Q1 How important to your practice is How Veterinarians Use ...How Veterinarians Use Compounding...
Transcript of Q1 How important to your practice is How Veterinarians Use ...How Veterinarians Use Compounding...
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Q1Howimportanttoyourpracticeishavingaccesstocompounded
medicationswhenyoubelievetheyarenecessary?
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VeryImportant Important NeitherImportantnorUnimportant
SomewhatUnimportant NotatallImportant
Importanceofaccessto...
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Q2Somesaythatveterinariansoftendonotrealizetheyareusingacompounded
medication.Whenyouadminister,dispense,orderorprescribeamedication,
doyouknowwhenyouareusingacompoundedmedication?
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# Feelfreetosaymoreaboutyouranswer. Date
1 Anyonewhoissmartenoughtograduatefromaveterinarycollegeiscertainlysmartenoughtoknowwhenacompoundedmedicationisbeingused!
5/23/20139:54AM
2 TOSAYYOUDONOTKNOWISREDICULOUS 5/22/20133:13PM
Yes
No
Notsure
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Notsure
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3 Aretheykidding??????Dotheythinkveterinariansareignorantofthemedicationswedispensefromourpharmacyanddonotrealizewhatismanufacturedandwhatiscompounded?Theymustbepartofaspecialinterestlobby!
5/20/20138:09PM
4 Iworkwithwildlifeandordercompoundedmedicationsmoreoftenthanretailmanufacturedones. 5/20/20136:14PM
5 generalizedaspecializedrequestorreplacementforoutofstock 5/20/20139:14AM
6 Iorderthemspecifically. 5/20/20136:49AM
7 OfcourseIknowthatIamusingorprescribedacompoundedmedication!IneedtodispenseorprescribecompoundedmedicationsbecauseformulationsthatIneedarenotcommerciallyavailable.
5/19/20131:18PM
8 Ispecificallyordercompoundedmedicationsforspecific purposes.IamVERYawareofwhenIamusingacompoundedmedication.
5/19/201310:23AM
9 Ofcourseaveterinarianisawareofthemedicationbeingcompounded.Whenthemedicationisorderedfromamedicalsupplieritisobvioustheoriginofthemedication.ifthereisafor-instancewhereaveterinarianisunsureoftheoriginofmedication-orifi tiscompounded.thatprofessionalshouldnotuseit!
5/18/20137:18PM
10 Wehavespecific flavorscompoundedforourfelinepatients. 5/18/20135:29PM
11 TheVeterinarianareveryknowledgableonthemedicationsandtheformstheycomein.Itisoftenrequestedtospecialordercompoundsforspecific patients/treatments.
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12 Therearespecific combinationsthatareveryeffectiveandhavebeenperfectedviaexperience.Theyarenotavailableinanywayonthemarket.
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13 Inmyexperienceveterinarianshavebeenmoreawarethanmyphysic iansregardingcompoundedmedications. 5/18/20139:10AM
14 Iorderallmedications. 5/18/20135:21AM
15 Veterinariansaren'tignorant,ofcourseweknowwhenamedicationiscompounded.However,doesthegeneralpublic ,l ikelymanydonot-nofaultoftheirs,theysimplylackthetrainingtomakethedetermination.
5/17/201310:26PM
16 SinceIusuallyorderitcompounded,naturallyIwouldknowifi twas! 5/17/20139:44PM
17 Youmustbekidding.Ican'tpossiblythinkthatanyoneinmyprofessiondoesn'tknowiftheyareusingacompoundeddrug. 5/17/20133:45PM
18 Weusecompoundedmedicationsspecificallyfortheirformulationsandflavorssothatadministrationiseasierforownersandpets. 5/17/20132:58PM
19 OfcourseIknowifamedicationIamusingiscompoundedornot.WhenIadminister,dispense,orderorprescribeanymedicationorproduct,Iknowexactlywhatitis,whereitcamefromandwhomakesit,compoundedornot.Thisistheonlywaywe(i.e.,veterinarians)practice.Whoevercameupwiththethoughtthatwe(i.e.,veterinarians)wouldnotknowthatamedicationweareusingiscompoundedisextremelymis-informed,hassomepoliticalagenda,orisjustflat-outignorant.Whointheworldthinksthat?Yougottabekiddingme.
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20 Mostcommonusages:bromideforseizuredisorders;l iquidmedicationsfordifficult-to-dosecats;cyclosporinopthalmicprepsforkeratoconjunctivitissiccafordogs
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21 Wealwaysknowexactlywhatisacompoundedmedication,thereisnoquestioninouroffice 5/17/20139:33AM
22 Compoundedmedicationsneedtobeorderedspecifically,sothisstatementisabsurd. 5/17/20139:25AM
23 Certainconcentrationsarenotappropriateforexoticsorl ightweightanimals&mustbecompounded. 5/17/20138:53AM
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24 Whenweordercompoundedmedsweorderthemspecificallybecausetheownercannotgetthemintothepatientinpil l formorthemedicationisnotcommerciallyavailableoronbackorder.
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25 Yes,Iorderaspecific compoundedmedicationandformulationforaspecific patientanddiseaseprocess.Itistheonlymethodtogetthemedicationinsomepatientstocontroltheirdisease.
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26 MostofthecompoundedmedicationsIuseinvolvetheadditionofflavoringsorachangeintheconsistency.Forinstance,drugsthatwouldnormallybedispensedinpil l formareputinaflavoredl iquidtobegivenorally,oreveninatransdermalpreparation.Therearealotofanimalsthatsimplycannotbemedicatedusingpil lsorcapsules.
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27 Ithinkveterinariansknowwhentheyareorderingmedicationsastoiftheyarecompoundedornot. 5/16/201311:33PM
28 WheneverIorderamedicationthatiscompoundedthefirsttimeIspeakdirectlytothecompoundingPharmacist.Il iketobesurewhatisbeingcompoundedandthatitiswhatmypatientneeds.
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29 OfcourseIknowitiscompoundedbecauseIspeciallyorderitforspecific animals.Ialsotelltheowners. 5/16/20139:04PM
30 AlthoughImaynotknoweverytimeIusecompoundedmeds. 5/16/20138:32PM
31 compoundedmedicationasisdispensingacommercialmedicationeveninabottleotherthanwhatthatmedicationcamein,is"offlabel"useofthismedication.Manytimes---mostofthetimeveterinariansbuyacommercialproductinalargevolumeandthendispensepartofthisouttoanindividualpatient.Thatis,asIunderstandit,"offlabel."Iuseandordercompoundedmedicationsforthefollowingreasons:Nocommercialproductiscurrentlyavailable(thisiscomplicatedwiththeeverincreasingfrequencyofbackorders/commercialproductisunavailable,dosage/concentrationofthecommercialproductisnotappropriateforthepatient,patientcan'torwon'ttakethecommercialproductduetotaste,formofthemedication,ect.Idon'tandwil lnothaveamedicationcompoundedifthereisaviablecommercialproductavailableonthemarketthatthepatientwil laccept.Inmypractice,itisandneverwil lbeacostcuttingissuei.e.justtosavemoneyofthecostofthemedication.Ifullyrespectthemanufacturersofthecommercialmedicationsandrealizethecosttheyincurredtogettheproductapprovedandinthemarket.However,therearecircumstanceswithindividualpatientswherethereisnowaythatpatientisgoingtobeadequatelytreatedwiththecommercialproductforthereasonsIdescribedabove.Ifyouthinkthisisacopoutthenyoutrytreatinga1000poundhorsewithapasteproducttwiceadayversusapowderedcompoundedproduct.Somehorse'sjustdon'tl ikeandwil lviolentlyobjecttohavingapasteadministeredorally,yetdon'tobjecttoapowderedformofthemedicationmixedinwithfeed.Thatisbutoneexampleofwhycompoundingisbenefic ialtothehorse,theownerofthehorseandtheveterinarian.
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32 Ugh! 5/16/20134:44PM
33 Occasionallyadrugthathasbeenbackorderedisorderedfromacompounderbythestaffandthedoctorisnotnotifiedofthechangeinmanufacturerbythestaffpriortoadministration
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34 Ialwaysamfullyaware 5/16/20134:22PM
35 "Compoundedmedication",tome,representsageneric formofadrugoraspecific formulation(differentdosage,alternateform--powder,l iquid,capsule,etc.)thatisnotalreadycommerciallypreparedand/oravailable.
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36 Ispecificallycallacompounderforspecific needsthatcantbemetbyregularpharmaceuticals 5/16/20133:26PM
37 Iamfullyawareofthepedigreeofanydrugandit'soriginwhenIstockitororderitmyself.Itisonlytheoriginofmedicationsfromonlinepharmaciesthatarebeyondmycontrolorabil i tytoverify
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38 AtleastITHINKIknowwhenIamusingacompoundedmedication.PerhapsIdon'tknow.ButIrealizemostbrandnamesareNOTcompoundedandanythingformulated(especiallyl iquid,transdermal,etc)isl ikelycompounded.
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39 Wetendtousecompoundedmedicationsonlywhenthesizeormethodofdeliverydoesn'tsuittheowner,astheygenerallyaremoreexpensivethisisnotourfirstchoiceforthec lient
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40 HowintheworldcouldIprescribeacompoundedmedandnotrealizeitiscompounded?That'spreposterous! 5/16/20131:55PM
41 Weordercompoundedmedicationsfromcompoundingpharmacists,sowearealwayswell-awareofwhentheyarecompoounded. 5/16/20131:36PM
42 Iwouldsaythatitisplausiblesomestaffareoccasionallyunawarethatcertainmedicationsarecompounded,howeverveterinariansare(orshouldbe)alwaysaware.
5/16/201312:48PM
43 after9yearsofcollege,IwouldhopetoknowwhatIprescribed.(Aretheygoingtotellmethatabeurocrat700milesawayknowsandIdon't)???????.Ithinkthatoffendsme...........canIsue?
5/16/201312:35PM
44 Yes,marketdemanddictateswhethereffectivemedsaremanufacturedbylargepharmaco.Thatimpactsmyabil i tytotreatmypatients.Thankfully,compoundpharmaciesoffermeoptionsthatc learlyhaveaverypositiveonmyabil i tytocareformypatients.Further,givenmylevelofeducationandtraining,Ifinditinsultingforthegovernmenttotakea"parental"roleinthismatter.TheFDAwouldbemoreeffectiveifi tregulatedaccessofpharmaceuticalstothelaypersonwhoc learlydoesnotunderstandtheramificationsofmedstheycurrentlyhaveaccessto.
5/16/201312:24PM
45 Allmedicationsinmypracticeareprescribedanddispensedthroughtheveterinarianwithfullknowledgeoftheirsourceinc ludingcompoundedmedications.
5/16/201312:17PM
46 Ispecificallyseekoutcompoundedmedicationsforcertainpurposes.MostofthetimeIusedrugsthatarenotcompounded,duetoeasyaccesstomanycommonmedications,butfromtimetotime,thereisnotasuitablemedicationorformofthemedication,forasmalleranimal,andcompoundeddrugsbecomenecessary.Ireallydon'tseehowaveterinarianwouldnotknowthattheyareusingacompoundedmedication.
5/16/201312:16PM
47 ObviouslyIknowit'scompounded. 5/16/201312:02PM
48 Wehavemedicationscompoundedfrequentlyduetothefactthatdifferentsizepetsrequirespecific dosageamountsthatarenotreadilyavailable.Withoutthecompoundedmedicationsthesepatientswouldnotbeabletobemedicated.
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49 Ofcoursewedo.Wehavetoorderitfromaspecializedcompoundingpharmacy. 5/16/201311:45AM
50 Ihaveanexotics/avianpracticeaswellandcompoundalotofmedications. 5/16/201311:30AM
51 Astherearenotmanymedicationsapprovedforuseincats,manyofourmedicationsarecompoundedinadifferentstrengthordifferentformforeaseofadministration.Manycatsaredifficulttoadministeratabletto.Thingsl ikesmallertablets,fi lmcoatingortransdermalformsmaketreatingcatsmuchbetterfortheownerandmorehumaneforthecat.
