A vet can learn a lot from her clients. All she has to do is ask the right questions. In this case it’s about saving money—this time on your pharmacy bill. In this post my clients pony up on how they save big $ on their Rx’s. So if you spend any money on pet prescriptions you’ll definitely want to read this.
Most of what I have to say won’t make most vet hospitals happy (so you know, the following recommendations cut into my income, too) but everyone deserves to know what their economic options are, right?
Here’s some background on this:
Though it’s still not commonplace for veterinarians to accept the inevitable—i.e., the eventual loss of our in-house pharmacies—this protectionist veterinary worldview is changing. As I’ve explained on Dolittler before, at some point vets will have to realize that making money off drugs and products is not at the core of their business. Like your family doctor, they’ll send you elsewhere to have your scripts filled.
Pet owners, for their part, have spearheaded this veterinarian-circumventing movement by looking outside the vet hospital for savings on expensive medications and so-called, “vet-only” products. But the vet industry still has a long way to go before it meets your cost-saving needs.
In the meantime, it seems the downturn in the economy is accelerating this trend (if our hospital is any guide). Owners need more for less. That’s why human pharmacies and online pet drug outlets are fighting each other tooth and nail for your pet-dedicated dollars.
With that news in mind, here are a few ways to save on your pet’s pharmacy bills:
1-Prescription programs
I don’t normally go out of my way to praise a place that makes me cringe when I walk inside, but here’s an exception: Walgreens Prescription Savings Club, for $20 a year per pet ($35 for the whole family, including all pets), offers 400 different generic drugs at $12 for a 90-day supply. And many others at a sizable discount.
Sure, each drug has limits on how many pills (or ounces) constitute such a stash, but if your pet’s on levothyroxine (Soloxine), methimazole (Tapazole) or fluoxetine (Prozac), for example, you should save BIG. The plan also offers discounts on other non-generics so check it out. (Thanks for Christie Keith over at PetConnection for bringing this plan’s personal benefits to my attention.)
2-Four-buck antibiotics (and other drugs)
Yes, it’s true. You can get antibiotics and other drugs for $4 at many pharmacies (Wal-Mart, Kroger, Publix, etc.). I know that it can be a tremendous bit of convenience to get your one-time-only drugs at the vet, but you might want to re-think that if the hospital’s markup means your big dog’s cephalexin comes to $60 at the vet’s. Lots of other drugs qualify, too, depending on the store.
In fact, here’s a find: Wal-Mart sells meloxicam (can you say Metacam?) at $4 for a 30-day supply of 7.5 mg tablets. Sure, the tablets aren’t scored, so for safety’s sake this only works if your arthritic dog weighs 150 pounds. But what a boon for the huge dog owners to know about this! The veterinary equivalent would be unthinkably expensive in this case except for the most price-insensitive pet owners among us.
(OK, I hate Wal-Mart and Wal-Martification but how can you say no to $4 generic Metacam when you’re spending $150 on Rimadyl every month?)
3-Online pharmacies
Online drugstores are another possibility for price-shoppers. If veterinary-specific drugs are what you seek, this is perhaps the best way to find them at the best prices (sorry, no animal-only drugs on the prescription plans mentioned above). But beware—some sites are NOT what you think they are. A big red flag? The “no prescription needed” websites. Please stay away from these. Here's the FDA's advisory on this. Stick to outlets with a reputation to protect.
4-Ask about alternative drugs and generics
Let’s say your pet takes Baytril (an expensive pet-only antibiotic) for seven consecutive days a month as prescribed by his dermatologist. Will ciprofloxacin do? In many cases, the answer will be “yes.” This drug is available on most of the plans I researched above.
How about the Reconcile she takes for her severe separation anxiety? It’s fluoxetine (in case you hadn’t ever read the side of the bottle), aka Prozac. And it’s on all the lists, too.
