Vets’ prescription charges are back under the spotlight
Free prescriptions are now a thing of the past, following the reintroduction of charges. Jack Davies reports on how the industry has changed and what the future holds.
Farmers were warned last November that unless they made use of free prescriptions for animal medicines, they could be lost following a Competition Commission review.
From November 1, vets will once again be able to charge for prescriptions, ending a three-year moratorium that hoped to revolutionise the profession.
Under the scheme, farmers could ask for free prescriptions from their vet before ordering medicines online or from a supplier of their choice.
“Farm animal practice has changed a lot since the regulations came in,” says Rob Drysdale of Westpoint Farmvets in West Sussex, which also runs the internet store farmacy.co.uk.
“When the Government went back to consultation on the issue, we wanted free prescriptions to carry on. I am not against charging for prescriptions – a vet ought to charge for their time and they ought to be paid for what they are doing.
“But a lot of people are unaware these have now finished and a lot of farmers were just coming round to the idea of using them.”
Most vets have welcomed the decision to remove free prescriptions, claiming they should be paid like any other profession for the services they provide.
Society of Practising Veterinary Surgeons (SPVS) president Richard Hillman says: “Free prescriptions were in place for three years to regulate the market and give the internet guys a chance to get their act together and get themselves established – they have now done that, so reintroducing charges is the right way to go.
“I would hope all veterinary practices will charge for prescriptions. People should be able to charge for the work they do, and there is work involved in preparing and checking a prescription.
“It is a legal document and we take the responsibility of that very seriously. As a result we should get recompense.”
While some have set charges in excess of £30, others have decided to stick to the status quo and maintain the free service.
Mr Hillman says: “We have canvassed our members to find out how much time is involved in writing and checking a prescription.
“Practices know what they charge for their time for small animal consultation fees, for example, and they can use that to determine the price of the prescription depending on the time it is taking them to write and check the prescription.”
Some practices, however, have set a standard charge as well as a supplementary charge for each additional item on the prescription.
“The industry is in a hole on this at the moment,” says Jim Brodie, owner of Portland veterinary practice and internet pharmacy vet2go.co.uk.
“I can understand practices getting uptight about not having to charge for prescriptions.
“They have tried to get round it with extra charges such as medicine decision fees and hopefully they will go away now they are charging for prescriptions.
“We are waiting to see how this will pan out, but we have decided not to increase our own charges.”
Graham Mason, who runs farmacy.co.uk, says: “We are seeing an average charge of around £25 per prescription and in some cases we have seen vets charging an extra £12 an item.
“That is not fair at all – a prescription of five items would then cost more than £70 – it takes 10-15 minutes to fill out a prescription so that's an incredible fee.”
Both the BVA and SPVS have urged members to be cautious, aware that excessive charges will not only cause concern among farmers, but could result in another investigation into pricing.
“It is up to individual practices to decide if they charge on a per item basis or not – it is going to drive up the price but that is the right thing to do,” says Mr Hillman.
“In effect, practices have been taking a hit on profitability or cross-subsidising the price of free prescriptions over the last three years.
“I really think for people on the farm animal side, the prescription charge as a total cost of the medicines is going to be relatively small.
“On small animals it might be quite different, but when you are ordering medicines for 100 dairy cows, for example, it won't be that much. Veterinary practices are under enormous pressure, as is any other business at the moment, and we have to cover our costs.”
But Mr Mason says he previously worked for an animal health company and struggled with the number of complaints from farmers about the cost of medicines.
“They weren't complaining about the manufacturers' costs, but the costs vets put on it,” he says. “So vets shouldn't get silly with over-charging because we don't want to lose trust.
“Unfortunately, the way the profession has charged in the past means they have lost a lot of trust and that's why a lot of farmers want more and more medicines to go through the trade route.
“We don't want those calls to get louder because vets are setting charges too high.”
Internet pharmacies believe there will still be a viable market online following the reintroduction of prescription charges.
These services have seen continued growth over the last three years by offering cheaper medicines and acting as a reference point for prices.
“They could look at our price, and then approach their vet and ask them to match it or write out a free prescription,” says Mr Brodie. “Obviously now they will have to pay for that prescription.
“In fact it has done some good for other practices because it has encouraged farmers to discuss price with their vet.
“At the end of the day, if the farmer's vet can't match it, then it is up to them whether they go online or pay the higher price.”
While the service has grown, some farmers are afraid of affecting the relationship with their vet.
“When we set up the website the idea was to get cost-effective medicines to farmers,” says Mr Mason.
“When free prescriptions were introduced, we thought it was unfair for the vets to get nothing for the time of writing out a prescription.”
“So we passed back five per cent of our gross margin to the vets who prescribed the drug.
“Now vets can charge for prescriptions again, we will give that five per cent back to the farmer who had to pay that charge.”
While the new rules will provide a considerable challenge to the online pharmacies, Mr Mason believes prescription charges could, in fact, persuade more farmers to turn to the internet.
He says: “I think farmers in some situations were uneasy about asking for a free prescription because they had a good working relationship with their vet and they didn't want them to lose out financially.
“Now they can see that the vet is getting paid for writing the prescription, they are much happier shopping around for their medicines, be it going online or to another pharmacy, so there is a positive spin on this and an opportunity for us to grow.”
For many vets, prescription charges are nothing more than recompense for the service they provide to clients and the wider farming industry.
“Farmers need to look at the total package they get from their vet practice,” says Mr Hillman. “Having good veterinary care is part of the quality value-added produce that farmers in this country produce.
“Standards of veterinary care in this country are phenomenal and that feeds into the food chain into the quality food consumers have and the disease status of the nation's livestock industry.
“But we have got to be paid for that and I would have thought that a prescription charge was a relatively small price to pay for what vets in this country offer.”
Competition Commission investigationFree prescriptions were introduced in 2005 after the Competition Commission found evidence of a complex monopoly on the sale of prescription-only medicines (POMs).
The subsequent legislation gave farmers the chance to ask their vet to provide the prescription free of charge, and then purchase the medicines at a pharmacy of their choice.
The rules were put in place for three years and following a review, the Competition Commission and the Department for Business, Enterprise and Regulatory Reform (BERR) – formerly the DTI – have reintroduced charging.
Vets can now charge farmers for prescribing medicines, but there is no guidance, leaving vet practices to set their own fees.
Animal Health Supplement