5/16/201311:29AM
52 Alltheveterinarianinourpracticeareveryawareofthemedicationsprescribed. 5/16/201311:27AM
53 Weknowwhatweareprescribing.ThatstatementisanINSULTtoallhardworkingprofessionalveterinarians. 5/16/201311:14AM
54 IspecificallyhavetocallacompoundingpharmacytogetacompoundeddrugsoI'mnotsurewhodoesn'tknowwhentheyareusingacompoundeddrug.Thatdoesn'tmakesense.
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55 Ourmanagementstaff,technic ians,andveterinarianscommunicateaboutwhichmedsarecompounded. 5/16/201311:04AM
56 Whenmedicationsareonbackorderweknowthemedicationiscompounded.Thelabel,bottleandstrengtharealsoanimportantindicator.
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57 Ifitisorderedlegally,itisc learlylabeled...thisopinioniscompletelywrong... 5/16/201310:44AM
58 Compoundedmedicationsareacriticalpartofourpracticewhentreatingonlycats. 5/16/201310:26AM
59 Weuse2differentcompoundingpharmaciesforoursuppliesandthemedicationsarec learlylabelledwiththecompoundedpharmaciesname.You'dhavetobeanidiotnottonoticeit(mostveterinariansarenotidiots).
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60 Icannotimaginebeingstupidenoughtonotknow. 5/16/201310:20AM
61 Compoundedmedications,becausetheyarespecific totheimmediateuse,causelessstresstotheanimals. 5/16/201310:19AM
62 Iworkinseveralpractices.Compoundedmedicationsarealwaysc learlymarkedassuch. 5/16/201310:12AM
63 WeneedtobeabletogettheEXACTdosageintheformthatthepatientanimalwil ltakereadily. 5/16/20139:46AM
64 Ofcourseweknowwhenweareusingacompoundedmedication! 5/16/20139:46AM
65 Unfetteredaccesstocompoundedmedicationsenablesourveterinarianstoprovidetheverybestmedic inetoourpatientsbasedontheirindividualneeds.Animalsarenotpeople,andtheywon'tfollowdirectionsl ikeapersonwould.Theywil lnotconsumethemedicallynecessarydrugsthatweprescribeunlesstheyarehighlypalatable.Forc ingveterinarianstoonlyusethosemedicationsavailablefromlargepharmaceuticalmonopoliesintherelativelyfewdosagesandconsumableformsthattheymanufacturedamagesourpatientsabil i tytorecoverquickly.
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66 Iamflabbergastedbythestatementthatveterinariansdonotrealizetheyareusingcompoundedmedication.Ispecificallyorderincompoundedmedicationswhenneededandamfullyawareofmyuseofcompoundedmedications.
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67 Wehavetoorderitspecifically.Idon'tknowhowanybodywouldnotbeawaretheyareusingcompoundedmeds! 5/16/20139:22AM
68 WhenIneedacompoundedmedication,Ispecificallyseekoutapharmacythatisaccreditedtodosuchwork.Mostoften,Iamusingacompoundedmedicationbecausenocommerciallyacceptablealternativeexistsforthesituationfac ingmyparticularpatientandc lient.
5/16/20139:19AM
69 Honestly,youwouldhavetobeprettydensenottoknow. 5/16/20139:15AM
70 Iamusuallytheonehavingtocompoundmedicationbecauseapatientcan'torwon'ttakeit,ortheownercan'tgiveitduetotheformat.Alsohumandrugsthatwecommonlyuseareoftennotinsmallenoughdosagesizes,sothisisanecessity.
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71 BigpharmapullsdrugsbecausetheyworktoowellorthemedsaretoocosteffectiveienotenoughprofitsforPfizer.Thiscommonnonsensemuststop.Andsincenoonewil ldoanythingaboutthemonopolythatbigpharmahasonmedic ine,compoundedmedsareoneoftheonlychecksandbalanceswehaveonthisdisgustingandprofitdrivenindustry.
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72 Ineedcompoundedmedicationformyverysmallpatients-betheyChihuahua'sorsmallcats 5/16/20138:54AM
73 Ipersonallyrequestcompoundingorcompoundedmedicationsforallmypatients,soIalwaysknow! 5/16/20138:52AM
74 OfcourseIdoasdoALLVeterinarians.Whatpeoplethinkwearethatstupid? 5/16/20138:49AM
75 Ithinkitisimportanttouseapprovedproductsforthevastmajorityofmyneeds,anddoso.Ithinkitisi l legalforcompounderstomanufacturecopies(whethertheybethesameformorasimilarform)ofapproveddrugsandsellthemforlowerpricesthantheapproveddrugs.ThesecopieshavenoguaranteestoevenworkandIhaveexperiencedthemnotworkingandknowmanyothershaveaswell.
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76 Itisobviousthatyouareusingacompoundedmedic ine.Labelsarecompletelydifferentthenmanufacturedproductsandyouknowyouordereditthatway
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77 Compoundedmedicationsarerequestedforverysmallspecies(birds,pocketpets)orwhenmedicationdeliveryneedstobealtered(catsthatcan'tbepil led).
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78 Inourpractice,compoundedmedicationsareusedasalastresortandrequireresearchandorderingthroughreputablecompoundingpharmacies.Theseprescriptionsarenottypicallyorderedthroughadrugmanufacturer.Intherarecasethattheyareitisc learlydescribedwhenorderingandlabeluponreceiptthatitisacompoundeddrug.Itwouldbeextremelydifficulttoconfusethisissue.
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79 Compoundedmedicationsareorderedandlabeleddifferentlyfrommanufacturedmedications.Theyareorderedspecificallybecausethereisnotanotheroptioneitherfromadrugavailabil i tyissueoranpatientadministrationissue.(someanimalssimplycannotnotbepil ledeitheronashorttermorlongtermbasis.
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80 Compoundedmedicationsarealwaysc learlylabeledandhavetobespecificallyordered.Theyappeardifferentfrommassproducedmedicationsinalmosteveryway
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81 OfcourseIknow.IfIorderitfromacompoundingpharmacy,itiscompounded! 5/16/20138:10AM
82 IknowtheyarecompoundedbecauseIamspecificallyorderingthemfromacompoundingpharmacy. 5/16/20138:10AM
83 IamthoroughlyawareofwhichmedicationsarelabeledforthespeciesItreat,andwhichmedicationsIhavetogo"offlabel".Withthisinmind,IamalsoawareofwhichmedicationsareofflabelandaremadeindosesizesthatarenotapplicabletothespeciesItreat.
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84 Wecompoundmedsformanyreasonsinc ludingalteringpalatabil i tyandtailoringdosesmorespecificallyforapatient'sneeds. 5/16/20137:36AM
85 anymedicationthatisalteredfromitsoriginalformiscompounding,evencuttingpil ls. 5/16/20137:22AM
86 Ifwechoosetouseacompoundedmedicationwedosobecausethereisnotavailabil i tyofthenon-compoundedmedication,orweneeditinadifferentform.
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87 Ihavenoideahowaveterinariancouldnotknowthisinformation. 5/16/20137:17AM
88 Forsmallanimalpracticeitisprettyobviouswhenweusecompoundedmeds. 5/16/20137:16AM
89 Howcouldyounotknow?Seriously.... 5/16/20137:14AM
90 Idon'tknowhowIwouldnotknowitiscompoundedwhenIordereditspecificallyfromacompoundingpharmacy. 5/16/20137:12AM
91 "Donotrealize..."?thatmakesabsolutelynosense!HowcanInotrealizethatsomethingIspecialorderedfromacompoundingpharmacyisnotacompoundedmedication?
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92 Asdoctorsofveterinarymedic ine,wearefullyawarewhenweselectacompoundedmedicationforourpatients.Weinformourc lientsofthepotentialriskswitheverymedicationthatisprescribed;weperformthatdutywithcompoundedmedicationsjustaswedomedicationsfromothersources.Inthepracticeofmedic ine,weweighmultiplefactorsineveryprescribingdecisionwemake.
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93 Iwouldn'tbeusingthemiftherewasn'tashortageofavailableproprietarymedicationinappropriatedosestrengthsformypatients. 5/16/20136:53AM
94 onlyacompleteidiotwouldnotbeawareifhe/shewereusingacompoundedproduct. 5/16/20136:52AM
95 Thatc laimiswildlyinaccurate.Wehavetoorderacompoundedmedicationsfromacompoundingpharmacy.Ofcourse,weknowit'scompounded.
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96 IonlyusecompoundeddrugswhenIhavenothingcomparablealreadyavailableorinaformthepets-especiallycats-wil l take.SoIamalwayswellawareofthenatureofthemedicationIamusingorprescribingtomypatients.
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97 inexoticsitisoftendifficulttohavemedicationthatistherightdosageorstrengthfortheanimalthatrequiresimmediatetreatment-whenwritingaperscriptiontobefi l ledbyacompoundingpharmacyandhaveitsenttothepetitcantakeupto5days-bythattimethethepethasfinished1/2ofthetreatmentcourse....
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98 Wealwaystry.tousethenoncompoundedmedicationsfirstandasbestaspossible. 5/15/201310:18PM
99 Compoundinghelpswithtinypatientsforwhomtherearenomanufacturedequivalents. 5/15/20139:50PM
100 OfcourseIknow,IhaveorderedthedrugfromareputablecompoundingpharmacysuchasWedgewood 5/15/20136:55PM
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101 Especiallyusefulforcatsandsmalldogs.Iknowit'scompoundedbecauseIordereditthatway! 5/15/20133:40PM
102 wemustordercompoundedmedsspeciallyforaspecific patient,usuallywhena"brandname"medisnotavailabletofitthepatient'sneeds--therefore,itwouldbeverydifficultNOTtoknowthatthemedwascompounded
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103 OfcourseIknowwhenIprescribeanymedication,andwhereitcomesfrom,andhowitisused. 5/15/20132:42PM
104 compoundedmedsareonlyavailablefromacompoundingpharmacy 5/15/20132:28PM
105 Wecallandorderthemedicationfromacompoundingpharmacy,soifwedidn'trealizewewereusingcompoundedmedsweshouldn'tbepractic ingmedic ine!
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106 Absolutely,weusethembecausewehavenootheroptionsforourpets. 5/15/20131:53PM
107 WhenIuseacompoundingpharmacy,IassumeIamgettingacompoundedmedication. 5/15/201312:05PM
108 Werespectcompounders'labeling,andnoteitwhenadministering. 5/15/201311:53AM
109 Thisisamazingtome.Idobelievethatveterinariansknowwhenwepurchaseadrugfromasuppliervs.acompounder 5/15/201310:02AM
110 Whosaysthis?? 5/15/20139:56AM
111 Weordercompoundedmedicationseitherduetocommercialinavailabil i tyand/ortohavethecorrectdoseforthepatient. 5/15/20139:44AM
112 Weshouldalwaysknowwethercompoundedornotasweareorderingthesemedicationsfromthepharmacy,andnotchangingthemoncereceived.
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113 Weordercompoundedmedicationsfromacompoundingpharmacy.Othermedicationsareorderedfromadistributer-thedifferenceisveryc lear.
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114 IbuythemedicationsthatIknowarecompoundedbecausethatistheonlywayIcangetthemforcertainanimalsandconditions 5/15/20138:26AM
115 Ourc linic wil lprescribetoapatientmedicationthatisnotavailableforpurchasefromourdistributor.Wehavehadseveralmedicationsthathavebeenonbackorderandnotcommerciallyavailable.
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116 Wearemedicalprofessionalsthattakeanactiveroleinwhereweorderourmedications.Weknowthedifferencebetweenacompoundingpharmacyandamedicaldistributor.
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117 Itiscompletelyobviouswhenusingcompundedmedication!!!! 5/15/20138:03AM
118 Idonotseeanywaythataveterinariancouldnotknowthattheywereusingacompoundedproduct 5/15/20137:59AM
119 Ourc lientsareadvisedandtheoptionpresentedtothemforuseofacompoundeddrugwhenappropriateandrequiredforthebestmedicaloutcome.
