In just one week I’ve seen two separate incidents in which common veterinary products purchased online don't seem to be what they say they are. Both were ordered from large, well-established outlets and neither has yet been evaluated for its true contents. But they don’t look like the real thing.
What gave it away?
One box of Frontline. One box of Heartgard. On the outside, both looked identical to the stuff on my shelf. On the inside, however, the Heartgard’s characteristic chews were the wrong size. (The owner noticed immediately and brought it in for us to check before she administered any.)
The Frontline was another matter. The flea and tick-killing ampules looked the same, but the printed material adhered to the back of them was missing (that’s where a description of the weight and dose goes). This owner was simply distressed that the product wasn’t doing anything and asked if we might offer anything better.
In the other couple of instances of possible counterfeiting I’ve been directly on hand to verify, both also involved Frontline. One was purchased from a local feed store and another at a nearby, big-box pet retailer. The feed store situation was especially stressful given that the patient had suffered a reaction (this geriatric dog was depressed for a few days after the application).
Despite the possibility of a bad outcome and the opportunity to save other pets from the same, consumer reluctance has interfered with my ability to “work up” these cases. In fact, all my counterfeit Frontline clients have declined to do anything more than return the product and get their bucks back (even the one whose pet suffered a reaction!).
So it is that I can’t know whether these particular Frontline ampules really contained what they said they did...or did not. Nonetheless, you should know that instances of Frontline (and Advantage) counterfeiting have been numerous enough to warrant this EPA alert on counterfeit flea and tick products intended for sale through veterinarians. It’s clearly a big problem in the cutthroat pet product marketplace––more so as the products get pricier.
The Heartgard case is another matter altogether but I can’t comment on its specifics yet since we’re still investigating. In any case, it may turn out that this online-sourced Heartgard simply came from another manufacturing plant in another country. It may well contain the appropriate amount of ivermectin (the active ingredient). It’s probably perfectly safe. But would YOU chance it if you noticed a significant difference in the size of the chew? I don’t think so. And Heartgard’s manufacturer doesn’t want you to either...not until it gets a chance to check on it first. Good on them.
But now back to the Frontline and other flea and tick stuff...because that’s where the counterfeiting really ramps up and where corporate responsibility goes all murky on me.
Luckily, there IS one safer way to source your flea and tick supplies: buy it from me. OK, I don’t mean ME. But your best bet––safety-wise––is always to buy veterinarian-only products from reputable veterinarians. In fact, veterinarians are the only ones supposed to carry the stuff anyway. Did you know that?
By way of protecting our exclusive-distributor status (in return for our recommendation of their products), veterinarians are the only retail outlet many manufacturers will officially sell to.
So now you might ask, “How’s it that I can’t Google the word “dog” without getting 400 ads for Frontline? How do all these places get the stuff? Is it all counterfeit?”
Um...no. Let’s just say Frontline’s manufacturer has crafty ways of getting its products the wider distribution it believes the product deserves. (Other manufacturers do the same thing.) Some of their product is sold through third-party countries where distribution rules are more lax. Some is bought by US veterinarians in bulk then sold to your local PetCo (for example). And some, it’s alleged, is sold directly by the manufacturer through semi-veterinary intermediaries. Never mind that all these modes of circumvention (known as “diversion”) violate their own veterinary-exclusive policy and creates what we call a “gray” market for flea and tick products not intended for sale except by a veterinarian.
Whether you like the exclusive veterinary distribution idea or not (that’s another post’s topic)––and most of you won’t––some argue that this very system is what has created a market for counterfeit products.
By way of illustration, compare the vet-only distribution of non-prescription flea and tick products to how we more safely distribute most veterinary drugs. By virtue of individual veterinary provider, pharmacy regulations and FDA oversight, counterfeiting is not a commonplace occurrence for online-sourced Baytril and Comfortis, for example.
Because flea products are expensive at your veterinarian’s office, and because––according to the manufacturer at least––you can only buy them through vets, unregulated access to these flea and tick products has become a popular solution. In this scenario, the manufacturer doesn’t have to back up its product (because it’s not sold through a vet as they say it should be) and the oversight is especially lax.
Therefore, its argued, veterinarians have effectively created the counterfeiting mess we’re in with our high prices and demands on exclusive distribution of certain flea and tick products. Without our veterinarian-protecting free market interventions, we might all be safer, they say.
Though you won't catch me arguing me right to remain the exclusive distributor of these products, I will step up and defend veterinarians on this point: The veterinarian is not as responsible for the high price as you might think (why else are you only saving about 10%-20% online?). The veterinarian wasn't the one who set up these exclusive distribution policies to begin with. Nor is the veterinarian their only [dubious] beneficiary.
Though these products are a counterfeiter’s easy target any way you slice it, I‘d argue that most of the problem was created––and is now perpetuated––by the manufacturers who market them.
Manufacturers CAN label traceable, counterfeit-thwarting packaging (they have the technology)...and they mostly don’t. Manufacturers CAN help prevent diversion...and they mostly don’t. Manufacturers CAN aggressively investigate/prosecute those outlets responsible for carrying counterfeit products...and they mostly don’t. Manufacturers CAN back up the products sold outside a veterinarian’s office...and they mostly don’t.
Why? Because as long as they pay simple lip-service to the problem of counterfeiting (which they can pointedly claim is being perpetrated by evildoers outside their control), continue to play-act under the umbrella-like sham that is their so-called veterinarian-only distribution, shirk responsibility for their diverted products, and vociferously cry foul when product safety-related problems hit the news...they’re off the hook.
More importantly, not only are they in the clear when the proverbial dog doo hits the fan...they’re in the black, too. Because they stand to make far more on these products when they’re available everywhere...in direct contradiction to their own policies.
Should you happen not to like their distribution policy? Blame the veterinarians for their protectionism. And when the EPA claims Frontline Plus’s high reaction rates are worthy of an advisory to help safeguard the public? Blame your wide distribution (yes, they did) and the presence of possibly unsafe counterfeits on the gray markets.
