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Medicines and the DTI

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THE Government made clear from the moment they were published that it was intent on implementing the Competition Commission’s recommendations on the supply of prescription-only veterinary medicines (POMs), and nothing has happened since to suggest that its position has changed. The recommendations were published in April 2003, after an inquiry lasting 18 months. The Competition Commission had found that ‘complex monopolies’ existed in the market for POMs and its recommendations, described as ‘remedies’,were intended to put that right. In February this year, the Department of Trade and Industry (DTI), which had commissioned the inquiry, published a consultation document explaining how it intended to apply the remedies and sought comments on draft legislation (VR, February 26, 2005, vol 156, p 261). The BVA and the RCVS have both responded, and have expressed concern about the details of the proposed legislation, the practical implications and the impact on animal health and welfare. However, the DTI’s consultation document served to underline its determination to apply the Competition Commission’s recommendations and, despite the validity of the profession’s concerns, it remains to be seen what effects their comments will have.

The DTI’s draft Order on the supply of POMs will depend on the new Veterinary Medicines Regulations which are currently being developed separately by the Veterinary Medicines Directorate. The Government’s intention is that the two sets of legislation should be introduced at the same time, at the end of October this year. There is a problem in developing the two sets of legislation concurrently, in that the Veterinary Medicines Regulations, which are still under discussion will fundamentally change the way veterinary medicines are defined. In particular, POMs, which were the subject of the Competition Commission’s inquiry, will mean something different under the new Regulations: this will affect not only the way the Order is drafted, but the medicines to which it will apply. As things stand, it is impossible to assess the full implications, and this can only be done properly once the Regulations are finalised.

Among the requirements in the DTI’s draft Order are that practices should make clients aware that prescriptions are available that can be dispensed elsewhere, and display, in a prominent notice, the prices of the 10 most commonly supplied POMs. The BVA and RCVS argue that, in most cases, a waiting room notice should be sufficient to make clients aware of the availability of and other policies relating to prescriptions, obviating the need for lengthy discussions in the waiting room and the increased costs that would result. At this stage, it is doubtful whether the ‘top 10’ price lists will be of much value to clients, given that, under the draft Veterinary Medicines Regulations as they stand, it would not be possible to include trade names in the lists.

The DTI’s consultation document raised the possibility that a number of the Competition Commission’s recommendations could be implemented via the RCVS Guide to Professional Conduct rather than through the proposed Order, provided this meets the desired aims. Anticipating this possibility on the basis of an initial consultation letter back in 2003, the RCVS Council approved draft advice for possible inclusion in the Guide (VR, November 8, 2003, vol 153, p 578). At a meeting last week, the RCVS Council reaffirmed its view that implementation through the Guide to Professional Conduct was the best way forward, on the basis that the recommendations could be incorporated with existing advice, and that this form of regulation was more appropriate for a self-regulating profession (see p 757).

One of the Competition Commission’s most contentious recommendations was that, for a period of three years after its recommendations were applied, veterinary surgeons should not be able to charge clients for writing a prescription. In incorporating a provision to enforce this requirement in its proposed legislation, the DTI sees it as ‘an important step to rectify the distorting effects arising from the current tendency [among veterinary surgeons] to use elevated prices for POMs to subsidise undercharging for their professional services’.At the same time, the DTI has made clear that ‘neither the Competition Commission nor the Government are saying that veterinary surgeons should not be paid for the work they do’, and suggested that the costs incurred in writing a prescription can be recovered by adding an amount to the consultation fee, provided this is done in a way which does not discriminate between clients who require a prescription and those who do not. Both the BVA and the RCVS point out that this requirement is flawed, not least because it will mean that clients who do not require a prescription or whose animal does not need medication will end up contributing to the costs. The only fair way to cover the cost of prescriptions is to charge those clients who wish to have them, and the provision should be scrapped.

The Competition Commission looked at the supply of POMs in terms of market economics and, in seeking to apply its recommendations, the Government seems to have lost sight of the wider picture in terms of animal health and welfare overall. The comments from the BVA and the RCVS can be found on their respective websites (www.bva.co.uk,www.rcvs.org.uk). It may be too much to hope for and the evidence to date is not encouraging, but it would be nice to think that, even at this late stage, a little more sense might prevail.

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