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120 wecompoundmedicationsforeaseofadministrationanddoseingsincesomeofthesmallersizescomerciallyavaiablecannotbeaccuratlydosedoradministered
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121 Itisimportantforaveterinariantofindtheeasiestformofmedicationanownercanadministersafelytoananimal. 5/15/20137:41AM
122 Whenyouhavetocallacompoundingpharmacytoorder-youknowitiscompounded. 5/15/20137:17AM
123 Thisisridiculous!Youwouldhavetobeblindandstupidtonotknow. 5/15/20136:47AM
124 Thatstatementisidiotic ! 5/15/20136:15AM
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125 Eachmedicationonourpharmacyshelveswithinourveterinaryhospitalisstoredinitsoriginalcontainer,whetheritcomesfromapharmacy,veterinarydistributor,orcompoundingpharmacy.Theyareallc learlylabeledandeasytoread,thereforeitisnotdifficulttoquicklyfindoutifsomethinghasbeencompounded.Furthermore,ourentirehospitalanddatabaseiselectronic,inc ludingprescriptions.Eachmedicationisnamedwithdetail,andislabeledas"compounded"ifso.Lastly,wehavespecific trainedpharmacystaffthatcanansweranydoctor'sortech'squestionsaboutanymedication,aswellasaPharmacyManager.
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126 HowcanyounoteknowyouareusingacompoundedRx...ithastobeordered 5/15/20135:46AM
127 Iamalwaysawareofmedicationbeingcompounded,whetheritisanindividualorderforaparticularpatientoraninpatientproductwestockinthehospital.
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128 ThereisNOreasonwhyacompetentveterinarianwouldbe"unaware"thatheorsheisusingacompoundedmedication.Typicallytheveterinarianistheindividualwhoisrequestingthecompounding,andweworkc loselywiththoseperformingthecompoundingtomakesurethatthecorrectdose,etc.isbeingprescribed,whetherthecompoundingisbeingperformedbystaffinthehospital,orbyanoutsidepharmacy.
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129 WithoutcompoundedproductsbeingFREELYavailableasneededwithoutarbitraryrestric tionsapplied,Iwouldhaverealizedtheabsoluteabsenceofsomemedicationsduetoproprietaryproductionshutdownsofcriticalmedicationsinrecentyears.Compoundersareacriticalgapfi l lerwhenourregularmedicationsgoonshortorlongtermhiatusduetoproductiondisruptions.
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130 ItisveryobviousbecauseIamusuallyorderingit. 5/14/20139:19PM
131 Therearespecific reasonsastowhyIreachforacompoundedmedicationversusandcommerciallyavailabledrug,inc ludingtasteandformulationforeasieradministrationtoadifficultanimalandalsotohaveadifferentconcentrationthatallowsformoreaccuratedosingfortheanimalinsteadofsplittingtabletsorgivinganextremelyminuteamountthatIcannotwithconfidencesaytheanimalreceivedthemedication.
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132 Onewouldhopeaftergoingthroughasmanyyearsofschoolasveterinariansdotheywouldknowwhatmedicationstheyareusingandforwhatpurpose.Theattendingveterinarianisthemostknowledgablepartywhenitcomestodiagnosinganddispensingmedicationinwhateverformforthepatient.
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133 Whoarethese"SOME"?Iknowit'sacompoundedmedicationbecauseIspecificallytailoredadose&requestedaspecificcarrier/formofthemedandthenordereditfromtheCOMPOUNDINGpharmacy.
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134 IalwaysknowwhenthemedicationthatIuseordispensehasbeencompounded. 5/14/20138:48PM
135 intentionallyusecompoundedmedicationsbecausemypatientsaresmall(cats)andmanyofthedrugsIneedformypatientsarenotmanufacturedinthedosageformsthatIneedformypatients
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136 Ineedthesemedicationsandrelyonrespectedpharmaciestocompoundittogetthedesiredstrengthandmethodtobeabletoadministerittoananimal.
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137 Ifeell ikethisisanobviousanswer,andthequestionorratherwhatsomesayisinsulting. 5/14/20138:16PM
138 Idonotusecompoundedmedsifthereisapremadeproductavailable. 5/14/20137:57PM
139 Duh!Ihavetoorderitfromacompoundingpharmacy...! 5/14/20137:56PM
140 Iwouldthinkitextremelyunusualforaveterinariannottoknowwhentheywereusingacompoundedmedications.InfactIreallycannotimagineitatall.
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141 Thatisabsolutelyridiculoustosuggestthatwewouldnotknowthataproductwewereusingwascompounded. 5/14/20137:44PM
142 OfcourseIknow. 5/14/20137:38PM
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143 Ithinkitisobviouswhenweusecompoundeddrugs. 5/14/20137:37PM
144 Weusecompoundedmedicationsonlywhennoncompoundedmedicationsarenotavailableornotindoseorflavorswhichallowustotreatourvariedpatients.
5/14/20137:30PM
145 theavailabil i tyoftheseproductsisessentialtothehealth&wellbeingofourpatients.c l ientsalsoappreciatetheaffordabil ityfactor 5/14/20137:26PM
146 TothinkIdon'tunderstandwhatmedicationsIamprescribingispreposterousandaninsulttoveterinariansasawhole. 5/14/20137:11PM
147 Thisisaridiculousquestion-Ispecifyexplic itlyontheprescriptionthatIneedacompoundedsizeormethodofadministration.Ionlycompoundwhenmanufacturedmedswil lnotwork.
5/14/20137:00PM
148 Wespecialorderalmostallcompoundedmedicationsforeachindividualcase. 5/14/20136:21PM
149 Intheveterinaryfieldwehavepatientsthatrangefromlessthanapoundto2000poundsandmanytimestogetthemthemedic inethattheyneed,inaformthattheycantake,orwil ltake,orthattheirparentscanadministerrequiresthinkingoutsidethebox.
5/14/20136:20PM
150 Howcouldyounotknow? 5/14/20136:08PM
151 Wespecificallyordercompoundedmedicationsfromacompoundingpharmacy,usingawrittenprescription. 5/14/20135:48PM
152 Wehavemanyanimalsthatwil lonlytakecompoundedmedication,eitherbecauseofflavororownersareunabletopil l ananimal. 5/14/20134:50PM
153 Usuallyyesalthoughtheremaybeproductsthatarecompoundedthatiamnotawareof.Thecomppundedproductsthatidousearevertimportanttomypractice
5/14/20134:40PM
154 Usuallystandardpharmaceuticalcompaniesonlymakeacertainsizeanditisahumansize-withanimalstheyoftenneedasmallermgdoseandcompoundingpharmaciescancreatethatdoseforus.
5/14/20134:26PM
155 WhenIorder/dispenseacompoundedmedicationfromacompondingcompanyIknowthatithasbeencompounded! 5/14/20133:56PM
156 IdefinitelyknowsinceIorderthemfromcompoundingpharmacies!HowcouldInot? 5/14/20133:47PM
157 Thereisabsolutelynodoubtwhenaproducthasbeencompoundedratherthanpurchasedasacommerciallyavailableproduct. 5/14/20133:46PM
158 Normally,wearetheonesspecificallyorderingacompoundedmedication.Itiseasilydeterminedwhichmedicationsarecompounded.
5/14/20133:40PM
159 iknowitiscompoundedwheniorderitfromacompounder 5/14/20133:37PM
160 HowcouldaprescriberNOTknowit'scompounded??WhenIorderspecializedformulationsfromacompoundingpharmacy,Iknowthatitisnotanmedicationcarrying"FDA"approval.
5/14/20133:30PM
161 absoloutely,compoundedmedicationarespecialorderinourpractice 5/14/20133:22PM
162 SometimesImayuseacompoundedmedicationwithoutrealizingit. 5/14/20133:17PM
163 Iusuallyonlygotocompoundedmedicationforaneaseofuseissue-l ikeforsmallerdosagesordifferentformsiel iquidortransdermaltoallowc lientstoadministermedicationmorereliably.
5/14/20133:17PM
164 I'mnotsurehowyoucouldsaywedidn'tknow?Wespeaktoacompoundingpharmacytoorderthemedication. 5/14/20132:59PM
165 Wespecificallyhavemedscompoundedfortheeaseofadministrationtopetswhenotherroutesofadministrationarenotpossible. 5/14/20132:48PM
166 Allmedicationsarecompoundedsomewhere~!!!!!!! 5/14/20132:48PM
167 it'susuallymyideatoorderthecompoundeddrug 5/14/20132:27PM
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168 Weordercompoundedmedicationsforapatientbasedontheneedtocombinemedicationsforeaseinadministration,tochangethetypeofdeliverythatcanbeused(l iquidvstablet/capsule),toadjustdosesforsmallpatients,andtoprovidespecialflavoringortransdermalapplications.Eachisaspecialorder.Ofcourseweknowwhenweareusingthem.
5/14/20132:22PM
169 Verysil lytothinkwewouldnotknowthat. 5/14/20132:20PM
170 Ican'timagineanyonenotknowing.Idon'tbelievethatc laimwasmadeinearnest. 5/14/20132:19PM
171 Manytimestheveterinarianasksforspecific drugstobecompoundedtomakeaspecific medication. 5/14/20132:13PM
172 HowcouldyouNOTrealizeit! 5/14/20131:54PM
173 AcompoundingpharmacisttoldmethatT3waslevothyroxin.I'venoticedthatmanycompoundeddrugsarecountedoutofapurchasedbottlebyanemployeewhoknowslittletonothingpharmaceuticals.
5/14/20131:52PM
174 Theonlytimec lientsareevergivenacompoundedmedicationiswhenoneisscriptedbyme.Therehasneverbeenatimewhencompoundedmedicationshavebeenswitchedforregular.Iwouldnotthinkthatisevenpossible.
5/14/20131:47PM
175 Mostmedicationsneedtobereducedinstrengthforsmallanimals.Iusethistypeofmedicationonadailybasis. 5/14/20131:46PM
176 Manymedicationsmustbecompoundedduetodosingrequirementsand/orpalatabil i tyissues.Thisisofparticularconcernforourfelinepatients.
5/14/20131:41PM
177 Itismyjobandresponsibil i tytoknowaboutthemedicationsIuseforanimals. 5/14/20131:38PM
178 Somemedicationcanbeverydifficultorimpossibleforownerstoadminister,especiallyincats.Thesemedsneedtobecompoundedforexactdosageandneedtobeflavoredsotheownerwil lactuallygetthemedic ineintothepet.
5/14/20131:37PM
179 Theveterinarianordersit,obviouslyweknowitsgettingcompounded. 5/14/20131:30PM
180 Oftentimesthehumanformulationsareeithertolargeastrengthortosmallastrengthforourpatientsandwehavetohavetheproperdosecompoundedtomakeitareasonableamounttoadministertopets.
5/14/20131:27PM
181 Itisobvioustoaprofessional. 5/14/20131:25PM
182 ItismyjobasadoctortoknowwhatIprescribeformypatients. 5/14/20131:16PM
183 Wehavespecific medicationscompoundedbecausetheyarenototherwiseavailableindosessmallenoughtotreatsmallanimals 5/14/20131:07PM
184 Icallmycompoundedpharmacisttoaskforacompoundedproduct 5/14/20131:07PM
185 Iwenttoschoolfor8yearstogetaDVMdegreeandthenspentayearinuniversityinternship.TheconceptthatIwouldn'tknowwhatIwasprescribingisextremelyinsulting.Ihadanumberoffederalloanstopayformyeducation...sodoestheFederalgovernmentthinkmyeducationissoinferiorthattheywastedmoneyonit?
5/14/201312:59PM
186 IorderfromWedgewoodandknowanythingfromthereiscompounded 5/14/201312:56PM
187 Wetreatfish,birds,repti les,mammalsofallsizes,andcompoundingmakestreatmentoptionsmoreuserfriendly.Thedifferentflavorsalsomakeiteasiertotreatanimalsthatwecannotrestrainandtheyhavetotaketreatmentsvoluntary.
5/14/201312:50PM
188 Withoutquestion.Ihaveahardtimetakingseriouslysomeonewhomakessuchastatementasiscontainedinthisquestion. 5/14/201312:48PM
189 Weonlygowithcompoundedmedic ineswheneitherthecommerciallyproduceddrugisnolongeravailableorthestrengthofthedrugneedstobemadeinmuchsmallerdosesorifthec lientisunabletoeitherpil l orfeedinfood,manytimesweusetransdermaldeliverytosolvetheproblem.