Don’t get me wrong, I think Frontline’s a great product. But plenty of veterinarians who happen to agree with me on this point refuse to stock it, nonetheless. After all, if you’re recommending a product with a high counterfeit potential, does it not stand to reason that your patients are at an increased risk should their owners buy it elsewhere? How can you recommend a product like that, they argue? And I can’t completely disagree.
So where do we go from here if, like me, you're not willing to discontinue the use of these products? If you're not always able to convince your client base that they might be better off buying from me or some other veterinarian?
Do we ban non-vet sales? Ain’t happening. Many manufacturers would rather cut off their veterinarians than cut off their non-vet gravy train at this point––and I don’t blame them.
To my mind, the solution is simple: Take out the exclusivity clause for the veterinary middleman and give the product its widest possible distribution. Force manufacturers to take responsibility for the safe distribution of their products in all channels. Give them an incentive to disarm counterfeiters. And to help me make sure my patients’ owners don’t have to choose between what’s safe and effective...and the cheapest they can get.
Add Comment64 Comments
Whoa!! I'm sure glad you posted this. I did not know that Frontline, etc. was only supposed to marketed through vets. Maybe that's why mine is not working anymore!!
I believe educatedly that it is incorrect to say that the makers of the products are not liable if consumers it get through other distributors. If indeed it is their product, they should be liable for any side effects etc. for almost certain. As far as the counterfeiting and piracy of products, it is also very possible for them to take very serious and effective steps to stop those things. They would not be liable for the counterfeit product if it's not theirs, but they can and should be taking all possible action to stop this. If the product is merely pirated & sold at the reduced rate, the manufacturer is still liable for problems directly related to taking the product. Also there are many ways they can and should be warning consumers about this, plus ways they can pursue criminal and other remedies against the pirates.
BUT, MOST OF ALL, i cannot understand why a patient's owner would not complain!!! AT LEAST!!! And the vets, too. It will work! For ex. call and write to the co. and also call the State Attorney General's office to start. Complain to the FTC, and Commerce Dept. Just for starters. How many animals will be harmed if we owners refuse to do this????
SH August 22nd, 2009 02:00:38 PM
My frintline isn't working either! This is the worst fleas we've had in years!! And I bought it at a reputable farm supply store. I no longer have the vials, just the box, so I am not sure if it was counterfeit. This is scary. This week I am buying Advantage through my vet's online store. Thank goodness they just started that on their website, as they are 35 miles away. Much easier to have them deliver it to my mailbox.
Holly August 22nd, 2009 02:47:06 PM
Oh, SH, you must be a new reader - and rather naive, I hate to say. Animals are harmed by the multi-dozens (at least!) in every state (not even going outside the US), every single day! And because the hoops to jump through even to even get in touch with the companies, let alone the right person (if you can get to a human), and show conclusive proof that any harm was caused by their product.....it's a wonder that any suits get filed and that any justice ever happens - as rare as a hen's tooth.
Sorry for my cynicism, but the reason this happened is because everyone has bought into the idea that cheaper is not just better, but best, and in fact a right beyond the right of anything else, like a fair wage or safe products. even if you could give correct information to those who need it, they so often don't understand the risk, and they certainly don't 'believe' the science. And then there's the idea that if anyone says anything to discourage the purchase (as I tried to do at a neighborhood drugstore just yesterday), you get people acting as if you're a crazy person with some ulterior motive (I can't figure out what the person thought I'd get out of it).
KateH August 22nd, 2009 02:48:26 PM
This is appalling. I am going to copy this link and send to my Congressmen. When many people as I do consider their pet a member of the family, the idea that the greed of manufacturers endangers pets is criminal. There has to be some regulation to protect us of yet another instance of corporate greed.
Ann Hall
Ann Hall August 22nd, 2009 02:48:55 PM
Counterfeiting drugs has become such a huge market that lots of criminals have switched from illegal drugs to "legal" ones.
I take a very expensive anti cancer drug, Arimidex. It has specific side effects. I am SURE that I received one 90 day supply via my insurance company's "drug store" that was counterfeit. Had I it to do over, I would have made a stink. Normally I am on my horse tilting at windmills, but coming out of chemo and radiation....well, I just did not have the drive then.
My insurance company's provider likely did not know they were selling counterfeit drugs. The market for drug distribution is so complex it is easy to slip in bad stuff. Now my company will only buy from a distributor who guarantees they procure all drugs directly from the manufacturer.
I may literally live or die on the faith that they are truthful.
Something like "Obama care" will only make this situation worse.
Greed prevails all too often.
One of the expressions I live by is "don't appeal to man's better nature. He doesn't have one."
Carolyn August 22nd, 2009 02:55:10 PM
This is so stressful. We should have FDA-like organizations checking for the quality of these products.
Daniela Caride
www.TheDailyTail.com
Publisher
Daniela Caride August 22nd, 2009 03:25:07 PM
With this huge kerfluffle over all EPA flea products for pets, I wouldn't be suprised if this is another thing that shakes out.
Frontline and Advantage may have a "gravy train" with non-vet costumers, but the only thing that distinguishes them in the public's eye from cheap products like Hartz and Bio spot is their status as 'perscription only'. That's the only thing that would seem to justify their higher price to most consumers. Take that away, and to most pet owners it's no longer 'special'. It's just another over-the-counter flea drop except at 3 times the price.
One step that would help is for topical flea products to stop being regulated by EPA - they're much closer to drugs and should be handled by FDA. EPA 'registers' pesticides, while FDA approves drugs. EPA makes it illegal to sell pesticides certain ways - such as from other countries without an EPA registration number (often seen with products sold online) - but they don't do much else to protect consumers.
cyborgsuzy August 22nd, 2009 05:29:49 PM
Savings of "only 10%-20%"? Not at all. More like 50%.
By the way, when Frontline--and Advantage--stopped working for me last year, I made sure to buy them from several different sources (including two local vets) before giving up on them entirely. The first batch (Frontline) that didn't work came from an online purchase, but after that I bought from vets hoping the ineffective batch had been fake. No flea relief from either, not anymore, no matter the source. Drat.
