CMA inquiry chair hints at veterinary cascade rules review

Veterinary regulators have been encouraged to reconsider the protocol governing how clinicians decide which drugs should be prescribed to their patients.

The head of the Competitions and Markets Authority (CMA) inquiry into companion animal services has warned some vets were frustrated by a “lack of flexibility” within the veterinary cascade. But the RCVS said any changes to the rules were a matter for the VMD, which claimed it could not comment while the investigation was ongoing.

The issue was highlighted when CMA inquiry board chairperson Martin Coleman addressed the London Vet Show’s BVA Congress stream on 15 November.

Drug costs

He said the group had been told that “in some cases”, pets were going untreated or even being euthanised because owners could not afford the cost of drugs with an animal licence and vets believed they could not prescribe cheaper human medicines that would provide an alternative treatment.

BEVA also called for restrictions on the consideration of clients’ financial circumstances to be scrapped in its own inquiry submission, published earlier this year, though officials have insisted the rules do not prevent professionals from discussing all treatment options.

Although he acknowledged it was not the group’s role to “second guess” regulatory decisions, Mr Coleman suggested the issue could be reviewed before his group delivers its final report, which is due by November next year.

‘Work together?’

He said: “Government policy has been that cost alone is not a sufficient reason to move straight to prescribing a human medicine under the cascade and we respect that.

“However, might it, for example, be possible for the VMD and the RCVS (who effectively police cascade use) to work together to give guidance to vets on circumstances where, if a pet owner clearly cannot afford an animal medicine with the consequence that an animal would go untreated, a vet would be safe to prescribe or recommend a cheaper human equivalent in order to protect the health and welfare of the animal?”

In response to the comments, the VMD said it was “unable to comment” until the inquiry group’s final report and recommendations are made available.

Advice

However, the body has indicated that it gave advice in line with its guidance to vets who had asked whether human medicines could be used, though there is no collated data for the number of incidents or the period over which the enquiries were lodged.

Meanwhile, a college spokesperson said the VMD alone was responsible for making any changes to the cascade as the body responsible for enforcing the Veterinary Medicines Regulations.

He added: “Of course, if the VMD did decide to make any such changes to the cascade, or the guidance on its application, we would work with it to ensure that the professions were fully aware of the impact and implications.”

‘Clear connection’

Mr Coleman also sought to reassure delegates about the inquiry’s concern for animal welfare, following criticism of its approach from within the sector in recent months.

While he stressed that nothing the inquiry group had heard so far had caused it to question the care provided by the “vast majority” of veterinary professionals, he argued welfare could not be properly protected if owners couldn’t afford to do so.

He added: “There is a clear connection between protecting the health and welfare of animals and seeking to ensure that markets for veterinary services are working well.”