5/14/201312:47PM
190 Howwouldyounotknowitwascompounded? 5/14/201312:45PM
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191 IalwaysknowwhenIamusingacompoundedmedication.Compoundedmedicationsareusuallyrequestedforeaseofc lientusetoincreasecompliance.
5/14/201312:43PM
192 Weprescribeacompoundedmedicationonlythroughacompoundingpharamacy. 5/14/201312:43PM
193 Ithinkthatisfairlyobvioustoanyeducatedveterinarian. 5/14/201312:41PM
194 Mostofthetimeatleast.Therearesti l l onesthatyoudonotrealizeunti llaterafteryouhavebeenpurchasingitforabit. 5/14/201312:38PM
195 IalwaysknowifIhaveorderedacompoundedmedicationandIknowifIamusingageneric orbrandmedicationaswell. 5/14/201312:37PM
196 Thereareseveraldrugsthatwespecialorderascompoundedtoachieveaspecific dosingrangeortoprovidetreatmentthatisnolongeravailablecommercially.
5/14/201312:37PM
197 IbelievethatIamaware. 5/14/201312:36PM
198 IamalwaysawareofwhereofthesourceofeachmedicationthatIadminister,prescribe,ordispense.Idonotseehowanythingelsewouldbethecase.
5/14/201312:34PM
199 WhenIgotoacompoundingpharmacy,IprettymuchknowI'mgettingacompoundeddrug! 5/14/201312:34PM
200 That'sthemostridiculousthingI'veeverheard! 5/14/201312:33PM
201 Iknowthatwhenadrugischangedinanywayitisconsideredcompounded. 5/14/201312:32PM
202 Weabsolutelyknow!We'reorderingfromacompoundingcompanyspecificallyduetol imitedmarketavailabil i tyandormedicationstrength.
5/14/201312:31PM
203 Ofcourseweknowwhenweareadministeringacompoundedmedication.Itisoftentoobtainadosethatisnotavailableforourpatients(asmosthumanscomeinaone-size-fitsalldosingrangeandthatiswhatpharmaceuticalcorporationsgeartowards).
5/14/201312:29PM
204 Weordercertainmedicationsfromacompoundingpharmacy,whereeverymedicationiscompounded. 5/14/201312:28PM
205 Iintendspecificallyusecompoundingmedicationtoensureproperandfulldeliveranceofmedicationtomypatient,intheirownpreferenceofformgiven.
5/14/201312:27PM
206 Allofourcompoundedmedicationsusedarespecialorder,andassuchwealwaysknowthattheyarecompounded. 5/14/201312:27PM
207 SinceIhavetocalli tintoacompoundingpharmacy,andtailorthedosage(andoftenflavor)tothepet,Iknowthatitisbeingmixeduptomyspecifications
5/14/201312:26PM
208 Veterinarymedicationrequirestreatingdifferentspeciesatverydifferentpatientsizes.InordertodosemypatientseffectivelyIneedtheabil i tytousecompoundedmedications(i.e.differentconcentrationswithdifferentflavorsandroutesofadministration,etc.).
5/14/201312:23PM
209 Weorderanddispensethemedicationsoweknowwhereitcomesfromandwhomakesit. 5/14/201312:22PM
210 Compoundedmedicationisusefulandeffectiveinourpractice. 5/14/201312:22PM
211 Yes,absolutelyalways.Sincetheycomefromadifferentsourceandneedtobeorderedseparately,I'dsayitwouldbeprettyhardtoNOTknowthemedicationiscompounded.UsingmedsatatypicalprivatepracticeisNOTlikeaphysic iansendinganordertothepharmacyofalargehospitalorevenoffsiteandhavingitfi l ledwithnoknowledgeofcompoundingornot.
5/14/201312:21PM
212 Weusecompoundedmedicationswhenthereisnoviablealternativemedicationavailablecommercially.Manyofthemedicaitonsusedinveterinarymedic inesarenotusedinthesamewayinhumanmedic ineandthereforearehardtoobtainwithoutcompounding.
5/14/201312:21PM
213 TheonlytimeIuseacompoundedmedicationisifthenormalversionistoodifficulttogive(unflavored,tabletvs.l iquid,etc). 5/14/201312:20PM
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214 Wespecificallyordercompoundedmedicationsbecausemanufacturersdonotmakethedruginthestrengththatweneed.Wealsoordercompoundedmedicationswhenwecannotgetthedrugsweneedduetomanufacturer'sbackordersorbecausethey'vestoppedmakingadrug(whichhasbeenamajorproblemforthelastfewyears!)
5/14/201312:18PM
215 Aftergraduatingfromveterinarycollege,youwouldhavetobeanidiotnottoknowthedifference. 5/14/201312:14PM
216 IpersonallyordermycompoundedmedicationsthroughareputablecompoundingpharmacyforeachpatientwhenIdonothavetheminstock,sothereforeIalwaysknowthemedicationisacompoundedone.IfIcarryitinstock,Ihavetoorderfromthesamepharmacy,soagain,Ialwaysknowwhichmedicationiscompoundedandwhichisnot.
5/14/201312:10PM
217 OfcourseIknowit'scompounded--Ispecificallyorder&prescribeitthatway! 5/14/201312:10PM
218 Weonlyrequestcompoundedmedicationifi tisnotavailablecommerciallyoronmanufacturebackorder 5/14/201312:07PM
219 manyvetsinourpracticedonotrealizewhenourpharmacyiscompoundingamedicationandbelievetheyareprescribingitasFDAapproved.thisisanimportantissuethatihavetoemphasizeroutinelywithmypeers.
5/14/201312:07PM
220 thisisridiculous.Iordertheproduct,concentration,andevenflavor.ALWAYSknowit'scompounded 5/14/201312:06PM
221 ThatisoneofthemoststupidstatementsIhaveheard.Whoorderscompoundedmedicationsfromacompoundingpharmacyanddoesnotknowitiscompounded?Really....Whoarethosepeople?
5/14/201312:05PM
222 Wealwaysknowwhenweareusingcompoundedmedication. 5/14/201312:05PM
223 Compoundingpharmacieshavetheirownlabelonbottlessoit'sprettyobviousit'sacompoundedmedication. 5/14/201312:04PM
224 Wecannotactinthecapacityofapharmacysowhenwedispenseamedicationthatiscompoundedwehavetoprovideaprescriptionforit.Wedothisoften!
5/14/201312:04PM
225 Someofthel iquidmedicationswekeepashospitalstocktodispenseinsmalleramountsaremoreobviousthansomeofthepil lswedispenseinbottles.
5/14/201312:03PM
226 GenerallywhenIuseacompoundedmedication,it'sonethatI'veorderedfromacompoundingpharmacy,eithertoreplaceanotherdrugthatisnotcommerciallyavailable,ortoprovideamorepalatableformofaneededdrug.
5/14/201312:03PM
227 Itisveryc learfromthelableifamedicaitonismanufacturedorcompounded,asaveterinarianIamveryc learlyawaretheorigenoftheproductsIusedaily
5/14/201312:01PM
228 Ispecificallyorderthem. 5/14/201312:00PM
229 HowwouldINOTknowIwasusingacompoundeddrug?Ihavetocalli tinorrequestthecompoundedmedicationspecificallyformypatient.Wearedoctors..Whichtypicallyimplieswearen'tstupid!
5/14/201311:59AM
230 SometimeswhenIbuyitfromavetpharmacy,Idon'tknowifi t'scompoundedbuttrustthem! 5/14/201311:58AM
231 Absolutely!! 5/14/201311:57AM
232 Ifyournotsure,youshouldgetyoul icensechecked. 5/14/201311:54AM
233 IalwaysknowIamusingacompoundedmedication. 5/14/201311:52AM
234 Compoundedmedsareorderedfrompharmacies,nottheusualdistributors.Theyarealwayslabeledwithapharmacylabel,identifyingthesource,strength,andformulation,amongotherdetails.
5/14/201311:51AM
235 Yadayada 5/14/201311:23AM
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Q3Howimportanttoyourpatients'healthandmedicaloutcomesisyourabilitytomaintainofficestockofcompounded
medications?Answered:1,026 Skipped:4
79.82%819
15.89%163
2.92%30
0.49%5
0.88%9
1,026
4.73
# Pleasefeelfreetosaymoreaboutyourresponse. Date
1 Thereareoftensizesofdrugsthataren'tcommerciallyavailablethatareneededtotreatsmallerpets,andcompoundingismuchmoreaccuratefordosingthanhavingtheownertryto1/4or1/8atablet.
5/23/20139:54AM
2 TOOMANYDRUGSHORTAGES 5/22/20133:13PM
3 newtohaveimmediateaccesstosomedrugsversesthedaysittakestogetthemorderedfromaremotesource 5/22/201310:16AM
4 Ihaveanimalsthataretoosmallforthecommonmedicationsandthereforewehavetocarryl iquidsowecanadministertheproperdosage.Otheranimalsareextremelydifficulttomedicateandwehavetohavedifferentwaystobeabletogetthemedicationinthepet--transdermal,l iquid,flavored.
5/22/201310:11AM
5 sometimesthereisaneedtostarttreatmentimmediately,beforethereistimeforacompoundturnaround 5/22/20139:47AM
6 Il ive/workinaveryruralarea.Itcanbethedifferencein5-7daystostartamedicationforoneofmypatients.Ineverkeepverylargeamounts,justenoughtogetpatientsstarted.
5/20/201310:02PM
Importanceofofficestock...
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
VeryImportant
Important NeitherImportantnorUnimportant
SomewhatUnimportant
NotAtAllImportant
Total AverageRating
Importanceofofficestocktopatienthealth
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7 ThereareDAILYinstanceswhereIwouldnotbeabletotreatmypatientswithoutcompoundedmedications.Eitherbecauseofsize,species,orbecausethepharmaceuticalcompaniesfinditnolongerprofitabletoMAKEsuchmedications.
5/20/20138:09PM
8 Therearesomemedications(forexampleMetronidazoleinsizessmallerthan250mg)thatwegetcompoundedandareimportanttohaveonhandbecausewetreatalotofsmalldogsthatneedquickaccesstothesemedications.
5/20/20137:35PM
9 Critical,themajorityofwhatwedo. 5/20/20136:14PM
10 Manypatientsaretoosmallforthestockstrengthofcertainmedications.Itisalsoimportanttohaveavarietyofformulas(i.e.suspensions,flavoredmedications)forpatientsthatcanbedifficulttomedicate.
5/20/20132:15PM
11 Itisessentialtoourpracticetobeabletodispensecompoundedmedications.Manyofourfelinepatientscannotbemedicatedwithpil ls,andwaiting2ormoredaysforcompoundedmedicationsisnotacceptable,andwouldbebelowthestandardofcare.
5/20/201312:57PM
12 Certainmedicationsareunavailableforanimalsatlocalpharmaciesandsomepetsneedthesemedicationsupondischargefromthehospital.
5/20/201311:22AM
13 medicationsareneededimmediately,especiallyforexoticsandhorses 5/20/20139:14AM
14 Minnesotaalreadydoesn'tallow"office"stockofcompoundedmedicaitons.Thisalreadymakesitdifficulttogetanimalstreatedpromptly.Itiscrucialthatcompoundedformsareavailableforpickycats,pickydogs,exoticsforsmallsizesandmedsnotavailablebecauseofconstantgovernmentinterferencewithmanufacturingandavailabil i tyespeciallywithinthepast2years
5/20/20137:17AM
15 OftenIneedtodispensemedicationandfeelitwouldnotbeinthepatient'sbestinteresttohavetowaitseveraldaystohavetheappropriatemedicationformulatedandshipped.
5/20/20136:49AM
16 Iuseofficestockofcompoundedmedicationseverydayinmypractice! 5/19/20131:18PM
17 Wegenerallyusecompoundedmedicationswhenthereisnotaviablealternative. 5/19/201311:37AM
18 Wearecurrentlynotallowedtostockanycompoundedmedsatourcorporatepractice.Thisaffectspatientcareandthepractice'sbottomline.