Galadriel August 22nd, 2009 07:20:50 PM
You know, I don't really understand why most of the "veterinary-only" topicals are veterinary-only to begin with. I'm sure there's a financial incentive somewhere, but to me it makes more sense to stick the product on the shelf along w/Hartz, BioSpot, and other less safe/effective products, and let the good product outsell the crappy stuff. I get tired of the assumption by clients that I'm recommending specific products just because we happen to sell them, and I'd welcome what little profit we make off those products becoming a non-factor when it comes to those recommendations. Not only that, but the veterinary-only products have a higher safety margin, so I don't really see how it's dangerous to sell them without veterinary oversight, as the companies would have you believe. I'd much rather be able to recommend a specific active ingredient for clients to purchase as an OTC formulation...I truly believe some clients would be more willing to pay more for the product because it works AND because they weren't suspecting I had ulterior motives in recommending it in the first place. I.e., "I recommend a product with imidacloprid as the active ingredient, b/c it's very safe and very effective...it'll probably cost you a little more, but it's worth it", as opposed to, "I'd recommend Advantage...no, you can't buy it from the pet store...you either have to purchase it from a veterinary clinic or from an online retailer...I understand that it's less expensive online, but the only way to make sure you're getting a genuine product is to purchase it from an authorized veterinarian, and that's what's safest for your pet...", etc...you guys get my drift.
anna August 23rd, 2009 12:30:19 AM
Galadriel - you should look into dinotefuran or spinosad (Vectra [or FirstShield if it's purchased at a Banfield] and Comfortis). I hear a lot of good things about Comfortis from clients who suspected they were getting some resistance to the Advantage or Frontline, and I've been using the Vectra/FirstShield for myself for the last year or so...it seems to work really quickly, really well, and it seems to last at least a month, if not longer (the primary ingredients in both insecticides are fairly new to pet application). Vectra/FirstShield is going to be harder to find in a "grey" market, though...the manufacturer seems to be somewhat serious, at least for now, about preventing diversion.
anna August 23rd, 2009 12:35:44 AM
The flea products do not require a script. The manufacturers are entitled to sell them on the open market and they apparently do. I've read a number of places about these "exclusivity" provisions but would love to see one. Interestingly, Frontline's website for consumers says we "can" buy it from our vet and even offers a "find a vet" link but doesn't say that's the only place we can buy it. It sounds like vets sign up so they'll be in that database and it escapes me why vets would give up so much to get so little in return. I'm all for those exclusivity provisions to be history. In fact, I don't think most of these items should require any kind of permission or "script" to obtain. However, that isn't going to get the price at my vet's office down. My little vet clinic simply cannot buy in the quantities that a mail order company or centralized high volume distributor can; nor are they efficient enough to keep the cost down. If vets really want to do something to help in this, then refuse to sign exclusivity contracts, stop carrying more than an emergency supply of these products (which vets can, of course, buy through reputable dealers by writing their own scripts; shoot, my vet could buy from one of the sources I'm looking at on line and add a lovely markup and still be a discount from what I'm paying now) and offer order authorizations to patients along with a list of recommended distributors. It's simple, you say to your clients that you can provide a one month supply and an order authorization, no on site refills so get that get that order in the "mail" so you'll have what you need before you fur baby needs their next dose. By doing this, you make it clear to the client that these are not "prescription" items, that the distribution is being restricted by the manufacturers, and that you (the trusted vet) aren't going to play the manufacturer's game any more.
I'm quite sure that vets think they're always getting the "real" thing when products come in but there is no way you can be any more sure of that than any other distributor. In fact, a small clinic may be in a lesser position to determine that than a high volume distributor. One thing is for sure, get the number of distributors down and the manufacturer has a chance at limiting the counterfeiting because they can identify the source. It's really too bad consumers can't buy directly from the manufacturers and REALLY cut out the middlemen.
And how precisely do we hold the manufacturer responsible for counterfeit products? They didn't produce them. They AREN'T the manufacturer of the counterfeited products. They are, in fact, victims too. Yes, pets are being harmed by counterfeit products and their manufacturers but the manufacturers of the true product lose both profit and future sales, especially if their product is seen as widely counterfeited and/or ineffective. Most manufacturers will do what they can about counterfeit products for these reasons but every thing they do is going to add to the price too. Hey, there's a push for food to be trackable from source to consumer too. In our economy, can we all afford all these little extra price additions for each and every item we buy to be trackable?
And I can certainly understand why an individual would hesitate to try to take on trying to verify a product was a counterfeit. So, I send it to a lab. They test it at my expense. Then I try to track down the distribution channels it went through? And report it to what legal authority for action? I'm guessing it went across state lines so it's about to be real complicated and no law enforcement agency is going to want to take it on.
It's really a consumer fraud issue and consumers need to buy from trust worthy sources and doing that comes back to us cleaning up society generally. Lying, cheating, misrepresentation, fraud... These need to be generally unacceptable to us all.
There are always going to be counterfeit products out there and I can hear Dr. K's frustration that her clients' pets are being harmed and her frustration that she can't provide what she considers a more reliable distribution at a competitive price as the alternative to that. The products are admittedly in wide distribution and I can't actually find anything that indicates Merial has a policy not to sell to non-vets even in the US. Merial has chosen vets as their distribution channel in some countries and vets seem to have signed onto these marketing schemes for no good reason if they're really not making a profit. I don't understand blaming the manufacturer for something they didn't do or for not wanting to increase the price to consumers to combat something they didn't do.
All that being said, I wouldn't trust using any of the spot on flea treatments on any of my pets.
