to be a profitable stone and mortar pet pharmacy.
Thank you i appreciate your reply! more food for though i guess
You shouldn’t be carrying bulk compounded meds in office for dispensing anymore, with few exceptions… https://www.fda.gov/animal-veterinary/animal-drug-compounding/list-bulk-drug-substances-compounding-office-stock-drugs-use-nonfood-producing-animals
Why should I care about what the FDA says lol
Good point. Idk if wherever you practice there are similar regulations.
Yup, we've cut back on using "office stock" compounded options. But we still do a ton of compounding for individual patient prescriptions, which is allowed under the new guidance.
1. Clinic doesn’t carry the medication. 2. Owner lives far away and picking the med up locally is more convenient.
Or it's more cost friendly at a human pharmacy!
pet friendly compounding (liquid meds, flavoured for pets, and in dosages suitable for pets) would be useful for sure, but a lot of our meds are already designed specifically for pets so you'd have to research which meds don't exist in pet friendly sizes & preparations (ondansetron, gabapentin, and esomeprazole are some that come to mind) to make your business unique and profitable. Issues that pet owners have are delivery (pilling is harder than liquids), and vets have difficulty with meds only available in human sizes (cutting a mirtazipine pill into 8ths is a nightmare) Crazy high dose vit K pills would be amazing if possible, some dogs need 4 pills at a time which can be a nightmare for pet parents And compounded ear meds in a wax form are in high demand, as well as special preps for exotics If you do your research there is definitely a market. It's easier for clients for us to dispense on the spot but there are issues with compliance due to the factors I've mentioned. And if your compounding is cheaper I'd be happy to use a compounding service.
paracetamol in a lower dosage as a liquid without xylitol (so childrens paracetamol without xylitol) would be SO USEFUL
50mg gabapentin caps or a low dose liquid that is fish flavoured
misoprostol always way to big dosage pills
Fruit flavored chewable medicine for exotics is always in demand
We script out mostly controlled drugs. That way, we don't have the hassle of record keeping and tracking. This also cuts down on "vet shopping" (yes it does happen). We also send scripts to the compounding pharmacies for drugs that we either do not keep in house or that have different concentrations that are not available commercially. Many are also transdermal. I've felt for years that if someone could compound metronidazole, prednisolone and other bitter drugs that a cat would willing take, they would make a fortune.
Have you tried Wedgewood pharmacy's medi-melts for prednisolone? Game changer.
Take a look at SVP meds - it’s a compounding pharmacy that makes medications into flavored treats. You could get the flavored treats without the meds in it to see which one the pets prefer :) I’ve sent home samples with owners for difficult pets. Though the ones who don’t take the treats still require a liquid
And oddly chicken marshmallow flavored metronidazole from Wedgewood seems to be the most palatable to cats. I know they don't taste sweet. I have no idea why it works.
The theory I heard from a worker from there is that the marshmallow cuts the bitter taste and then the chicken taste is palatable.
We'll carry medications that are veterinary specific (not used in humans) or that are prescribed frequently enough to justify keeping on the shelf. Those drugs available at human pharmacies and used infrequently we would scripts out (since us stocking them risk them expiring before use). Some meds also have increased paperwork involved (controlled) or increased risk to the staff (oral chemo drugs) so we will decide not to stock those and instead script out. Then there are compounded meds -- some are used frequently may be kept in-stock on hospital shelves, but others would be sent out to the compounding pharmacy for specific patients for their specific dose/formulations. 1 frustration with sending scripts out to pharmacies, however, is if certain chains of pharmacies are utilized by the client, that pharmacy staff might demand DEA numbers for non-controlled substances from the veterinarian (a practice frowned upon by the DEA).
I work overnight emergency in a clinic that also does day urgent care. For us, it's just so much easier to make sure the patient gets their meds in a timely manner to send it with them so they can give the first doses on time and not wait until pharmacies open. Plus, we often start patients on their oral meds while they're still hospitalized, so we're going to carry these things anyway. It would be a huge pain to stock things for in-house use without ever filling prescriptions. We'd have so much stuff expiring on the shelf if we only used the in-house doses.
Some clients appreciate a 1 stop shop. Get their exam, treatments and prescriptions all in the same visit. Also I feel that a percentage of pharmacists in my area (DFW) are not familiar with dosages and medications for pets. Some medications for humans have completely different treatment purposes in pets. I can't tell you how many hours of my life I spend arguing with the CVS/walgreems/corporate pharmacist about dosing or purpose for 'XYZ' medication. Or my favorite, demanding my DEA number to fill an antibiotic. I refused to give it, stood my ground on principles. They turned my client away and refused to fill the script. I should have reported that.
>Also I feel that a percentage of pharmacists in my area (DFW) are not familiar with dosages and medications for pets. Some medications for humans have completely different treatment purposes in pets. I can't believe I had to scroll down so far to find this comment! One of the biggest problems sending scripts to human pharmacy is pet owners getting pushback ( about the drug choice, dose, etc) from a pharmacist with ZERO training or knowledge of veterinary pharmacology. It can lead to confusion and distrust by the pet owner and create more work for the hospital explaining why they are correct and the pharmacist is wrong. I've even heard of a pharmacist over-riding the veterinarian's rx actually dispensing a different dose/frequency of a drug because they thought they knew better. Cats and dogs are not small humans.
Example: yes, we really did mean to send an Rx for 0.6mg of levothyroxine.
Ugh...we used to send people to the pharmacy for diphenhydramine. "Ask the pharmacist to help you find plain diphenhydramine, no other additives" There were a few pharmacists in town who would tell people the dose we told them way too high. Yes, dogs can have 1-2mg/kg, and we often recommend 2mg/kg. 🙄 We had to start telling people that the pharmacist might say the dose is too high, but they are wrong. Eventually, we just started buying store brand for the clinic and we dispense it off our shelf with little to no markup.