5/19/201311:14AM
19 Duetolargeweightrangeinveterinarymedic inecompoundedmedicationsareamust.Especiallywithcatsandsmalldogs.Manymedicationscannotbedosedappropriatelyintheiroriginalform.
5/19/201310:47AM
20 IworkinashelterenvironmentinColorado.Recentlegislationwil lnotallowustokeepanoffficestocknowandwemustorderperpatientwhichisdifficultwhentheanimalmaynotevensti l l betherebythetimewegetitorderedanditarrives.
5/19/201310:23AM
21 Wehavepatientswhoaredifficultorimpossibletoadministertabletsto.Compondedmedicationsgivemeanalternativetotabletswithl iquid,flavoredpreparationsandcompoundingintotastetreatsortransdermals
5/19/20137:22AM
22 Itismoreimportantforthec lientotbeabletoobtainthecompoundedmedicationsperiod.Idoalotofscriptintopharmaciestoreducetheoverheadofmypractice.Aslongasthemedicationsareavailableeveryoneishappy.
5/18/20137:18PM
23 Manyc lientsareunabletogivepil lstotheircatsandrequirel iquidthatisflavoredsothecatwil ltakeit. 5/18/20135:29PM
24 Therehavebeencasesinwhichadayortwodelayinobtainingmedicationthatisinapetusablesizewouldbequitedetrimentaltothehealthofthepet.
5/18/20133:49PM
25 Whenwehavemedicationsinstockthatgivesustheabil i tytoadministertothepatientimmediately.Whenwehavetoplaceanorderittakesafewdaysforustoreceivethem,maybeevenlongeriftheweekendinterferswithshipping.
5/18/201311:13AM
26 Compoundproductsinsmalleramountsforpetitepatients(egdewormers,antibiotics)areneededquicklyandatsafeadministrativedoses.
5/18/201310:37AM
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27 Certainmedicationsaresimplynotavailableinappropriatedoseswithoutdangerousadditivesthatcankil l pets.Thesepatientscannotalwayswaitformailorder.
5/18/20139:10AM
28 NootheroptionsareavailableorIcannotaffordtopurchaseinlargevolumeduetothesizeofmyc linic . 5/18/20135:21AM
29 Whymustourpatientswaittoreceiveeffectivetreatment?WithofficestockofcompoundedmedicationsIcanoftenresolvesymptomsandcurediseasebeforeaspecialordercanbereceivedanddispensedtothec lient-wouldn'tyouwantthatforyourself,whynotourpatients,too.
5/17/201310:26PM
30 IfitissomethingthatIwil l usetotreatahospitalizedpatientorthatIwantapatientonimmediately,naturallyIwil l wanttobeabletohaveacompoundedmedicationonpremises.Ifi tissomethingthattheownercanhaveathometotreattheirpet,Iamfinewiththemhavingitsentdirectly.
5/17/20139:44PM
31 Withoutcompoundingwewouldbeunabletoprescribemanynecessarymedicationsthatarenotavailableindosagesappropriateforverysmallpatientssuchassmalldogsandcats.
5/17/20137:41PM
32 Oftentimes,itistheonlyformofamedicationthatistolerated,orthepetownercanapplyasinthecaseoftransdermals. 5/17/20135:13PM
33 Manypatientsneedspecific sizesthatcanonlybecompoundedorspecific flavorsetcinordertoadministermedications.Insomecases,iftheownerscouldnotusetrans-dermalgelsorflavoredmedicationstheywouldelecttoeuthanizetheirpetsbecausetheycannotgivethemtheappropriatecriticalmedications.
5/17/20132:58PM
34 Manymedicationsarenolongeravailableincommercialforms.Somemedicationsarenotusedinhumanmedic ineanylongersoarenotmanufactured-wehavetogetthemcompounded.Also,nottoolongago,diazepamwasbackorderdforalmost2yearsIthink.Thismedicationisl i fe-savingforpatientshavingseizures...so,wehaditcompoundedforin-hospitaluse.
5/17/20132:03PM
35 differentstrengthsareahugethingwithuswhenwecan'tgetthemfromregulardistributors 5/17/201310:46AM
36 Oftenpetsneedthesemedsthatday,Notin2-3days,responsecanbecritical.Itisdifficulttomanagehospitalizedpatientswithoutmedsavailable
5/17/201310:29AM
37 Itreatexotic petsandcompoundingismandatoryforattainingtheirdrugdosages. 5/17/20137:38AM
38 Weoftenneedtostartamedicationimmediatelywhenadiagnosisismade. 5/17/20137:29AM
39 Themostcommonin--stockcompoundedmedicationweuseisacompoundedearmedication.Weuseitacoupleoftimesaweek,atleast.Wealsousecompoundedbuprenorphineineverycatsurgicalprocedureandasananalgesiaforcats.Wecannotgetthisimportantmedicationinaformthatisn'tcompounded.Ifwedidn'thaveit,wewouldnotbeabletoprovidepainreliefforcats.
5/17/20137:23AM
40 Weoftenneedliquidsorflavoredmedicationforeaseofadministration. 5/17/20136:44AM
41 Manyanimalsneedimmediatetreatmentandcannotwaitformedstobeordered.However,duetotheirsizeortemperament,theyoftenrequirecompoundedmeds.
5/17/20136:30AM
42 Exotics,felines,etcoftenrequirespecialformulations,dosages,administrationmethodstoeffectivelytreatthem.Thesearen'thumansthatcanswallowapil l .Thedifficultyinadministeringmedicationstocertainanimalsandthetinydosesrequiredforsomemakecompoundingcriticaltopractice.Ibelieveitshouldbeuptothedoctortodecidethebestoptionsfortheirpatient.
5/16/201311:33PM
43 IhaveahousecallpracticesoIdonotcarryanycompoundedstockmedication.Ihaveallcompoundedmedicationseitherpickedupbytheownerfromthelocalpharmacyorhaveitdelivereddirectlytothec lient.
5/16/20139:58PM
44 Weareanavian,exotic (repti le,pocketpets,etc)practiceandmanyofourmedsneedtobecompoundedinpartduetooursmallpatientweight.
5/16/20138:32PM
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45 Asa"primaryhealthcareveterinarian"Ineedtohaveal imitedsupplyofmedicationsinstocktostartapatientonthemedicationsthatareappropriateforthemedicalconditionsbeingtreated.Idon't"stockpile"medicationsofanymedications.Inthisageofquickdeliveryandcommunicationl,Ihavenoneedto"stockpile"medications.Asasolopractitionerandowneroftheveterinaryc linic ,keepinginventoryataminimumisvital.Irealizetherearepricebreaksfororderingin"bulk"butthissavingrarelyifeverpaysoffforhavingtopayal ittlebitlessforamuchlargeramountofinventoryandthenhavethatinventorysetontheshelf.Thepracticehastopayforthemedicationsorderedupfront,ifi tsitsontheinventoryshelfverylongthatismoneythatisn'tearningthepracticemoneyandthe"discount"ofbuyinginbulkquicklygoesoutthewindowandturnsintheoppositedirectioninthattheinventoryisnowcostingthepracticemoney.
5/16/20136:54PM
46 Manyanimalswouldnotreceivethetreatmenttheyneedifi twerenotforcompoundedmedications. 5/16/20136:14PM
47 TherehavebeenseveraldrugsthatweuseregularlythatarenolongeravailablebecauseCompanyAboughtCompanyB,andCompanyAdecidedthatDrugXwasn'tprofitableenoughtocontinueproduction.Wealsousecompoundeddrugswhenbackordersituationsarise,orwhenweneedtodoseverysmallpatientssuchastoybreeddogsorexotic petsandcommerciallyavailablepreparationscannoteasilybetitratedforthesmallerpets
5/16/20135:41PM
48 If1/2kgyorkieneeds7.5mgFlagyl,trytodividethe250mgtablet!!!! 5/16/20135:29PM
49 Somepatientsneedtobestartedonmedicationimmediately,andcannotwaitunti lthedrugcanbecompoundedforthem.Havingthesemedicationsonhandallowsustotreatthepatientimmediatelywhennecessary.
5/16/20134:44PM
50 Trulyessential-oftenamatterofl i feanddeath,nottomentionownerconvenience 5/16/20134:28PM
51 Clientshardlyeverfi l l outprescriptionsandwhentheydoitishardlyeveronatimelymanner.Mostconditionsseeninveterinarymedic ineareemergencyanddelayoftreatmentcanmeanfatalityorworseoutcome
5/16/20134:25PM
52 Manymedicationsarenotinasizeorformulationneededforourtiniestpatientsandcompoundedmedicationsareabsolutelynecessaryandl ife-saving
5/16/20134:22PM
53 Theoption(andavailabil i ty)tousecompoundedmedicationstotailormypatient'smedicalmanagementforthebestpossibleoutcomeisextremelyimportant.Drugprotocolsshouldbetailoredtoapatient'sneedsnotadjustedtowhatiscommerciallyavailableandmanufacturedbylargedrugcompanies.
5/16/20134:20PM
54 Itisanessentialpartofmytreatmenttopatients 5/16/20133:26PM
55 becauseoftheverywiderangeofbodyweightanddosingrequirementsbetweenspeciesifthereisnotanappropriatesizeavailable,somepatientsmayhavetowait3-7daysbeforetheirmedicationarrives,andinmanycasesthisdelaycouldbefatal
5/16/20133:12PM
56 Obviouselyallofourpatients'healthandmedicaloutcomesareveryimportant,however,Idonotl iketocarrymedicationsthatcanoutdateeasily.Also,itismoreconvenienttoorderonan"asneeded"basis.Itiseasierforinventoryaswell.
5/16/20133:01PM
57 Havingofficestockcompoundedmedicationsforin-houseuseforhospitalizedandsurgerypatientsandleave-ineartreatmentsallowsustokeepoverheadlow(essentialforc lientsinthiseconomicc limate)yetprovidequalitymedic ine.
5/16/20132:48PM
58 thingsl ikecompoundedmetronidazoleintoal iquidareamustforcatsandtowaitanddispenseinafewdayswhentheindividualmedicationisreceivedisoftentolate,orconverselyownersmaynevergivethemedication
5/16/20132:32PM
59 Somemedicationswehavecompoundedinformsthatareunavailableandsomebecausetheyareunavailablebyotheravenuesinanyform,soitisofparamountimportance.
5/16/20131:36PM
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60 Theproblemsti l l existsthatinmanyifnotmostcases,weareforcedtousecertainformsofcompoundedmedicationstoprovidethesafestdosingorformulationforsmallordebil itatedpatients.Theresimplyaren'tenoughapprovedorappropriatechoicestosupplysuchawiderangeofsizesandbreeddifferenceswiththeoptimalcarewithoutcompoundedmeds.Ifwehadtoindividuallyprescribecompoundedmedstoeachcase,wewouldoftenneedtocompromisecarewhilewaitingforshipmentofmanyoftheseimportantformulations.ESPECIALLYimportantisthiscasewhendoctorsseeexotic patients(asIdo)wherethereareoftenNOchoicesofapprovedmedicationsavailableandtheirconditioncandetiorateinamatterof12to24hourswithoutappropriatecompoundedmedicationsavailableinc linic .
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61 Weusecompoundedmedicationsmostoftenbecauseitmakeseitherdosingorapplicationeasierfortheowner.It'snotterriblycommonforusandwewouldsurvivewithoutit.ThoughIhaveconfidencethatthemedicationswedogetcompoundedwouldnotberestric ted.
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62 Ijustthrowmudonthewalltoseewhatsticks.Don'treallycareifthepatientgetswell.#$@!%)(*??? 5/16/201312:35PM
63 Somemedicationsarenotcommerciallyavailableinsmallenoughconcentrationsorinaformthatiseasyforac lienttoadministertotheirpet.Example:amedicationmaybeonlyintabletform,butanownercan'tpil l theircatandneedsal iquid.
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64 Sourcesofneededmedicationsareoftencompromisedbyavailabil i ty.Compoundingsourcesareofprimeimportanceforthecontinuedappropriatecareofmypatients.