PJBoosinger August 23rd, 2009 06:38:57 AM
"The Merials and Pfizers of this world decry the gray market that allows these products to get re-routed to a third party retailer like PetMeds. And to show us how much they dislike this practice they stand up for their vets by refusing to stand by their products when sold through third parties." That'll go over to a judge/jury like a lead balloon except MAYBE in North Carolina. Read the Strict liability section and the Consumer protection one here. Please publish where manufacturers have said that. That's a deceptive trade practice class action suit waiting to happen :)
PJBoosinger August 23rd, 2009 07:03:01 AM
Daniela: The EPA is responsible for regulating these non-prescription flea and tick products. They've been doing a far better job of advising the public on these products' safety-related issues than I might have expected––lately, especially. (The two EPA links included in this post are some evidence of that.) The EPA does not care how the manufacturers market their goods, but they DO require that the products are safe at the point when leave the manufacturer's direct control.
Dr. Patty Khuly August 23rd, 2009 07:56:55 AM
Also, please be aware that if you purchase these online products and they fail in protecting your pet from, example, heartworms, your veterinarian is NOT responsible for treating your pet at HIS/HER expense!
However, our veterinarians here stand behind their products that they sell, and if administered correctly and your pet gets heartworms, they will treat your pet at no charge. The company they purchase from stands behind its products.
If you get your product online, good luck trying to get THEM to help you pay for treatments!
Thanks for the article.
deb bresnahan
meridian, ms
deb bresnahan August 23rd, 2009 08:17:11 AM
PJB: You won't find Merial copping directly to not standing behind their products when obtained through third-party sources. But their policy is quite clear:
This, from Dr. Zack Mills, vice president of pet sales for Merial U.S. in an interview for VIN:
“Merial does not support the sale or redistribution of any vet product where the vet-client-patient relationship does not exist."
This, parroted time and time again, does not make it so, but it does provide Merial some measure of legal distance in the event of a product concern. It is their official policy and they forcefully bring it up anytime diversion of products is discussed in a veterinary forum.
Yes I agree. It's a recipe for a deceptive trade practice class-action lawsuit. I, for one, would like to see one.
Dr. Patty Khuly August 23rd, 2009 08:24:20 AM
Y'all are gonna end up talking me back into practice! Although I'll have to hire some newly graduated slave labor to bring me back up to speed on the techie side and do the grunt work :)
PJBoosinger August 23rd, 2009 09:10:25 AM
And you'll be doing that for free, right?
KateH August 23rd, 2009 10:44:57 AM
The frontline I bought through my vet stopped working about 2 years ago. So was IT counterfeit...I doubt it. But even my vet said he's seen the frontline's effacy dimish in the last few years.
counterfeit...we've discussed this before...and even the products that are suspect might not be counterfeit, just packaged differently because they are coming from austrialia etc...
and of course there is the brand new shinny vectra product out....and truth be told, these products do work wonders..but are they really any safer for our pets? somehow I doubt it. They are after all still chemicals (pesticides)
I'm going back to lemon balm for now and reluctantly revolution when I have no choice.
this is big money business....the problem won't be solved anytime soon
LorriM August 23rd, 2009 11:14:21 AM
It is alarming just how many issues with flea control products have been coming up. They range from counterfeit products to adverse reactions.
It makes me cringe to read some of the stories and to see some of the pictures.
Wondering if you have heard anything regarding studies concerning the immunity to some of the flea treatment products. I keep seeing this mentioned but do not see any studies on it.
Just read one reporting on Advantage stating that resistence was not an issue (ten year study) but the low numbers might not be a good indicator--sponsor is Bayer.
It will be interesting to see how this all plays out when the EPA releases the findings in October.
Just a heads up, if you have any updates or useful info to share follow the issue on Twitter.
Ark Lady August 23rd, 2009 11:15:42 AM
Ark Lady: I agree that the trouble with all the studies on resistance to these products (none of which has confirmed the presence of resistance) is that they're all funded (at least in part) by those most invested in negative findings.
Do I think the products work less well? Probably––with respect to fleas, anyway. The efficacy against ticks does not seem to have changed (though it was never so great to begin with).
But we should also consider that the higher number of fleas and ticks may have significantly altered the dynamics of these products' efficacy. Climate change does seem to be affecting their population sizes.
Dr. Patty Khuly August 23rd, 2009 04:20:21 PM
Deb: Sorry I missed your comment earlier. Yes, it's true on the Heartgard issue. The company will typically compensate you for your pet's heartworm, hookworm, whipworm or roundworm treatment if your veterinarian can show you've been buying the product religiously through them. I've never heard of manufacturers doing so in any other instance. In other words, they will stand behind their product's failure if your vet can prove you've been faithful––and, of course, if you can prove you bought it through your vet. Otherwise? I agree...good luck.
Dr. Patty Khuly August 23rd, 2009 04:26:29 PM
Wait--I'm hardly naive!! I know a lot about it--but I hadn't heard this latest. Plus-I still think only multiple people complaining at the same time will makle a difference. The EPA regulates these meds b/c they're pesticides/insecticides. The FDA regulates our meds. So the EPA is charged with the responsibility to prevent &/or stop pollution--not bad pet medication per se. That's why the other regulating agencies, etc. involved must also be pursued. Also, no matter what the manufacturer says about it's not responsible if the product didn't reach someone through a vet--it is still responsible, if it is their product, for bad reactions.
All kinds of law are involved depending upon which scenario occurs.
Class-action would be the way to go. But it would take an animal law atty who knows these other regulatory schemes and product liability--plus even copyright, patent, trade laws, etc. etc.
I hate putting this stuff on my animal companions anyway--only do it for heartworm (interceptor) and b/c fleas are really bad in my multi-animal household. But, I'll continue to look for other solutions for the fleas. Can do for the dog, but cats will not let me spray stuff on them.
SH August 23rd, 2009 06:13:58 PM
"And you'll be doing that for free, right?" When I can collect it from the opposition. Truth be told, I don't really like my clients paying more than fronting some of the actual costs because there's an inherent conflict when they do that tends to interfere with an attorney's ability to make independent professional judgments.
PJBoosinger August 23rd, 2009 06:32:07 PM
Holly: I intended to comment on your assertion that your farm supply was reputable. IMO, many otherwise reputable farm supplies and pet retailers demonstrate that they have a little ethical problem when it comes to selling these products.