Don’t be shy. Though you know that in many cases your vet would rather you not ask, it’s my view that vets have a duty to provide “value” wherever they can. If doing so means they have to write you a prescription (as they are required to do by law if you ask for one) I think that only serves to strengthen your relationship to their practice, right?
5-“Vet-only” products
Here’s where things get murky—“gray,” to be exact. Many “vet-only” products like flea and tick meds are available elsewhere for less. “Elsewhere” may mean the local Petco or PetSmart or your corner pet store. It may also mean an online outlet or the local feed store. The problem is that way too many counterfeit versions of these products are making the rounds of these places (I know ‘cause I’ve seen them). That’s because only vets are supposed to carry them.
Whether you agree with the vet-only distribution of these products or not (and I don’t necessarily), the upshot is that the manufacturers won’t stand by a product sold by a non-vet establishment. But you can still save money if you shop around at different vet hospitals (I can’t believe I’m saying this) or buy them through your vet’s online VetCentric “VetStore” (yet another slightly murky issue). Here’s a post on the “gray market” issue and another on VetCentric.
6-Buying in “bulk”
I recently saved a client $360 a year when I asked the compounding pharmacy I use (RoadRunner) what the price differential was on a one-month vs. three-month supply of liquid cisapride for her cat. The answer? Zero. It’s the same price. Her $45 a month Rx is now $45 for a three-month supply. How’s that for savings?
The same kind of savings is typically possible with bulk versions of levothyroxine and other generics. Ask your vet how many pills/ounces she’ll authorize at one time and shop around.
7-Go ahead…ask your vet for a better price
OK, so your vet will almost surely look at you askance but it might just work—especially if you have a great relationship with your vet and he understands how much you’re struggling.
This works best if you buy in larger quantities and you’re a fabulous client in every other way. And wouldn’t you just LOVE your vet forever if he came right out and offered? This is a great loyalty-building trick I like to use: “I’m not supposed to do this but…” Works every time.
8-Split your pills
OK so this only works if tablets are scored. I would be very cautious otherwise. But if you ask your vet for a bigger scored pill or a stronger concentration this can really work out in your favor. For some drugs it’ll cut your costs smack in half.
Much more cautiously, I’ll submit one other HUGE cost savings option. When I do TNR work I apply Revolution (a flea and parasite medication) to my patients. I love Revolution for cats. It’s among my favorite products ever. But it’s really pricey, so I buy the dog size and break up the vial, carefully measuring out multiple doses for my ferals.
For owned and adored cats? I’d never risk messing up on the dose (the concentrations are different in the cat and dog versions so it’s tricky). But for my ferals? Gotta save wherever I can.
9-Consider large animal versions
This is a rural trick that works nicely for me in some select cases. For example, ivermectin for generalized demodex cases (red mange) when my clients can’t afford the more expensive milbemycin (Interceptor) tablets. I’ll also recommend equine glucosamine for bigger dogs. The Cosequin brand works well sprinkled on the food—and it’s MUCH cheaper. (Just keep the excess stored in the fridge, please.)
10-Your suggestions…?
OK so that’s all I’ve got. Now it's your turn to pony up your finds...
PS: Here’s a big disclaimer offered to me by my very cautious vet surgeon consultant: Though every vet is required by law to provide you with a prescription for a drug should you wish to purchase it elsewhere, there’s a catch when it comes to substitutes for veterinary-only preparations of drugs which may be deemed “off label.”
If there is an FDA approved veterinary drug available for your pet’s condition, veterinarians receive greater protections when prescribing labeled versions—because they have received FDA approval and have been deemed safe and effective for this specific condition in your pet’s specific species.
In other words, if a vet chooses not to write you a script for fluoxetine (Prozac) but rather one for Reconcile (the vet version), it may be because he/she is concerned about the liability of prescribing a technically “off label” version.
Do I think that’s all about marketing and not really a substantive argument? I do in the case of fluoxetine. But that’s not always true for some other drugs (Atopica and cyclosporine generics, for example). Keep it in mind.