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65 Ihaveatleast2patientsthatwil lonlytaketheirmedicationifi tisgivenasaflavoredtablet(whichmustbecompounded).Foroneoftheseanimals,thisisal i feordeathsituation,fortheother,thelackofthedrugwouldgreatlyimpactherqualityofl i fe.Becauseclientsoftenarenotabletoinformus2weeksormoreaheadoftimewhentheyrunoutofamedication,itisimperativethatIbeabletokeepcertaincompoundedmedicationsonhandallthetime.
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66 Theyaredogsandcats.Theyoftenwon'ttakeitinhumanpil l form.WENEEDTHISOPTION. 5/16/201311:53AM
67 Somemedicationsforinhospitalusearenotavailablethroughothervenues. 5/16/201311:45AM
68 Iusealotofcompoundedmetronidazoleinmyc linic foruseinbirds,repti les,andsmalldogs,cats,andothersmallmammals. 5/16/201311:30AM
69 Manysickcatscannotwaitseveraldaysforcompoundedmedicationstoarriveatthehospital.Theyneedimmediatetreatmenttoassureabetteroutcome.
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70 Itallowsustostarttreatmentrightaway.Somedrugsarealsousedinemergencysituationsanditiscriticaltohavethemonhandatthepractice.
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71 Wehavemanypatients,especiallycats,whoseownersareunabletogivethemcertainmedicationsinanoralform.Acompoundedtransdermalmedicationgreatlyimprovescompliance.
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72 Therearetoomanydrugsthatgoonbackorderwithnootheralternatives,nottomentionmostdrugsweusearehumandrugssosmallanimalsthatcouldbenefitfromthosedrugswouldgetleftoutwithoutcompounding.
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73 Wedesperatelyneedthesmallercompoundsforpatientsthatcannotreceivetheoverthecounterstrengthsorthepil lsandneedliquidsortransdermals.
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74 Wehavetohaveaccesstoinjectableapomorphineandbuprinorphinetomaintainourstandardofcare. 5/16/201310:43AM
75 Somepatients/casesneedthemedic ineASAPandcouldsufferfromthedelayittakestogetthemedic inecompounded.Manyclientsrunoutofamedic ineANDTHENcometotheoffice.Havingtothencompounditmeansthepatientmissesadoseortwo.
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76 Whenweareworkingwithcats,lessthan10%ofthemedicationsweuseareapprovedforuseincats.Theonlywaythatwecantreatthesepatientsistomaintainastockofcompoundedmedicationstotreatthecatwhentheyaresick-notwaiting48-96hoursforamedicationtoarrive.Catsaregreatathidingdiseaseandbythetimetheyareseentheyareusuallyquitesickandneedtherapyimmediately
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77 Clientsdonotwanttowait2-5daystorec ieveamedicationwehavedeterminedtheyneedtoday.Patientsshouldnotbeforcedtoneedlesslysufferwhilewaitingforamedicationtobepreparedandshipped.
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78 Theavailabil i tyandthecostofpetcarewouldbechangedramatically.Weneedtobeabletouseourmedicaljudgement. 5/16/201310:20AM
79 Havingofficestockincreasesownercomplianceandinturnthewellbeingoftheanimals. 5/16/201310:19AM
80 Veterinarypatients'medicationsaredosedbyweightandeaseofadministrationmustalsobeconsidered.Becauseofthehugevarianceinpatientsize,itisnecessarytohaveoptionsforgivingappropriatedoses.Palatabil i tyisalsoamajorconcern.
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81 WeneedtohavetheEXACTdosageandmedic ineinstocksothatwemaydispenseimmediately. 5/16/20139:46AM
82 Itreatmanysmallmammals,birdsandrepti les.Icouldnotmedicatethemwithoutaccesstocompoundedmedications. 5/16/20139:37AM
83 Lifeordeathformanypatientsattheendstagesoftheirl i fe,especiallywhentheyareunwill ingtoconsumeformsofdrugsthatarenothighlypalatable.
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84 Withoutanofficestockofcompoundedmedications,patients'healthwouldsufferandbeatriskduetounavailabil i tyofimmediateaccessofnecessarymedications.Forcertainsituations,anydelayorchangeintreatmentthatwouldbecausedbynothavingmedicationonhandcouldevenbel ifethreatening.
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85 Althoughthecompoundingpharmacyweusecangetmedicationstoac lientwithinadayortwo,certainconditionswarrantstartingthemonmedicationimmediately.Ifapethasbloodydiarrheatheownerwil lnotwanttowaitafewdays!
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86 Irarelystockcompoundedmedications.Iuti l izecompoundingforveryspecific situationsandhavingcompoundedmedicationonmyshelveswouldbeunlikelytobeanymorebenefic ialtomethancommerciallyavailableproducts.Thebenefitwithcompoundingisfoundinmyabil i tytoworkwiththepharmacytofitthespecific needsofmypatients.
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87 unabletogetanyformofdoxycyclinewithoutcompounding.ThenewrulesmakeitVERYdifficulttotreatmyheartwormpatientseffectively.
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88 Idon'tneedthemallthetime,butwhenIneedthem,weREALLYneedthemtobeavailable. 5/16/20139:00AM
89 Usually,weordercompoundingforaspecific patientbutourmost-usedcompoundeddrugismetronidazoletinytabs.Itwouldbeveryhardtopracticegoodmedic inewithoutbeingabletoprescribetheseonthespotforcatsandsmalldogs,asthereisnocommerciallyavailablealternativeandtheseareurgent-needcases.
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90 Usemanycompoundeddrugs 5/16/20138:49AM
91 IfIamgoingtohavesomethingcompounded,IwantittobeforjusttheanimalorgroupofanimalsIamtreating.ThereareveryfewdrugsthataretrulyunavailableandIwouldneedtohaveonhandintheoffice.NearlyallhaveapprovedhumanformsofthedrugthateitherIcanuseorshouldbeusedbythecompoundertomakewhatIorder.
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92 Manyproductsareeitherunavailableortooexpensiveinthecommercialmarket.Treatingsmallindividualsorunapprovedspeciesisimpossiblewithoutcompounding
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93 duetolawsthatdoprotectsafety,westric tlyusealocalcompoundingpharmacy.thelossinproductionisworththesafety/efficacyoftheproducts.compoundedmedicationshelpmeincreasec lientcompliance,anddoseoursmallerpatients.
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94 Orderresponsetimeisusuallyshortenoughtoaccomodatepatientneeds. 5/16/20138:37AM
95 Thisisespeciallyimportantnowthatsomanyprescriptionmedicationsareonindefinitebackorder.Consistenttreatmentwiththecorrectionmedicationisessentialtoameaningfuloutcome.
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96 Orderingcompoundedmedicationsiscriticaltoprovidingtreatmenttoourpatients.Withtheendlessdrugrecalls,longtermbackordersandunreasonablepriceincreases,wecouldsimplycouldnottreatmanyofourpatientsforthediseasestheyhaveifi twerenotforcompoundeddrug.Wewouldfarpreferdrugsbemoreavailablefromthedrugmanufacturers.Mostcompoundedmedicationscostmore,haveashortershelfl i feandarefarmoreinconvenienttoorderanddispense.Weusethembecausewehavetoinprovidingahighlevelofcareandcomforttoourpatients.
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97 Antibioticsandpainmedicationsforsmalleranimalsandexoticsare,manytimes,notavailableinthecorrectdosages.Itisimperativethatwebeabletoprovidepainmanagementanddiseasemanagementtothesepatientsinthesamewaywedoforourlargerpatients.
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98 Iwouldaskthecommitteelookingintothislegislationtospendanhouratashelterandtrytogive6randomcatsacommerciallypreparedpil l ,eitherdirectlyorhiddeninfood.Itwil l quicklybecomec learthatthisisalmostimpossibleformostcats,andmanydogs.Equallytrytakingahumansizedpil l andbreakitinto1/6thssothesizeisappropriate,ortrygivingacata"cherryflavored"children'sversionofadrug.Allwil l beveryunsuccessful.Withoutproperlyprepared,readilyavailablecompoundeddrugs,manycatsanddogswouldsufferthroughil lnesswithfewalternatives.
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99 Therearemedicationsthatcanonlybeobtainedviacompoundingthatarecriticaltosuccessfultreatment.Andthosemedicationsareoftenneededimmediately.
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100 IordercompoundedmedicationswhenIamunabletopurchasethecommercialpreparationduetoavailabil i ty. 5/16/20138:10AM
101 Thereare5-7compoundedmedicationsIcanthinkofinstantlythatareessentialtoappropriatepracticeofmedic ineinmyc linic .Throughtheyearsastheseregulationshavebeengettingmoreandmorestric t,Ihavetriedtofindalternatives.Thereissimplynotenougheconomicdrivefordrugcompaniestomakethesemedicationsspecificallyforveterinaryuse.Mypatientswil lNOTsufferbecauseoflackofeconomicdriveifthereisanythingatallIcandoaboutit.
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102 Oftentimesweorderthecompoundedmedicationonaspecific needbasis-notmuchinhousestock. 5/16/20137:51AM
103 Itisveryimportantforustobeabletomaintaincompoundedmedicationstoensurewehavecorrectdosesforpatients-especiallysmalleranimalsthataredifficulttodosewithtypicalpil l strengths.Also,catsoftenrequirecompoundedmedicationsforbetterpalatabil i ty.
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104 Especiallynowthatoureconomyhasforcedsmallerpharmaceuticalcompaniestoc losetheirdoorsandthathasseverelyl imitedouraccesstoalotofthedrugsweuseeveryday.
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105 Manypeoplecannotseemtoplanaheadfarenoughtoaskforthemedicationtobecompoundedforthemsowekeepasmallbackuptobereadywhentheycall
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106 Namebranddrugsupplyisoftenaffectedforavarietyofreasons.Backlogsoccurtoelevatetheprice,fromaninabil ityofacompanytoacquirerawmaterialsandwhenaplantisshutdownbyauthoritiesforviolationstonameonlyafew.
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107 Mostarenotstockedandspecialorderedasneededbutthereareaselectfewmedic iationsthatneedtobeinthehospitaltouseimmediatelywhenneeded.
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108 couldnotdosemostdogswithoutsomeformofcompounding 5/16/20137:22AM
109 Crucialactually. 5/16/20137:21AM
110 Therearenumerousconditionsinhorsesthatareveryseriousandtimesensitiveandrequiremedicationthatwecanonlygetcompoundedinauseableform.Takingthisawaywouldcauseirreparableharmtothosepatients.
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111 Weneedtobeabletotreatpetsthedaytheyareexamined-thisiswhywealsostockourownpharmacy.ThisisespeciallyimportantwhenmedicationssuchasDoxycyclinegoonbackorder.Additionally,compoundedmedicationscanbeflavored,whichcanhelpthepetownermedicatethepetinasafermanner.
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112 Twothings,One,somemedicationsareonlyavailableascompoundeddrugsdependingonshutdownsandbackorders,andtwosomedosagesthatarecriticaltovetsarenotmadecommercially.
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113 Weusuallyorderthemedicationsasneededbecausethepracticeownerdoesn'tl iketokeepabigstockofthingsincasethey'reshortdated.
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114 Withrecentproblemswithmanufacturersitisoftentheonlywaytoobtainthemostefficaciousmedications. 5/16/20137:13AM
115 Weusecompoundedmedicationswhenthereisnothingelseonthemarkettotreatoutpatients'problems.Takingawaytheabil i tyororderthesemedicationstakesawayourabil i tytotreatourpatients'diseases.
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116 Asaveterinarian,itiscriticallyimportantthatcompoundedmedicationsareavailableandin-stockinoffice&onourambulatoryvehic lesinordertobeginimmediatetreatment.In-stockaccesstocompoundedmedicationisavitalcomponentinmitigatingthediseaseprocess;withouttheabil i tytohavecompoundedmedicationsin-stock,ourpatientswouldsufferunnecessarypainandpotentiallydisablingorfataloutcomesiftherewasadelayintheavailabil i tyofcompoundedmedic ine.Tostateitc learly-Ourabil itytopracticeveterinarymedic ineinthebestinterestoftheanimalandc lientisfundamentallycompromisedwhenwearelimitedinourabil i tytokeepcompoundedmedicationsin-stock.