If the manufacturer doesn't believe the product should be sold without a valid veterinarian-client-patient relationship, if the distribution channel is shady, how reputable can your retailer be in this respect? After all, it's almost impossible to know whether some of these products are counterfeit or not as they've probably changed hands several times before it gets to the store. If the distribution shell-game for gray market products is too byzantine for me to work out (or for the Veterinary Information Network, which attempted an investigative report on this and did a pretty good job of it), how can a retailer figure it out?
All gray market products are automatically suspect. Your retailer knows this. I would urge you to make it known to them. Perhaps you can print out the EPA report on counterfeits I included in this post and hand it to them. Otherwise, you need not be confrontational. But I promise you they know the not-so-fine ethical line they tread in selling these products.
Dr. Patty Khuly August 24th, 2009 07:46:47 AM
Regarding the efficacy of flea & tick topicals and the issue of resistance, I have a hard time believing the notion that "resistance isn't an issue". I've got a pretty good background with pesticides, and resistance is always an issue. It's called evolution, and no matter how much Bayer claims they can hold it at bay it's just not so. the active ingredient in a lot of these topicals (imidacloprid, permethrin-based stuff, etc) aren't unique to topical pet applications. They have broad-based applications. While Bayer might not have documented resistence issues, I promise you there is some non-biased science-based peer reviewed research out there that has demenstrated resisteance to imidacloprid. Rotating topical treatments is common sense & should be standard practice. I do it routinely - I rotate between K9 Advantix and Frontline every treatment. I know there are issues with topicals for folks who also have cats, but there should be enough options out there that everyone could find a couple options to rotate. Also, I've found that topicals don't work for squat when it comes to ticks. When ticks have been a problem, the only thing that has worked for me has been the amitraz collars. I always keep one on hand, just in case. Ticks disgust me more than the fleas. Luckily, niether has been too bad this season. I've actually not had to apply topical to my dog in roughly 3 months, and have gotten by with a few capstars.
Chip August 24th, 2009 10:09:17 AM
thought these were interesting
http://sev.prnewswire.com/biotechnology/20080204/NYM12104022008-1.html
http://www.patentgenius.com/patent/6867223.html
LorriM August 24th, 2009 01:37:42 PM
LorriM: SummitVetPharm is doing a good job of keeping its products from getting diverted. They've added a sophisticated tracking system to their Vectra product (which it says adds mere pennies to the cost of production) and actively goes after veterinarian diverters. It's so far identified half a dozen instances of diversion in the product's short history and it's gone out of its way to go after the individuals or companies responsible.
The cynical me knows they're using this approach as a marketing tactic for a new product they desperately need veterinarians to support. They know veterinarians are angered by the Bayers and the Merials and their laissez faire approach to their products' diversion. They know that many of us won't carry these products now that we've been insulted by their disingenuous talk and their lax approach to their products' gray market safety issues. If Vectra can provide an alternative sold only through vets, they stand to gain through their assiduous control of their products' distribution.
Nonetheless, I love this approach because––if nothing else, it's a great statement on what the rest of the industry is NOT doing, and easily CAN.
Dr. Patty Khuly August 24th, 2009 02:22:22 PM
I believe the drug companies initially market their products "sold by veterinarians only" as a gimmick to get an endorsement from the veterinary community. These items end up on the gray market because of the large volume discounts they give if you buy very large quantities at a time. The grey market not withstanding, these large volumes are far more than I can purchase as a solo practitioner and this puts me at a competitive disadvantage with larger clinics. I have brought this issue up with the drug reps but to no avail. I think that if they charged every clinic the same price regardess of the quantity ordered, it would eliminate the diversion as well as be more fair to the smaller clinics. I do not think it is be too hard for them to figure out who is diverting these products since the drug reps visit the clinics and know good and well when the practice is ordering more drug than they can reasonaby sell out of their clinic.
Hobson August 24th, 2009 03:35:17 PM
Hobson: Have you ever gotten those faxes from shady distributors looking to buy Frontline (et. al.) from you in bulk? I have. They promise it'll earn you big bucks and help you get big savings on these products for your own use. I can think of at least a handful of veterinarians where I live who would happily take part in these diversion scams. And there's no excuse. The manufacturers know darn well where their product is headed when a solo-practitioner veterinarian in Miami starts buying 250 cases of their stuff every month instead of the two he previously bought.
Dr. Patty Khuly August 24th, 2009 05:37:19 PM
I get them, incidentally they are all from the Boca Raton or Pompano Beach area , where Pet###Xpress is based. I have given them to my reps and they just "tsk tsk". I downloaded copies of the legal action against P#### Express from the state pharmacy board which included thousands of dollars of fines, showed it to some clients that wondered why they should not just order stuff from them.
Hobson August 24th, 2009 06:32:30 PM
Hobson: Don't get me started. How do you happen to feel about VetCentric? For years I've been considering offering a link here on Dolittler for non-Rx products only. (Sort of like an Amazon affiliate program.) As much as I prefer to give the business to veterinarians over the PetMeds of this world (via VetCentrics, et. al.), I worry that a VetCentric link would dilute my position with respect to product sales (i.e., veterinarians are not retailers). Yet after years of no pay for Dolittler, I sometimes get to wondering...
Dr. Patty Khuly August 25th, 2009 06:46:32 AM
I saw an interesting (maybe 20 minutes...maybe another program) tv story on the the "owner" of 1800petmeds (same as the owner of 1800contacts) quite a while ago. if you are not familiar with it, you might try and find it on the internet...it was enlightning. Not that I order from them anyhow...I have other favorite online resources.
LorriM August 25th, 2009 06:55:23 AM
Doc, Hobson..., How does your community feel about Doctors Foster and Smith?
PJBoosinger August 25th, 2009 07:59:00 AM
I can't speak for other vets, but I was fired recently and some of the reason was because I told clients that they could get the Furminator from Foster & Smith's or Petsmart. The vet I worked for didn't carry the product, but felt that I was encouraging clients to go elsewhere for anything. (My quiet opposition to R/D and suggesting another food also had something to do with it.)