Add Comment55 Comments
More disclaimers on off-label drug uses: Your vet is in the best position to advise you but there are plenty of safe ways to use off-label drugs. Consider that most of the drugs we use in dogs and cats are used "off label." It's perfectly legal and their usage conforms to the "standard of care" we expect from veterinarians. But always defer to your trusted vet when it comes to doing some of the splitting and substitutions I mentioned above.
OK, now I'll sit back and wait for the emails from Pfizer, Boehringer-Ingelheim, Lilly and PetSmart (not to mention all the PO'ed vets). Wish me luck.
Dr. Patty Khuly November 21st, 2008 09:17:56 AM
Excellent post Patty! To add a couple of small bits: Not only are a lot of human drugs used on pets used "off-label," but a HUGE number of drugs are also used "off-label" on humans. Off-label use not not necessarily bad medicine; often it's good and correct medicine. On the "Vets Only" products you can actually find at Petco, most of it is flea and tick stuff, and the gray market here is pretty simple as you probably know from water-cooler conversations with other vets. Some vets subsidize their practice by buying entire skids of Frontline, etc. and selling it out the back door to pet stores. The drug companies know this is happening (it's a "big wink"), but they also know that their own profits are tied (to some degree) to the marketing gimick of selling and distributing through veterinarians. Go to "CafePharma" on the internet and click on the "veterinary sales" bulletin boards and read the commentary. Quite a hoot, mon! For small wound wound repair, I am a big believer in CrazyGlue, as you know (it's the methy version of VetBond which is an ehylene-based glue equal to a 4.0 stitch). Sure there's some expensive vet-only stuff that is more flexible, but if I'm not using that on me, why would I use it on the dog? For antibiotics without a prescription (useful for flesh wounds, and repeating urinary and ear infections), you can use fish antibiotics. See >> http://www.terrierman.com/antibiotics.htm For ringworm, I like "Fast Actin' Tenactin." Works well and is over the counter. I recommend skipping expensive rimidyl (why use a Cox II?) for short term pain control (such as for a wound) and using plain old buffered aspirin. Other basic safety and savings tips: Skip routine teeth cleaning (the best amnd most assured way to avoid anesthesis complications). Remember that dogs and humans have the same basic tooth structure, but humans live to 80 or more and dogs are dead at 15; they may get plaque, but they never get cavities if fed hard food and raw chicken. For flea powder, look at Sevin powder in the garden section of HomeDepot. A bag is a couple of bucks and works wonders under kennels and in vaccuum bags where fleas collect. It's a regular flea powder too; says so right on the bag! The biggest cash saver, of course, is simply to say NO to vaccines after that first year of a full-shot program. T-cell immunity is for life as science has clearly shown us (though the law says we have to renew rabies vaccines every 3 years anyway). And what's the TWO BEST ways to save money on pet health? 1) Pick your dog carefully. Avoid breeds of dogs that are walking cancer bombs, orthotic nightmares, liver disease factories, etc. Really look at breed health survey day (see http://www.thekennelclub.org.uk/item/570 ). Also avoid dogs that are over about 40 pounds. Smaller dogs live longer and, as a general rule, have fewer expensive hip and knee problems. It's hard to beat a small mongrel terrier in my opinion! 2) Put an ID chip in your dog and a slide tag on the collar, fence the yard well, and stay the hell away from string leashes. A good fence, a good solid web leash, a collar tag, and a little canine obedience training can result in every dog owner saving THOUSANDS of dollars. One bumper is all it takes. An ounce of prevention here is worth a pound of cure at the vets. Patrick
PBurns November 21st, 2008 11:10:59 AM
Patrick's comment about skipping dental care is ridiculous. To equate humans - who, hoipefully, are brushing their teeth and getting some maintentance work from dentists throughout life - and dogs, who generally don't get any help from plaque build-up and tarter formation which weakens tooth and jaw, is laughable. The huge loads of bacteria in their mouths get swallowed and contribute to heart disease, which is expensive and shortens their lifespans. And most of us have fairly close contact with our dogs (and cats, who DO get cavities, since their enamel is thinner), so the smell alone is often "worth it" to pay to have a real cleaning done. Just feeding hard food, without some scrubbing of the teeth, doesn't keep plague off. If people only ate croutons and never brushed, they'd have dental problems in no time. I do agree that trying not to select a dog that will probably have lots of medical issues is a practical approach to saving money, but finding and loving a best friend often is not a practical matter.
