4 Jul 2025
Regulators urged to act after paper estimated hundreds of thousands of pet owners can’t access care because of the requirements – but VMD said it has “no plans” for a review.
Allister Webb
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Image: andreysp03 / Adobe Stock
Fresh questions have been raised about the rules that govern veterinary drug prescriptions after new analysis claimed the present structure isn’t working for clinicians or their clients.
Regulators have been urged to act after a newly published paper estimated hundreds of thousands of pet owners can’t access care because of the cascade’s requirements. But the VMD said it has “no plans” for a review, while a major industry group has insisted the current system should be protected, arguing reform also carried risks.
The new paper, published by VetSurgeon.org, is based on the findings of a survey of more than 1,100 clinicians that was carried out late last year.
Out of more than 900 complete responses, more than a quarter (25.8%) said owners were unable to afford licensed drugs that vets are required to prescribe “very often”, meaning at least once a week.
The paper estimated that equates to 8,400 pet owners a week and nearly 440,000 a year if that proportion is applied across the UK’s entire veterinary workforce.
A further 38.8% said they experienced the same issue “often”, between one and four times per month, while “rarely” and “never” accounted for only 10% of responses.
Vet David Mills, who co-authored the paper, said the scale of its findings was “quite shocking” and showed reform was necessary.
He argued the present system only benefits pharmaceutical companies, because of the practice of retro-licensing, and had left the sector in a “drug purgatory” of rising costs to both practices and their clients.
He admitted being unsure of the appetite for change within the sector’s own regulatory bodies, but argued that the ongoing Competition and Markets Authority (CMA) investigation could be a “very powerful tool”.
He said: “I would strongly urge them to take this study and its findings into consideration. For the first time we have real-world evidence of the impact of the cascade on veterinary drug affordability.
“The CMA will have an opportunity to push for regulatory change, and rather than concentrating on a new VSA, which would bring negligible benefits to practising vets, I would hope they could see how the cost of medications is pricing out many owners of being able to afford care.”
Although cascade reform was mooted by CMA inquiry chair Martin Coleman in a speech at last year’s London Vet Show, many veterinary groups have previously expressed their support for the present system.
In response to the new paper, the VMD said: “Current UK veterinary medicines legislation ensures the safe use of veterinary medicines and the protection of public health and the environment.
“The VMD do not plan to review the prescribing cascade or promote the use of human medicines over the use of veterinary medicines.”
NOAH argued the present system “already provides vets with the flexibility they need to ensure effective, affordable care while maintaining rigorous safety and efficacy standards”.
Its spokesperson claimed change could risk undermining species-specific treatment, responsible medicine use and animal health innovation – the latter despite the paper’s argument that recent innovations had been “modest” – and warned there was no pharmacovigilance process in place for the use of human medicines in animals.
He added: “We must protect a system that balances access with safety, and which continues to serve the best interests of both pets and their owners.”
The RCVS said it supported enhanced consumer protection through mandatory practice regulation, which it is currently in discussions with Defra about, but said cascade changes were a matter for the VMD.