KateH August 25th, 2009 08:43:25 AM
KateH: That sucks! Shame on your former employer for that one. I've worked for similar individuals. As to the Furminator, though, I've seen the best deals on Amazon (I seem to be plugging Amazon a lot today).
PJB: Drs. F&S sells vaccines along with these flea and tick products. Though I won't put them in the same category as PME (for their abuse of prescription regs, etc.), they annoy me for what I consider their ethical lapses on the subject of gray market sales.
Dr. Patty Khuly August 25th, 2009 11:35:59 AM
Dr F &S are not real big players in the grey market, but seemed to have stayed legal regarding prescription meds. I mainly fill prescriptions from PME. We have recently opened our own on-line store through AAHA Marketlink and Vetstreet. Our prices either match or beat PME and our products are definitely not diverted. The markup is not as high since we do not have to order, unpack, label or dispense the products. The store is available through our website.
Hobson August 25th, 2009 01:08:45 PM
Hobson: That's what I like about VetCentric. No stress. And I can beat PME's prices (and happily snatch their business wherever I can with properly distributed products).
You like VetStreet and Marketlink better, why? Would you have any objections to Dolittler sporting a VetCentric store? Just curious...clearly, I'm still mulling it over.
Dr. Patty Khuly August 25th, 2009 02:59:18 PM
We use Vetstreet/marketlink because they were already doing our reminders and our website. I would have no objection to Doolitter sponsoring a store, but I am not sure about your employer. I would have to think about an employee of mine who ran an internet store for pet products. It would be open for discussion.
Hobson August 25th, 2009 04:28:21 PM
Hobson: Employer's cool about it. After all, as I've said repeatedly here, I would only work (as long as I have) for someone who viewed product/Rx sales as an added bonus, not as a way practicing veterinarians should be making their money. For Dolittler? Let's just say it's got to survive somehow. I haven't been able to afford any upgrades for eons (and it could sure use the help). I'm rationalizing that maybe a veterinary blog deserves a few extra concessions.
Dr. Patty Khuly August 25th, 2009 04:45:32 PM
Good point, I welcome the day when Veterinarians sell no products and we are paid for what we know and do. Until then, we have bills to pay and product sales are important.
Hobson August 25th, 2009 04:49:41 PM
Sounds like we clients will be seeing much more outsourcing from our vets of these ancillary services which, of course, I think is a great idea. Any chance the 2 of you could put your heads together and fill us in on what might get outsourced and to whom? I'm curious about these 3rd party vendors.
On the way home today from the vet's, I was thinking how nice it would be if my vet bills were electronically accessible so I could download them on line the way I do my check register; how nice it would be to download each line item and be able to sort them out by pet for my own records. As usual, I had one pet with me today and came home with ancillary stuff for 3. I've heard of one company that provides a copy/storage service for vet records is out there already; they get client consent and then work with the vets so files are accessible to emergency clients and vets used while traveling.
PJBoosinger August 25th, 2009 05:20:56 PM
PJB, one of my drug distributors is the vendor for my online store most of the items I stock plus some that i don't are available. if it is a Rx item we must approve it, but OTC products can be ordered by the client. They set up an account through our website pet portal. This company will also download my reminder file and send out reminders for me. Saves us a lot of work.
Hobson August 25th, 2009 08:41:58 PM
Hobson, I really like that concept. I'm much better about getting things done if I get ticklers to remind me. I try to put everything on my electronic calendar these days for the same reason. I'll probably be nudging my vet to get a website and store soon. In the meantime, do/can you have clients for OTC that aren't people with pets under your care? If so, link please.
KUDOS to Dr. K for that series of rags on us pet owners who let our fur babies pack on too much weight. I was already working on it but that sure helped to keep me going! Happy to report my once 35 pound Shiba is now 19.2 pounds and my Lab who was 125 pounds is now a healthy 78 pounds! AND they got their first CBCs and Chem 12 too which were quite good except for some very mild anemia for the Shiba for me to look into. Now that they're almost caught up, I may even attempt to get my cats on a better track. I'm sorry, cats are harder, they just are; they're not nearly as cooperative as dogs - at least mine aren't! However, this did get to me so I'll try even harder. Can't someone event something like BMI for pets?
My new vet called me one of her "better" clients. Hehe, little does she know. Although I suspect she suspects there's a history there. She did note that neither of my dogs had proper "tuck", dead give away of their past weight apparently. :)
PJBoosinger August 25th, 2009 09:13:06 PM
I feel like this is now shameless self promotion but ...my website is www.abac.vetsuite.com, I would welcome some feedback regarding the website.
Hobson August 25th, 2009 10:15:40 PM
Hobson, That's about the least blatant self promotion I've ever seen. I really like the clinic info section (especially the list of services) and you've got a nice set of links (not too much, not too little, like the inclusion of the Chambers of Commerce, maybe add your local BBB?). If I were your client, I'd want to know which of the articles you'd reviewed and maybe a recommendation list (and I'd try to talk you into writing a few of your own). Back to the topic of self promotion, you should put your name on the "Home" page. I'm probably not the only one who hunts for my doctors websites by searching for them by name.
This one's probably still just a judgement call for vets but I'd encourage it. A few years back, some Bar Associations started mandating that lawyers hand out a little brochure during first visits on ethics and professional responsibilities with contact information for filing complaints. Attorneys cringed but complied and there wasn't a deluge of complaints so now many of them have the brochure and link to complaint forms on their websites. As you know, the effectiveness of boards is widely variable. However, I do think it makes clients feel like a professional is more open if they aren't "hiding" who the complaint goes to so I'd be inclined to put that on the website too.
Oh, and the link line (under your clinic name) on your home page needs a left shift so all the links are on one line instead of wrapping to a second line.
All in all - NICE website!!! Neat, professional, runs smoothly and quickly; all the things I look for when looking for my own providers. I'm not really very comfortable with any professional who doesn't have one with the basics these days. Do review it periodically for needed updates. That's the biggest mistake I've seen lately; outdated info on websites always raises my eyebrows.