Kate November 21st, 2008 11:33:08 AM
Wow - great post Dr. Patty. So far, I have not had to deal with this stuff (my dog is still young) but I am going to bookmark this post for future reference. She recently has a prescription for an antihistimine and they just told me to take it the regular pharmacy $8. No biggie. But I could see this being important info once she ages and has the tendency towards more health care issues and more meds. As for #3, the flea/tick and heartworm meds - I recommend buying them from a Vet. There's too many knock-offs out there to risk it. My Vet's price is only like $5 more. Plus, if you buy a 6 month supply, you get one month free (which makes it lower than the online places that are reputable). Peace of mind is worth it.
Creature of Habit November 21st, 2008 12:59:06 PM
As the owner of ferrets, for whom many, many medications are off-label, I have one warning about off-label use: don't assume anything about cross-species use. PBurns mentions buffered aspirin above. It's very dangerous for ferrets I know for sure, and perhaps other species as well. So do ask your vet before trying whatever cost-saving ideas you might have.
I can contribute one tip. At various times my ferrets have needed famotidine to sooth agitaged stomachs (ferrets are pretty prone to ulcers and other digestive disorders). Instead of paying for prescription famotidine, on my vet's adivce I buy regular strength Pepcid A/C tablets, the active ingredient of which is famotidine. A quarter of a tablet is the correct daily dose for the average ferret. The tablets aren't scored, but you can get precise enough with a pill cutter, especially given that the active ingredient isn't perfectly distributed throughout the tablet anyway.
Thanks for sharing the tip on the Walgreen's prescription club!
regina November 21st, 2008 12:59:42 PM
I agree with Kate... dental health for pets is really important, regardless of their lifespan.
I think if you can avoid Dental cleanings then that's a GREAT way to save money -- but avoid them because you are taking excellent care of your dog/cat's teeth, not just let them rot. It's still unbelievable to me that people still buy that hard dry kibbles somehow "clean" teeth... Kate's crouton analogy was good. I don't feed dry food anymore, I feed raw, which keeps their teeth in great condition, and any small buildup the diet doesn't take care of (usually the 2 front canines), I make sure I take care of it with bi-weekly brushing. It's worth it for a non-stinky mouth and overall health of the pet. Remember that the dog's genes play a part too... my Pit mix gets more plaque build-up than my St. Bernard/Collie mix even though they both consume the same diet -- so with the Pit, I have to give her teeth a little extra attention. Still worth it though!
Carissa November 21st, 2008 01:02:22 PM
Yeah, Patrick's always on the money but I gotta say I'm bullish on dentistry. But that's pobably only because most of us won't train our pets to sit for daily brushings. Brushing daily IS cheaper. But it's lots more time consuming. Is it better for the pets? Undoubtedly. Then there are always those pets with severe enough periodontal disease so that even daily brushings won't preclude dentals. Most of you are lucky enough never to have seen (or smelled) these mouths up close and personal. Can't tell me that avoiding dentistry's doable in these cases.
