3 Apr 2026
Regulators are facing fresh pressure to review the vet medicine protocol following the authority’s latest reports.
Allister Webb
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Medicine regulators have been urged to recognise cost as a “critical factor” in pet owners’ treatment decisions and look again at the rules governing veterinary prescribing decisions.
Veterinary and welfare critics of the cascade have seized on new comments by the Competition and Markets Authority (CMA) to make fresh calls for the model to be reformed.
But an industry group claimed changing the system would not address financial concerns and could even limit available care options.
Although investigation leaders had previously voiced concerns on the issue, the cascade was not referenced in the CMA’s provisional remedies published in October.
But the latest documents, published on 24 March, referred to a “high volume” of submissions from vets, professional groups and charities raising concerns about the “accessibility of affordable medication” under the present regime.
The summary paper continued: “We think that the VMD and Government should consider amending the cascade in recognition that cost is already a critical factor in pet owner decisions and, at the least, clarifying when cost can be taken into account.”
The full report went on to argue that a review should be considered “to ensure appropriate weighting between welfare, public health and competition” and urged the RCVS to examine the issue, too.
The college said it would be “happy to work collaboratively and support the VMD” on the issue, though it stressed it was for the directorate to decide whether a review should take place.
Meanwhile, a Defra spokesperson said the Government would respond to the authority’s recommendations “in due course”.
But the comments were swiftly welcomed by the British Veterinary Union, which said it hoped the VMD and Defra would “acknowledge this and act on it”.
Elsewhere, BEVA veterinary projects officer Lucy Grieve claimed the CMA had shown its cascade-related concerns were matters of regulation rather than competition.
She said: “The real-world impacts of a review could improve access to affordable treatments, reduce potential harm to animal welfare and minimise pressure on veterinary professionals operating within the existing complex, and sometimes unclear, rules.”
Dogs Trust veterinary and welfare director Karen Reed argued the drawbacks of the present system had already been established.
She said: “While we understand the significant investment required to produce licensed animal-specific pharmaceuticals, there have been a number of instances where a licensed product has been introduced following the successful use of a generic over a number of years.
“This has resulted in the obligation under cascade to use a much more expensive version of the same active ingredient and we would support amendment of the cascade to include cost intervention.”
But officials from the animal health industry group NOAH insisted the system remains a “vital part” of the medicines framework
Its spokesperson said: “The CMA’s own analysis shows multiple factors influence the veterinary medicine prices faced by pet owners and changing the cascade would not address them.
“In fact, without the cascade, there would be a real risk of reduced treatment options and poorer welfare outcomes.”