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117 WithouttheuseofcompoundedmedicationsIwouldnotbeabletoprescribemedicationsthathavebeentakenoffthemarketinhumanmedic inebutisverybenefic ialtoourpets.OftentimesIcangetcompoundedmedicationsatalowerpricethanIcanbuythemforandresale.Inveterinarymedic inethisisveryimportantbecauseitallowsmyc lientstotreattheirpetsatanaffordablecost.
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118 Especiallysomemedicationssuchaspotassiumphosphatewhichcanmeanlifeordeathforsomediabetic ketoacidosispatients. 5/16/20136:53AM
119 withmoreandmoreproductsnolongercommerciallyavailable,thecompoundpharmacistisourlastandbesthopefortreatingourpatients.ifoneofthesedouchebagsenatorshadalovedonewhoselifedependedonmedicationthatwasonlyavailableviacompoundingthey(thesenate)wouldstopthiswitchhunt!!!IDIOTS!!!!
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120 Whencommercialdrugsareonbackorder(whichisextremelyfrequent)compoundedversionsareouronlyoption. 5/16/20136:42AM
121 Easyofmedicationacceptanceisagreatpartofthereasonforusingcompoundedmedications.Catsdonotdowelltakingnonliquifiedmedicationsaswealsoseerisksofcapsulesandpil lsbecominglodgedintheesophaguscausingnecrosisofthesevitaltissues.Horsesalsobenefitfromcompoundedmedicationsprimarilyforacceptanceandcomplianceofadministeringthemedications.
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122 Idoalotofexotic petsandcatswhicharedifficulti fnotimpossibletogiveoralmedicationssocompoundedmedsarerequiredsincetherearenomanufacturedtransdermalsandfewliquids
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123 Idon'tfeelallcompoundedmedicationsneedtobeinstock.However,Idofeeltherearesomepreparationsthatarehighlybenefic ialtohaveimmediateaccess.
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124 Manyofthecompoundedmedicationsweusearetomakethempalatabletorhethepetorgivetheownertheabil i tytoactuallymedicatethepet
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125 Especiallyforcats,forwhomnoncompoundedmedicationsareoftennotwellaccepted. 5/15/20136:53PM
126 It'smuchmoreconvenienttomaintaininventoryofcompoundedmeds,butusuallyoktoprescribethemindividually. 5/15/20136:41PM
127 IfwedonotcarrytheRx,theownermaynottakethetimetopickitupatanotherlocation,riskingthepatientshealth.IftheRxwouldbemailedtotheowner,thepatientshealthmaybeatriskduetoadelayinstartingaRx.
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128 Formostcompoundedmedication,Itrytoprescribeitfor1patient.Insomec ircumstancesIneedtohavecompoundedmedicationontheshelftouseimmediately.Thepatientdoesnothavetimetowait5-7daysforaprescriptiontoarrivebymail.AlsomanymedicationshavebecomebackorderedandunavailablefromtheregularmanufacturersandIneedcompundingpharmaciestofi l linthegapunti ltheregularmedicationbecomesavailableagain.
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129 Theabil i tytobeginimmediatetreatmentisoftenvitaltopatientoutcomeespeciallybecausec lientstendtodelaypresentationunti lthepatientisserioustocritical.
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130 Manymedicationsarenotmadeatstrengthssuitableforsmalleranimals-thehumanequivalentistoobig.Also,formanyc lients,compoundedmedicationsaretheonlywaytheycanaffordtomedicatetheiranimalswithcertainmedications.
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131 Whencatsneedmeds,Iwanttobeabletosendaneasilyadministered,ietransdermalcompounded,Rxhomethatday.Givingavomitingcatapil l isuseless.Theycan'twait2-3daysforamedtobecompoundedandsenttothemtobetreated.Theyusuallyhavealreadybeensickfor2-3daysbeforeanexam.
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132 wedonotusuallymaintainstockofcompoundedmedsunlessthereisamanufacturer'sbackorder-otherwise,ourcompoundedmedsaremadeupforspecific c lientsandtheirpetsandthereforearenotkeptasstockonourshelves
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133 Compoundingcantakeseveraldaystobemadeandshippedandinsomeinstancesthepatientneedscertainmedicationsasap. 5/15/20133:07PM
134 Itrynottostockcompoundedmedsandonlyuseprescriptionsforspecific animalsasIhavebeenleadtobelievethatistheLEGALwaytodo.ITwouldbeaverybigenhancementstomyc lientstobeabletogetthemedicationatthesametimeastheirappointment.
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135 TherearedosagestrengthsIuseregularlyforacuteconditions(can'twaitforshipment)thatarenotavailablecomercially 5/15/20132:28PM
136 Wetypicallydonotstockcompoundedpreparations.Weprefertohavethepharmacycompoundforeachpatientindividually. 5/15/20132:13PM
137 Weneedoptionsinveterinarymedic ine.Notallanimalswil ltoleratepil lsorcapsules.Andsomemedicationsarenotavailableinthelowerdoseswemayneed.
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138 Itisextremelyimportantespeciallywithalltherecallsandshortsuppliesofmedications,ifi tweren'tforcompoundingpharmaciesourpatientscouldn'tgetthemedicationtheyrequireforhealingthereforewouldsufferwithouttreatment.WealsoseeexoticsandthisisourONLYoptionusuallyduetosmalldosingandpalatabli l i ty.WecouldNOTtreatourexoticsifwedidnothavethisanoptionthereforenoonewouldbringthemintobcthereisnothingwecando!Thisseemsridiculoustomethatouranimalsmayhavetosufferbcoftheseproposedlaws.
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139 Somemedicationsaresometimesnotavailableduetomanufacturerordistributorbackorders,butaresti l l criticaltoourpatientsneeds
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140 Particularlywithophthalmic,neonatalandseptic patientsIstandagoodchanceoflosingtheeyeorthepatientwhilewewaitfordrugstoarrive.Iwisheverycongressmanhadtolooksomeoneintheeyeandsay"wecouldhavesavedyoureyeorfoalbutwecouldn'tgetthemedic inefastenough"!
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141 Weareveterinarianswith100%mobileequinepractice,andstockedproductsonthetruckhavebeenthestandardinourtypeofpracticeforoversixtyyears.
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142 Compoundedstrengthsandformulationsareessentialineverydaypractice.Someofourpatientsaretoosmalltotakeafullstrengthadultformofadrugandbreakingthepil l orcapsuleisnotpossibleandcanresultinanimalsbeingunderdosedoroverdosed.Catsoftencannotbemedicatedorallyandthatcanresultinthembeinguntreatedorownersgettinginjured.Transdermalpreparationsareessentialintheseanimals.
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143 Wehavesomepatientsthatsimplycannottakeamedicationanyotherway.Beingableto'hide'amedicationinsideaspeciallyflavoredtabletorl iquidisinvaluable.
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144 Iusehomedeliverypharmaciesratherthanmaintainingapharmaceuticalinventory. 5/15/201311:23AM
145 Someownersareunabletoadministerpil lstotheirpetsandneedmedicationformulatedintoatastyl iquid,chew,ortransdermal.Somepetsaretoosmallandrequirecompoundedmedications.Thesepetswouldnotreceivethemedicationtheyneedwithoutacompoundingpharmacy.
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146 Catsareverydifficulttomedicate.Compoundeddrugscanbemadetotastebetterorbesmallerinsize.Withoutthemmanycatscouldnotbemedicatedathome.
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147 IwasundertheimpressionthatIamnotlegallyallowedtomaintainofficestockandsoprescribeforeachpatientindividually,butitwouldbeniceforthec lienttonothavetowaitifIamabletodothis.Insomeinstancesitisveryinconvenientandaltersspeedofrecoveryortreatmentsuccess.
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148 Oftenmedicationsinstockstrengthsaretoostrongforoursmallerpatients. 5/15/20139:56AM
149 Weoftenneedmetronidazoleinl iquidformforsmallpatientswithdiarrhea.Otherwise,smallpatientssometimeshavetowaitwhenproductisshippedtothemorifcompoundingpharmacyisc losedoverweekend.
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150 Theimportanceisfargreaterthanimagined,especiallywhenthedrugisnotavailablethroughdistributors.Oftenprescribingacompoundedmedicationisnottimelyenoughforsomemedications,anddelayisl i fethreateningastheownerwaitsforthemedtobecompoundedandthenshipped(sometimesseveraldays)Ifi tisonourshelfwecanprescribeitinatimelymanner,,,
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151 Abil itytocontrolpainanddiseaseinanimalsisoftenchallengingaswecanbewithoutlabelusemedicationsforongoingcareorgettingtoproperdosingintervalfortinypatients.
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152 Exotic animalsandsmallpets(<15lbs)oftenrequiredosesofmedicationsthatarewellbelowstandardmgstrengths.Additionally,someanimals(exoticsandsomecats)areimpossibletomedicatewithpil lsandrequirel iquidmedicationsforsuccessfultreatment.
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153 Acertainamountofveterinarydrugscanonlybeobtainedthrucompoundingandthesedrugsareimportantforourpatients'health...withoutcompoundeddrugswewouldbel imitedinthewaywetreatourc lients'petstothedetrimenttoourc lientsandtheiranimalcompanions.
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154 It'smoreimportanttometobeabletoorderacompoundedmedicationasneededthanitistokeepitinstockinhospital 5/15/20138:20AM
155 Havingmedicationavailabletoprescribeanddespensequicklyisimportant.Havingthismedicationalsosimplifiesthedespensingofthemedicationwhenwehaveit.Themorerestric tions,paperworkandrequirementsfororderingcompoundedmedicationsonlydelaystreatmentofthepatients!
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156 ManymedicationsthatareFDAapprovedforhumanuseareusedextra-labelbytheveterinaryprofession.Manyofthesemedicationsareverydifficulttoadministertosomespeciesbasedonsizeoftheanimalorthedifficultyinadministeringduetotaste.Thecompoundedmedicationshavebeenal ifesaverfortheveterinaryprofessional.
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157 Manydrugsneedtobeformulatedforourdifferentpatientsizesinasmallanimalpractice.Standardpil l sizesoftencannotbedosedsmallenoughforminature/pocketpatients.
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158 Someofourpatientsaredowntotheirlastresortinmanagingthespecific conditionforwhichthecompoundeddrugisprescribed. 5/15/20137:51AM
159 Weareanemergencyhospital.Weseepatientsofallshapesandsizes24-7.Ifapatientcomesinforanemergencyat11pmonaFridaynightandneedsacertainmedicationinacompoundedform,itmightbe3or4daysbeforethey'reabletogetthatmedicationfromacompoundingpharmacy.Byhavingsomeinstock,wecangivethemasmallsupplytogetstartedunti lafullprescriptioncanbecompoundedbyanoutsidecompoundingpharmacy.
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160 withoutthisoptionwewouldbeunabletotreatmanypetsthattheownersareunabletogiveapil l ortabletto.Alotofcomerciallyavailablemedicationscanbedifficulttoquarterandaccuratlyaddministerandalotofthemarebittermakingadministrationmoredifficult
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161 Somanyinstancesapatientneedsamedicationnowasapposedtowaitingforaspecialordertocome. 5/15/20137:41AM
162 Monthsofamedicationsbackordercanhaveseriousconsequencestoapatient'shealth. 5/15/20137:17AM
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163 IfIdon'thavethemedicationsonhand,itcanpotentiallytake1-3daystogetthemedications.Indealingwithexotics,oftentheydon'thavethatmuchtime.Ifyoudon'ttreatimmediately,theywil ldie.
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164 Therehavebeensomanydrugrecallsandshortagesinthepastfewyears,thatwithoutbeingabletoobtaincompoundedmedicationswewouldhavebeenseverelyhamperedinourabil i tytopracticeveterinarymedic ine.
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165 Criticalinmanycases.OftenacompoundedformistheONLYwaytogetapatienttotakeal ife-savingmedication. 5/15/20136:21AM
166 Itisvitaltobeabletoproperlydoseourpatients.Thedosagesofmanymedicationsaretoohighortoolowforveterinarypatients.Compoundingisessential.Ifthepharmaciescan'tdothrirjob,we'l l havetogobacktodoingitourselves.