*sigh* I wish they could all have perfect terrier mouths... ;-)
Oh, and cats do get nasty cavities. But then, Patrick isn't exctly a cat man... ;-)
Dr. Patty Khuly November 21st, 2008 01:53:55 PM
Does anyone know if you can use Claritin on a dog? I've been getting Climastine from the vet, or Tavist at the paharmacy for my 15lb guy.. I can get samples of the Claritin, and cut the cost to zero.. I have to look into the raw diet as a way of keeping Socks teeth clean.. I'm able to brush his teeth.. and I've been using a gel that works well for the tartar, and plaque.. Now if only he'll let me pluck the hair in his ears.. I actually feel sorry for the guy.. It's rough doing it, therefore we don't, and then he gets ear infection.. ughhh
barri November 21st, 2008 05:26:06 PM
Dr. Khuly, could you tell me a little more about your experience using Claritin for dogs?
I ask because my dog is allergic to, like, everything: 7 types of trees, 5 types of grass, lamb, eggs, wool, some weed called lambsquarter, dust, mold, cockroaches and human dander. My vet recommended that I give my dog (20lbs) 10mgs a day, and it made a significant difference in the amount of itchiness I saw. She went from chewing on her legs/feet to the point that they were bloody and raw to actually having fur! We do take some additional precautions- bathing, strict about food, etc., but if we miss even a single dose, she's chewing on herself again for a few days.
Crystal November 21st, 2008 06:12:36 PM
You can use a pillcutter for many unscored pills. Available in drugstores.
silkenpaw November 21st, 2008 09:44:09 PM
My vet is happy to save me money where ever he can! He will even write out a script for human medication for use off label and make it generec where possible. I have a pill cutter that works even with unscored pills. I have a wonderful relationship with him and he understands that I'm not rich but want to do the best I can for my pets. I know there are vets out there that are more interested in how much money they can make, it may be an insignificant number but they exhist. If they can make more on their drug sales they're going to do it. It took me 15 years to find this vet!
Donna November 21st, 2008 10:46:56 PM
Claritin (loratedine) is used in dogs but its effects are generally considered minimal, at best. The one clinical trieal I read about was inconclusive on whether it works at all. And it's expensive relative to other antihistamines. Sorry--I should not have dismissed your question so quickly (I was answering from my iphone and sometimes I abbreviate too much since my thumbs are so big.) ;-)
Dr. Patty Khuly November 22nd, 2008 08:28:39 AM
I split up the revolution for my cats....only time I have ever really had to use a little algebra outside of school...<lol>
unfortunately it no longer works on NJ fleas...either does frontline.....
I've gone to ordering most of my Rx's now...I just can't keep paying the vet the 3x markup
LorriM November 22nd, 2008 06:17:38 PM
Dr. Khuly-
Thank you for your comments on the use of Claritin in dogs. I agree that it is quite expensive in comparison to other meds- we spend about $25 a month on it for my dog (we use the dissolving tabs because they're easier to give). When we tried benadryl, it was much cheaper, but less effective.
To be honest, I don't know which part of the equation is helping control my dog's allergies- the prescription food, extra bathing, management (no wool in this house any more, which makes it hard to find sweaters, let me tell you!), and of course the Claritin. I don't know how much the Claritin contributes overall, but it does seem like she's worse when she misses a dose. Maybe the minimal effectiveness you talk about is just enough to help?
Crystal November 22nd, 2008 11:58:58 PM
To Crystal:
With regards to the Claritin Redi-Tabs (the dissolvables), also look at the Alavert tabs. Alavert is also Loratidine, and is cheaper than actual Claritin.
I just remember my vet getting annoyed at me when I asked him to verify the loratidine dosage that I'd been giving one of my cats for allergies. *blush*
Della (RPh)
Della November 23rd, 2008 01:35:12 AM
OK and here's one more for you (I can't believe I forgot to mention it):
Some pet heath insurance plans offer prescription reimbursement. This can be critical for owners to know when selecting a carrier. I'm not sure, however, whether they'll reimburse you for meds obtained at a non-vet pharmacy. I assume so but I'm not sure. Maybe VPI, Embrace, or another company's peeps can answer this for us.btw, both VPI and Embrace offer Rx plans. Others? Not sure.
