WHY GETTING YOUR PET’S PRESCRIPTION FILLED AT A PHARMACY ISN’T AN EASY OPTION IN CANADA

With three dogs, Anna Mikicinki knows how quickly veterinary bills can add up. To save on costs, she found a solution that involved shopping for pet medications from halfway around the world.

Mikicinki went online and discovered the Australian manufacturer of NexGard flea, tick, heartworm, and parasite treatments for her Australian shepherd and two Pomeranians. By purchasing directly from the manufacturer, she was able to save nearly 70%.

“In Canada, a nine-month supply would cost me around $1,170 CAD. From Australia, a nine-month supply costs just $366,” she told The Fifth Estate via email.

But this year, the company stopped selling directly to Canada, leaving Mikicinki to find a workaround.

“I have to have them sent to a friend in Australia who sends them to me now,” said Mikicinki, who lives in Dorchester, Ont., near London.

The Fifth Estate and Marketplace, along with Radio-Canada’s investigative programs Enquête and La facture, collaborated on an in-depth investigation into the evolving landscape of veterinary care in Canada. Their report covers everything from access to pet medications to the impact of corporations and private equity firms acquiring independent clinics.

Our investigation uncovered how the veterinary industry, through exclusive distribution agreements between pharmaceutical manufacturers and distributors, restricts who can buy and sell pet medications.

This issue was recently highlighted in a report by the Competition Bureau of Canada, which emphasized the need for more options for Canadians when filling their pets’ prescriptions and called for greater access to affordable medications.

“While manufacturers have started to eliminate exclusivity clauses in their contracts, distributors continue to enforce exclusive distribution policies, selling only to veterinarians,” the report stated.

The Fifth Estate examined regulations across the country and learned they vary from province to province.

In Quebec, pharmacists are permitted to dispense animal-specific medications, with a distributor, CDMV, ready to supply them. However, in Ontario, provincial veterinary regulations explicitly prevent vets from reselling medications to pharmacists, except in certain situations. Meanwhile, in British Columbia, New Brunswick, and Nova Scotia, veterinarians are prohibited from reselling pet medications to pharmacists altogether.

Beyond restricting sales, the CBC/Radio-Canada investigation also uncovered efforts by industry players in Ontario to target veterinarians who have assisted pharmacists trying to enter the pet medicine market.

In one case, Vet Purchasing, a distributor owned as a co-op by veterinarians, confirmed to The Fifth Estate that it limits sales to their members, leaving pharmacists out in the cold.

The head of the largest vet association in Canada, meanwhile, defends limiting the sale of pet medications to veterinarians as a safety issue.

“Human pharmacists and human pharmacy technicians know nothing about the species I’m treating,” said Dr. Tim Arthur, president of the Canadian Veterinary Medical Association.

Fighting for more access

In 2020, Dr. Howard Covant, a veterinarian based in Thornhill, Ont., just north of Toronto, was found guilty of professional misconduct by the provincial veterinary regulator for selling animal-specific medications to pharmacists. His efforts to increase access to these medicines led to a seven-year legal battle with the regulator.

Covant argues that it creates a conflict of interest for veterinarians to both prescribe and sell pet medications—a practice that isn’t allowed for human doctors, dentists, or optometrists.

“If I’m the one prescribing the only medication that can save you, and I’m also the only one selling it, that’s a problem,” said Covant, who has been a veterinarian for 39 years.

While veterinary regulators recognize a potential conflict, and guide vets on prescribing and dispensing, Covant thinks pharmacists should also be able to dispense medications for pets.

He said while veterinarians are still the ideal choice to decide what medications are best for pets, “the question is: ‘Is the medication available over the internet or at a pet pharmacy the same as the one that your veterinarian is selling?’

“And the answer is yes. And if they’re selling it for 30 per cent less and it’s not going to endanger the animal to pick that medication up, why wouldn’t you?”

Canadians seeking options

Many pet owners in Canada may not be aware that they can ask their vet for a prescription for their pet’s medications and take it to a pharmacy.

However, the CBC/Radio-Canada investigation found that while veterinarians are required to provide a prescription if requested, they aren’t obligated to inform clients about this option.

In contrast, pet owners in the U.S. and other countries have more options for accessing pet medications.

In the U.S., pet owners can purchase medications online or at physical pharmacies, including from major retailers like Chewy, Costco, and Walmart. This change followed a 2015 review by the Federal Trade Commission.

In the U.S., 41 online pet pharmacies are accredited by the National Association of Boards of Pharmacy. In Canada, however, there are only two, both located in Ontario.

The Competition Bureau weighs in

“What we found is that there’s a system of exclusive distribution, which means that the drug manufacturers sell exclusively to distributors who then sell exclusively to veterinarians. Effectively [they] were pushing aside or excluding pharmacists,” said Youssef Zine Elabidine, a competition law officer with the Competition Bureau of Canada.

“Our recommendation is to actually mandate the supply, because we want to ensure that pharmacists are able to participate in the marketplace,” he said.

‘They know little about those drugs’

Tim Arthur of the CVMA argued that the practice of veterinarians both prescribing and dispensing medications has been in place for decades and serves the best interests of animals. He emphasized that veterinarians possess specialized knowledge about animal-specific medications that pharmacists lack.

“Some of the drugs I use don’t have human equivalents, so pharmacists know very little about those medications,” Arthur explained.

While the price of human medicines in Canada is regulated by the Patented Medicine Prices Review Board (PMPRB), the prices for animal medications remain unregulated.

Arthur said veterinarians rely on markups from the sale of pet medications to help sustain their business, often raising prices on cheaper drugs in order to keep more expensive services affordable.

While he said vets will offer the public more options for their prescriptions, if directed, he warns the potential loss in revenue could result in prices being raised for other services.

The Fifth Estate obtained a copy of the Ontario’s Veterinary Medical Association (OVMA) member newsletter issued just days after the Competition Bureau report. In it, the OVMA tells members the status quo remains, for now.

“Currently, the recommendations in the paper do not change the existing landscape of veterinary medicine. However, OVMA is actively monitoring this development and collaborating with our partners to ensure that any emerging concerns are addressed in a timely manner.”

Some pharmacists want more collaboration

Pharmacist Grace Frankel in Ste-Anne, Man., knows first-hand how pharmacists and their understanding of human medicines can help pets.

Two years ago, her Australian shepherd, Finnigan, started experiencing seizures that almost killed him.

“He’d have a seizure and then would have another and another, and they would get closer and closer together until we couldn’t actually stop his seizing until he was hospitalized,” Frankel told The Fifth Estate.

Working with her veterinarian, they figured out that Finnigan had a gut disease and put him on a regimen of prescription medications and supplements. The key drug that saved him was a new human drug that the vet was not aware of.

“Even though animals are different, they share a lot of the same problems that we do and they’re treated for the most part, pretty similarly”, Frankel said.

The vast majority of drugs used for pets are derived from human medicines. In Health Canada’s database of drugs authorized for humans, there are 3,433 entries. For animals, there are 157 entries.

Finnigan’s seizures are under control and Frankel said her knowledge as a pharmacist helped keep him alive.

“I think that this is just an untapped opportunity for two different professions to work together. If opening this up and competition drives prices lower, I’m all for that.”