PJBoosinger August 25th, 2009 11:35:16 PM
Oh, well, we're so OT now anyway... I'm not liking the looks of this hematoma on my girl's neck and my poor Shiba's been pacing most of the night. I find myself wondering if my newly graduated vet might have gotten some experience with leeches (ick) during her schooling and if they'd work on this like they would on pillow ear. A couple of more hours of Shiba pacing and I'll bet I work up the nerve to ask even if (ICK) the whole concept freaks me out. I know at least one place within easy driving distance that has medicinal leeches but I'll have to get over that old movie that keeps playing in my head now...
PJBoosinger August 26th, 2009 06:57:42 AM
PJB thanks. I am required to post the state phone # for complaints conspicuously in my office. I will make sure I review the articles and get my name on the home page. It is always a work in progress.
Hobson August 26th, 2009 08:06:36 AM
I like the site, too. It's basic. It's clean. It's functional. And it's got cute pet pics, too! It's everything a vet's website should be. But how do your clients like it? Do you find they're ordering products like Frontline from you instead of PME?
Dr. Patty Khuly August 26th, 2009 11:40:16 AM
I have only had the store up for a couple of months, response has been slow but steady. Nothing moves real fast in this community anyway.
Hobson August 26th, 2009 03:26:52 PM
Hobson, Thanks for the access. I really like the pet portal. Having records, instructions, and reminders on my laptop instead of having them get quickly buried on my desk or tacked to the frig would be incredibly nice! Nice storefront too. Like that which items require approval is really apparent.
PJBoosinger August 26th, 2009 05:06:18 PM
At the risk of sending Dr. K, Hobson, and the other vets here into fits. What's everyone's opinion of JustAnswer.com? (And I'll admit to already being a bit prejudiced in their favor for the moment since they were available in the wee hours of the morning to pat me on the head and tell me not to panic this morning when I was exhausted and overly concerned about this hematoma my Shiba has.)
Dr. K, my new vet actually rolled her eyes when I asked about leeches for pillow ear in Labs and/or for this hematoma my Shiba has!
PJBoosinger August 26th, 2009 05:13:04 PM
PJB: Don't fret. I get a lot of eye-rolling, too. Cultural shifts get that a lot, you know.
As to JustAnswer.com: I think it was made for things like aural hematomas. Some things can be explained through this medium. Sadly, most things cannot. As long as that line is crystal clear (info vs. advice), I think it's a great business model.
Dr. Patty Khuly August 26th, 2009 08:09:43 PM
What you can do, ugg boot moron, is stop commenting on this blog!!!!!!!!! I don't think it's censorship to prevent jerks like this (and the other ones of all stripes) from clogging up the comments. I hate seeing a higher # of comments than last time and wanting to read real worthwhile comments (Yes, yours are worthwhile, PJ!) and finding crappy spam masquerading as real people!!!!!!!!!!!!! (Yes, I', not happy this week - trying to find a better home for an honestly abused dog and not getting any responses from more than 70 people. Very disheartening.)
KateH August 26th, 2009 10:01:21 PM
On a kinda related note to the actual blog topic, What's up with Virbac? 1 and 2 And how common are recalls for vet meds generally?
Before Dolittler, I would have been annoyed by the eye rolling. I just smiled, time will tell. Despite my ICK reaction to leeches, it sure sounds like it's worth a try for Labs. I know I've been comparatively lucky with my Labs on the pillow ear issue!
I used to tell my legal clients to call a friend for "head patting" and non-professional ranting instead of paying me $150/hour (and, yes, I did charge and collect for that particular type of service). I think JustAnswer.com is a nice alternative for that :)
KateH, well it is censorship but, as I've said before, it's also Dr. K's blog (and I'm not the least bit sure commercial spamming even qualifies for complete free speech protection; am sure it was not the least bit contemplated by the founders) so I'm in agreement with you on this one. Can also sympathize on the home hunting. Found out that the county I moved to doesn't have an animal shelter and almost no rescue organization (informal referral to individuals through the local vets, of whom there are maybe 6 in the county). I'm stealing myself for finding out we have an old fashioned "shoot the strays" policy in the county because I'm sure that's what I'm about to find out. Yep, very disheartening out there.
PJBoosinger August 26th, 2009 11:19:06 PM
And sympathies to Dr. K on that spam! I've been by here at odd hours of the night and have a pretty good idea of how much of it she cleans up in the wee hours of the morning. If having a corporate sponsor will get you a better spam filter, find a decent sponsor and go for it!
PJBoosinger August 26th, 2009 11:36:35 PM
FYI for those who see PJB's comment re: Virbac recall...this recall applies to Banfield's WormShield product (ivermectin/pyrantel) as well - WormShield is simply Virbac's Iverhart Plus repackaged through a business agreement to be marketed in Banfields. Just a heads-up in case anybody knows anyone who purchases their heartworm preventive from a Banfield.
anna August 27th, 2009 12:25:22 AM
Anna, that's nice of you to add that info. I didn't know that Banfield's did that. And thank you for the sympathy, PJ. I've really been upset in not being able to find a place for this dog. He's not a bad dog, he just has a guy who went uber-Cesar on him because he's actually afraid of dogs. (No, it's not Cesar's fault directly, but his 'theories' often lead to humans attacking dogs and creating huge problems - in this instance a death sentence - for dogs.)
KateH August 27th, 2009 10:50:57 AM
PJ, do you think the new vet will look up and info on leeches, or do you think she's made up her mind and won't even consider that it might work? I mentioned leeches to my ex-vet, and he dismissed me quite rudely (as if I was a fool for even thinking it would be sensible). Of course, he did that about putting a yoga mat (or similar) on the stainless exam table, and using something other than ace for thunderstorm anxiety (and many other things). Even new vets can be swayed by older vets (teachers, mentors) into not even thinking about the idea of trying anything different.