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Dr. Patty Khuly November 23rd, 2008 09:43:35 AM
The danger of scoring those unscored tablets:
Please consider that some medications are meant to be given intact-meaning not cut or split-and that is why they are not scored. Enteral coated medications that need to survive a trip through all those digesty-juices of the stomach could be easily dissolved if cut in half and administered. Then you're really wasting your money, because your pet isn't getting the medication. Also it might irritate the hell out of the tummy.
That said, split it and stick it in a gelcap (cheap cheap cheap) that can survive the tummy juices :)
Another thing I recommend: ask your vet to set a vaccine schedule for your pet that corresponds directly to his or her needs. Better for your pet and wallet because it can possibly cut down on the number and frequency of vaxes.
I work at a specialty practice that sees internal med and surgical patients-we use tons of generic drugs (the really spendy ones-like cyclosporine, cefpodoxime) and write out a lot of scripts. This actually ends up making us money and improving the medicine we practice-the client spends a hell of a lot less on drugs, is grateful to us, and can then spend a bit more on the patient's care-what they're here for in the first place.
Morgan November 23rd, 2008 08:59:25 PM
Another way to save, and still have the convenience of getting drugs at your vet. I go to Banfield (I don't need a side discussion on that, please), and while they don't advertise it, they will price match on all of their prescription drugs, not just the vet-only flea and tick stuff.
Katie November 24th, 2008 04:01:42 PM
Katie: We would never denigrate your choice of vets. If Banfield takes great care of your pets it should make us happy...not suspicious of your personal choices. On the price-matching all I have to say is: Go Banfield! (But can they really match $4 drugs? Wow!)
Dr. Patty Khuly November 24th, 2008 04:56:27 PM
Sams Club is awesome. Not only do they offer the one month for $4, and 3 month for $10, but their price on things that don't qualify for that is better than anywhere else.
I get Zacks heart medicine for $10 for 3 months. When he had eye surgery a few years ago he was on a very expensive eyedrop, and sams had it for about half the price of anywhere else.
You do not have to be a member to use the phamacy.
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Steve Matthews November 26th, 2008 01:24:14 PM
jackson: Discouraged? Sounds like you and I are totally in agreement. ;-)
Dr. Patty Khuly January 4th, 2009 12:34:41 PM
You CAN buy flea and tick meds online, no prescription. www.jefferspet.com or www.drsfostersmith.com
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I have not had to deal with this stuff (my dog is still young) but I am going to bookmark this post for future reference. She recently has a prescription for an antihistimine and they just told me to take it the regular pharmacy $8. No biggie. But I could see this being important info once she ages and has the tendency towards more health care issues and more meds. As for #3, the flea/tick and heartworm meds - I recommend buying them from a Vet. There's too many knock-offs out there to risk it.
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I have not had to deal with this stuff (my dog is still young) but I am going to bookmark this post for future reference. She recently has a prescription for an antihistimine and they just told me to take it the regular pharmacy $8. No biggie. But I could see this being important info once she ages and has the tendency towards more health care issues and more meds. As for #3, the flea/tick and heartworm meds - I recommend buying them from a Vet. There's too many knock-offs out there to risk it.
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Thanks for the nice money-saving tips, doc. The economy is getting better, but until it recovers for real, we all have to scrimp to make ends meet. Get more bang for the buck on healthcare (human and pets), give up the luxuries, make the kids take part-time jobs, work a 2nd job, etc.
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MKV to AVI Converter , can also be called as MKV to AVI Video Converter or MKV File to AVI Converter, which is designed to convert your mkv files to various video, audio and HD Video formats, including avi, wmv, mp4, 3gp, mpg, mpeg, mod, vob, aac, ac3, aiff, mp3, TS, MTS, M2TS, HD WMV. HD MOV, HD. h.264, etc.
ad December 10th, 2009 08:56:45 PM
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Juan jones January 26th, 2010 06:34:11 PM
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jack li February 2nd, 2010 02:07:41 AM
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