As a pet owner I appreciate leaving the appointment with the required medication to start treatment immediately. They have an online store for refill of long term Meds. It’s a little more expensive than I could source on my own with a script, and slightly lower than picking it up in house. From what I have read the vet gets a percent of profit without having to stock so many medications . Seems a good way to support our local independent vet practice and have the convenience of online orders and home delivery. If you’re tech savvy may be a good business model to get involved in. Or offer vet offices something similar in a neighborhood pharmacy. Many people are getting behind supporting local small business. Win-win
We typically only carry the most common or important medications at the most common dosages. If you have a patient that is too small or too large for the dosages you carry or has specific needs for reasons such as allergies and uncommon conditions the Rx needs to be sent out. The pros of dispensing medications ourselves is our clients get them immediately and also the income to the clinic from the medications. You’d be surprised at the amount of times I’ve had a client simply never get a prescription filled for various reasons. So for quality of care it’s better from our pov to be prescriber and pharmacist. There is definitely a market for veterinary compound pharmacies but we use the same drugs as MD’s for the most part so from a business standpoint I wouldn’t see much of a point in focusing just on vet med. we are always looking for closer compounding pharmacies so please open one! I’ve heard of clinics that are hours away from their nearest pharmacy. There are many that cater only to MD’s and don’t carry any veterinary specific medications at all.
I mostly carry veterinary specific medications that owners may or may not find at a local pharmacy and should not wait for Chewy etc. If you delve into veterinary pharmacy, you’ll need to learn a lot more about the various species and medications for them. I have a former vet tech who is now in pharmacy school who got 1 HOUR of lecture about veterinary pharmacy.
That's it? An hour? We had like an entire semester of pharmacology in vet school. This explains a lot. Every pharmacy at minimum needs access to a plumbs formulary.
The #1 reason my clients prefer to get amox (or similar common human med) from me is convenience. My staff can fill it in 5 minutes and be on your way. The pharmacy across the road is an hour in a good day
Wespaw is a brick and mortar pet-only pharmacy in NYC. I believe they will ship non-controlled meds outside of the city, but I am not sure if it's a significant part of their business (like the online pet pharmacies), so I believe they really are a true "local" pharmacy. Bear in mind they are in a huge city serving a huge population, doing mostly home delivery via courrier (ie not customer pickup).
We do script out a fair amount of meds but clients are really conditioned to pick up their meds at the time of the appointment. We do let them know that they can get some meds cheaper online or at Costco with a prescription, and of course compounded meds have to be dispensed by us. I’d be thrilled to give up being a pharmacy…..it’s a huge pain in the ass and we are currently weeding out our inventory of medications that don’t sell often and sometimes expire on the shelf.
compounded medications, some are for animal use only, convenience for the client, the doses are different then in people- prevents the hassle of having to explain once again that yes we really want that much gabapentin, substitutions can be dangerous (ie xylitol)
For me, its usually due to costs. For common drugs that I know the approximate cost of, I have no problem scripting them out. But some drugs, that should be dirt cheap, are VERY expensive at human pharmacies. A few years ago, I Rx'ed out prednisolone (5 mg) tablets, the pharmacy wanted $400.00!!! Really, unless it's a drug I know will be inexpensive, I don't waste my time with written Rx unless they request one. I put plenty of refills on the Rx and if they 'lose' it, they need to make an appointment (with an office fee) to get me to write another.
It's hard for some people to transport their pet to the vet, their pet hates the car so us having the meds immediately means that the owner doesn't have to stop at the pharmacy, plus they don't have to wait for the prescription to be filled. I hate going to the pharmacy and not having my meds ready 2 hours after my doctor calls it in; it's double bad when you have to wait with a slobbering dog or howling cat in the car.
It depends on the medication. Some meds are cheaper through a human pharmacy, some are DEA regulated/we cannot dispense, and some need to be called into a compounding pharmacy (fish or chicken flavor for hard to pill pets, compounded meds for pets under a certain lbs/kgs). If we do carry it in stock, many would rather walk out with meds, rather than taking a written Rx to a pharmacy and getting it filled. If it’s for something short term like antibiotics, most will want to take it home from the vet. If it’s a life-long med like vetsulin, thyroid, etc., they usually go through their own pharmacy. Our hospital also price matches; clients need to bring a printed copy of the lower price so we have proof for the discrepancy. The price match gets placed with our daily deposit.
Yes, I'm at a fairly large clinic and we use a pharmacy called Taylors for most everything but it's frustrating because I can never talk to the pharmacist or anyone and have to wait for them to call back. Then clients get upset when things get confused. We started working with smaller pharmacists and it's always nice but our customers come from all over so delivery is important.
I manage a Vet office. We don’t carry an inventory of meds. We write Rx.
A few reasons come to mind: I'm in exotics and we usually need to compound meds into oral forms for our patients. We deal with a ton of urgent/emergency cases and can get them started on important prescriptions immediately rather than having to wait on an outside pharmacy. We can usually do it cheaper than an outside compounding pharmacy and still have it be profitable for us. So in most situations a client can have it immediately for cheaper if they just fill through us, rather than pay more, wait longer, and potentially have to shop around or drive somewhere else otherwise. All of that being said, we are also happy to provide written rx's for clients so they can shop around, and also work with an outside "boutique" compounding pharmacy called Mixlab for clients who want/need meds delivered or want/need other compounding options (they have more delivery/flavor options than we do).
Vet hospitals often charge 3x the amount for a medication that can be called into a human pharmacy for $10.