KateH August 27th, 2009 11:02:05 AM
I'm not a fan of Cesar's techniques either. Not even of us non-trainers taking any single method as gospel. It's much more complicated than that. My enormous Lab is terrified of small dogs but it comes across to others as vicious rather than fear. It's a long slow road back from that fear for them. You've got my sympathies and best wishes.
Vet: She had a knee jerk reaction and I'll let her have it for now. I've already made some in roads by getting my girls weight to appropriate levels and I admit to doing a sneaky thing by getting their blood tests and praised before asking about "home made food". What to you think of homemade food? Not really, don't think it's good for them. Huh, that's what my girls are eating. REALLY???
I'm learning some new skills too so hoping that over time, we'll both learn and change. My own styles haven't worked well in the past with doctors (vet or human) so I'm learning new ones. I feel like I'm being manipulative but I think I can learn to live with that if it benefits my pets. That swaying happens in nearly all the professions, newbies don't have much choice but to depend on their elders and it has both good and bad consequences. Most of the time, if you want a professional to buck the system they've been taught, you have to let them start by doing it quietly and behind the scenes. It's sad but true.
PJBoosinger August 27th, 2009 03:57:07 PM
I'm shocked at the near-compliments afforded the EPA in some posts above regarding regulation of OTC topical spot-on flea and tick products. The EPA has demonstrated again and again they are probably the most lax oversight regulatory agency in the federal government. Think about it--they issue a "Public Advisory" in April/May announcing that they received over 44,000 potential adverse incidents in 2007! That's up significantly from the over 28,000 adverse incidents reported in 2007! That's unbelievable. How many pets must be injured and killed before the EPA takes action? And if over 44,000 adverse incidents are reported how many go unreported? The vast majority of the population has no idea how to report incidents to the EPA or the National Pesticide Information Center or even to the manufacturer. I wouldn't be surprised if less than 10% of actual injuries/deaths ever get reported. Hartz Mountain has been cited and fined for not passing accurate and timely information along to the EPA as federal law requires. Their spokesperson, John Mullane, told The USA Today newspaper in 2005 that 7,000 reported cat and kitten injuries and deaths was a "small number compared to the total number of applications". A "small" number? That same year the EPA finally buckled under the media attention, consumer activism and total adverse incidents and issued a Cancellation Order against Hartz's cat and kitten flea and tick products. Yet the number of incidents has increased and the EPA issues a Public Advisory and says it is renewing its scrutiny--pathetic. They also refer to the manufacturers and registrants as their "business partners". I thought the public, animals and our environment were supposed to be their "business partners". It appears we are an ignorant annoyance and they will do anything they can to work with the manufacturers and registrants to keep these reprehensible products in the marketplace.
The EPA is doing a "good job--lately"? Hardly.
Matthew August 29th, 2009 01:24:22 AM
It's been an especially bad flea season everywhere. My vet carries Comfortis and Advantage. I decided to use Comfortis for the summer months. Works fantastic and no, my dogs did not get sick taking the tabs. My vet said though Comfotis is 2 months old on the market that his office has sold a ton of it with no side effects. Any med can cause side effects so, held my breath and tried it. So happy I did. No more flea worries. I also had my yard sprayed by a good pest control company.
Nancy Makowski August 29th, 2009 02:59:17 PM
Matthew: It would be a gross overstatement to say I support the EPA's milquetoast approach to handling most consumer/public health concerns. I, too, view it as a weak and largely ineffectual body––particularly with respect to CAFO ops, CAFE standards and all the other issues they cave to on behalf of industry lobbyists. I meant to say that the EPA seems like it's at least been *saying* something with respect to vet industry products––surprising, given that it says little and does even less.
Trust me, few of us here thinks the EPA is doing what it should to protect our interests.
Dr. Patty Khuly August 30th, 2009 01:21:58 PM
Thanks, Dr. Khuly--I appreciate your clarification and comments regarding the ineffectiveness of the EPA. I may be defensive about any perceived supportive comments of the EPA because of their complicity in the injuries and deaths of so many thousands of pets and animals over the years. Their support of the manufacturers of flea and tick products over the years has been unconscionable. I could go on and on with example after example of facts regarding their incompetence and outright complicity. This issue has flown under the radar for far too long--the vast majority of pet owners and almost all non pet owners have no idea just how reprehensible the EPA has been in following their federal obligation of protecting citizens, animals and the environment. In parallel, the flea and tick manufactuerers (over the counter pesticide producers) are among the worst of the worst corporations in the world. This includes BioSpot, Sergeants, Hartz, Adams and many others. They are completely uncaring of the carnage, death, injury and devastation they create in the name of their own profits. They have a disregard for the adverse health affects on infants and children even though scientific testing has clearly demonstrated the risks associated with these ingredients, particularly neurological problems for infants. This is not "new" news for veterinarians and veterinary schools. However, unlike you, most veterinarians and almost all veterinary schools will not publicly speak up on this subject. Two reasons: 1) The manufacturers, particularly Hartz Mountain, have extraordinarily irresponsible, intimidating and threatening legal departments. They also have the capability to financially hold their head under water much longer than the average vet or citizen and don't mind losing a few thousand dollars in order to intimidate or hurt the average vet or pet owner. 2) Their financial contributions to veterinary schools and "veterinarian of the year" awards and recognition events combined with significant donations and public showcasing of themselves with shelters, etc., creates an environment where they can control their benefactors. It's pathetic. The combination of the lax oversight and sheer incompetence of the EPA with the manufacturers appalling disregard of safety and willingness to obfuscate the facts and mislead the public has led to animal death, injury and family guilt and emotional devastation. It's a terrible situation but one day the real truth will have the full light of day and these unconscionable corporations will brought to account. It must be pure hell to work for these guys.
Thanks again, Dr. Khuly.
Matthew September 8th, 2009 06:59:47 PM
I've been using Frontline purchased from equine-mega-store.com in Australia for over two years now, and the product is the real deal at about half the price of what my vets charges. My vet tried to convince me what I was getting is in fact counterfeit. Not true! Greed has made Frontline in the US market nearly unaffordable.
Cal November 23rd, 2009 10:02:35 AM
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