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167 ThenumberofscenariosinwhichIusecompoundedmedicationisendless!Catsaresomeofthemostdifficulttomedicateforowners.Havingmedicationcompoundedintoaflavoredl iquidispriceless!
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168 WithregardtoRxingcompoundedmedications,Idon'tkeeptheminstock.Rather,IdispensethemedicationorsupplementandprovideawrittenRxforthec lientstotaketothelocalcompoundingpharmacy,
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169 Wemaintainanextensiveexoticsspecialtyarea,andmanyofthemtypicallyneedsomesortofcompoundedmedication(antibiotics,anti-inflammatories,etc).Eachdifferentspeciesmetabolizeseachdrugdifferently,sohavingthefreedomtocalculateeachdosageappropriatelyanddispensetherightamounteachtime,helpsusserveboththepatientandthec lient.
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170 CRITIVALTherearemanypetsthatwouldnotbetreatedifwecouldnotprovidemedicationinaformthattheownercouldbesuccessfulatadministering.
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171 Whentreatingexotic speciesandveryoldorfractiouscats,itisessential. 5/15/20135:29AM
172 Ifthemedicationdoesn'tgetintothepatientasprescribedduetodifficultyofadministration,thereisnochanceofsuccess. 5/15/20135:26AM
173 Weseepatientsonadailybasiswhowouldbeunabletobemedicated(mainlycats)withouttheuseofcompoundedmedications. 5/15/20135:19AM
174 Withsuddendrugshortages,itcouldmeanlifeordeath,successorfailurewhentreatingdisease,protectinghumanandanimalhealth.
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175 Usediagnostic compoundsinstock(ACTHgel) 5/14/201310:03PM
176 Thereisrarelyadrugstrengthavailablethatcanbeusedforexotics.Weneedtohavecompoundeddrugsonhand.Wecan'twaittoorderwhileanimalisindistress.
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177 Weareafelinespecti l i typracticeandorpatientsoftenwouldnotgetbetterifwecannotstarttheircompoundedmedsasap. 5/14/20139:57PM
178 Manyofmypatientsaregeriatric horseswhoseownerscannotaffordtheproprietarydrugs,buthavingsafeandeffectivecompoundedoptionsallowthemtocarefortheirretiredanimalswithintheirbudgets.Also,thegeriatric animaloftenbecomeshardertomanagewithoutcreativeflavorsandformsofmedicationbecauseoftheirreducedappetiteandfinickybehaviors.
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179 SometimessuppliersareonbackorderandtheonlyaccessIhaveiscompounded. 5/14/20139:19PM
180 Manytimesofficestockofcertainmedicationsmeanstheanimalcanstarttreatmentwhennecessary,nothavetowaitunti lshipmentsarrive,whichcouldbeseveraldaysdepending.
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181 Itcantake1ormoredaystoreceivecompoundedmedicationforaspecific patient,sohavingthemedonhandtodispenseisbetterforthepatientifi t'sverynecessarytogetthemedicationstartedASAP--iemetronidazolebeingacommonone
5/14/20138:52PM
182 ManyofthemedsthatIusearenotavailablefromanon-compoundingpharmacy. 5/14/20138:48PM
183 havingtowaitdaysfororhavingtoovernightanessentialcompoundedmedicationcouldriskapatientssuccessfultreatmentandwilldefinitelyaddtothecostoftreatmentforthatptient
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184 Ver,Veryimportant.Weneedtohavethisreadiltavailableforourpatients. 5/14/20138:17PM
185 Therearemanydifferentbodysizesofanimalsandmanufacturesdonotalwaysprovedapil l orsizetofitwhatIneed,soIhavetogetitmade.
5/14/20138:16PM
186 weneedapomorphinetogetpetstovomit 5/14/20138:05PM
187 HavingSustainedreleasebuprenorphineforpainreliefiscriticaltohaveonhand!Youcan'thavepeoplegopickitup!Especiallyafterthecompoundingpharmacyhasc losed!
5/14/20137:56PM
188 Some,l ikeapomorphineareusedinemergencysituationsandthereisnottimetogetadosecompoundedspecificallyforthatpatient.
5/14/20137:47PM
189 Mostoftenwhenweneedacompoundeddrugweshouldnotwait2or3daystostartit.Weshouldbeabletostockitandkeepgoodrecordsincaseofproblems.
5/14/20137:37PM
190 Mostmedicationsthatrequirecompoundingareneededonshortnotice.Ihavebecomeaccustomedtoprescribinganinitialamounttotesttheabil i tyofafamilytoadministerandusethemedicationandcanthenscriptoutalargeramountforthepatienttoreceivetotheirhome.
5/14/20137:11PM
191 TherearemedicationsthatIcannotgetinanappropriatesizeormethodofadministrationexceptbycompounding. 5/14/20137:00PM
192 Therearemanymedicationsthatdon'tcomeinanappropriatesize(ieMetronidazoleforsmallcats)thatIl iketokeepinstock. 5/14/20136:38PM
193 ManypetswouldotherwisenottakemedicationifwecouldnotgetacompoundedVersion 5/14/20136:21PM
194 Asabove...manypetsalsostressveryeasilywhichcanbedetrimentaltotheirhealth,,sohavingtheproperdoseofmedicationinapalatableformortransdermalformistheonlywaytheycangetthetreatmenttheyneed.
5/14/20136:20PM
195 Someofthemedicationsweusearejustnotavailableinsizesorstrengthsthatweneedforour.smallpatients 5/14/20136:09PM
196 IscriptoutalmostallmymedicationsbecauseIammobileanddon'thaveroomtocarrystock. 5/14/20136:08PM
197 Ifwedonothavethemedicationneededinstock,treatmentisdelayedunti lthec lientoruscanreceivethemedication. 5/14/20135:51PM
198 Manyofmypatientsareminorspecies(egbirds),andhavingaccesstocompoundedmedicationsisvitalfortheirhealth,asthedrugsarenotreadilyavailableotherwise.
5/14/20135:49PM
199 Inthepastyearseveralmedicationshavebeendiscontinuedorbecomeunavailable.thesehavebeenmedicationsthatareessentialtoourpracticesuchasopthalmicmedications,andcertainantibiotics,orinjectableanti-inflammatorymedications.
5/14/20135:48PM
200 Foralotofpetsinourpracticeweneedtokeepmedicationonhandforthesize&dosageofourpatients 5/14/20135:00PM
201 Frequently,havingcompoundedmedicationsonhandcanmeanthedifferencebetweenapatientl ivinganddying.Iseeonlycatsandveryoftendosagestrengthsorformsavailablearenotappropriateformypatients.Painmedicationsarealsooftennotavailableinappropriatestrengthsordosages,particularlyforanesthesiause.Withoutcompoundedmedication,Iwouldnotbeabletopracticetoashighofastandardorassafely.
5/14/20134:55PM
202 ManymedicationsarenotavailableinthesizesorformulationsneededtotreatthemanyspeciesandsizesofanimalsIseeeveryday.Compoundedmedic inesarearealblessingtomypatientsandreallyimprovepatientcareandoutcomes.
5/14/20134:27PM
203 Again,oftenweneedasmallerdosagesizeandhaveitmadeinaformthatistolerablefortheanimalssuchasaorall iquidinanappetizingflavor
5/14/20134:26PM
204 Forverysmallpatients,weoftencannotgettheappropriatesizemedicationthroughtraditionalpharmacies.Itisalsoverybenefic ialtohavetheoptionofflavoredmedicationavailabletoensureownercompliance.
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205 Compoundsallowourveterinarianstostartpatientsonamedicationappropriateforthemimmediately.Withsomuchvarianceinneededdosages,compoundedmedicationmakesiteasytoprescribemedicationtomultiplepatientsregardlessofweight.
5/14/20134:04PM
206 Clientcomplianceisdefinitelyincreasedandthereforeimprovedpatientcare. 5/14/20134:02PM
207 Manymedicationsarenotavailable(orthepricehasskyrocketedtowhereitwouldbeimpossibletodispense)throughcommercialmarketsiedoxycyclineforonemajorexample.
5/14/20133:56PM
208 Beingabletoadministermedicationsinaformthatpetswil ltoleratetakingisvitaltothesuccessofourtreatmentplans.Thisisespeciallyimportantwhenyouaretalkingaboutamedicationthepetwil lneedtotakefortherestoftheirl i fe.
5/14/20133:49PM
209 Illpatientsneedtobetreatedpromptly.Adelayofseveraldayscouldprovefatal,especiallyinexotic species. 5/14/20133:46PM
210 IhaveMANYpatientsthatrelyoncompoundedmedicationstosimplymaintaintheirl i fe! 5/14/20133:41PM
211 somemedicationsareonlyobtainedthroughcompounders 5/14/20133:37PM
212 ThisisWAYbeyondjustconvenience.Weusecompoundedformulasforacutesituationsthatcannotwaiteven24hoursformedicationtobereceived.
5/14/20133:30PM
213 Especiallywhenthepharmaceutic companiespulloutneededdrugsforunknownreasons. 5/14/20133:27PM
214 Therearesomedrugsthatareverydifficulttoadministerorallytocatsandbeingabletohavethemcompoundedtoeitherl iquidorgelpensmakethemmucheasierforc lientstouse.
5/14/20133:21PM
215 Therearedefinitelyl i feanddeathsituationswherestartingthemedicationthesamedayiscriticaltohavingapositiveoutcome.Waitingtogetstartedonmedicationbecauseitmustbemailedisoftenunacceptable.
5/14/20133:17PM
216 Weseecats,dogsandexotics.Weneedtobeabletostockcompoundedmedicationsinavarietyofstrengthstoaccommodatesmallexoticsl ikehamstersaswellaslargedogs.
5/14/20133:17PM
217 Becausethepharmacyweusehassuchrapidresponseandweareasmallc l inic ,IdonotroutinelystockcompoundedproductsalthoughIdothinkitisimportantthatIhavethatoption
5/14/20133:04PM
218 ThereareinstanceswhereweneedtodispenseamedicationNOW.Theanimalcannotwaitthe1or2daysrequiredforthepharmacisttocompoundthemedicationthatwemaintain.Themedicationsweuseroutinelyarenotalwaysavailableinadosagereadilyuseableforapetthesizeofacat.
5/14/20132:59PM
219 Occasionallyback-ordersofvitalmedicationsoccurandwhenthereiseithernosubstitute,orthesubstituteisprohibitivelyexpensive,compoundedmedicationscanmakeal ifeordeathdifferencewithpeople'spets.
5/14/20132:59PM
220 needtostarttreatmentasap 5/14/20132:50PM
221 Someanimalsareverydifficulti fnotimpossibletomedicateandusingcompoundedmedicationscangreatlyaffecttheabil i tytoadministerthesemedications.Computedmedicationsgiveustheabil i tytousealternativewhenthetraditionalrouteisimpossible.Compoundingisessentialinveterinarymedic ine.
5/14/20132:42PM
222 Hospitalizedpatientsoftenrequiremedicationsinformsotherthanwhatareprovidedfromthedistributorswhichmeansoftentimesusingcompoundedmedications.Vomitingpatientsrequireinjectablemedication,felinepatientswhoaredifficultpatientstoorallymedicatebenefitfrommedicaltherapyviatransdermalapplicationofmedications.
5/14/20132:37PM
223 veterinarypatientsarenotalwayseasytomedicateandtheycomeinawiderangeofsizesandspecies.Itiscriticaltohavecompoundeddrugsavailableforthesedifferentneeds.
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224 Importantduringtimesofsignificantbackorderorunavailabil i tyofadrugweneed...l ikerecentlywhenPrednisolonecouldn'tbefoundforcats.Wehadsomecompoundedinasmallamountsowecouldsend10-15pil lshomewithapatientatatimewhenneeded.
5/14/20132:22PM
225 Manycommerciallyavailablemedicationscomeindosagesthataretoolargeforthesmallerveterinarypatientsandinformsthatcannotbesplit.Havingcompoundedmedicationsmakesitpossibletomedicatethesesmallpatients.
5/14/20132:18PM
226 Currently,thereisalmostalwaysadrugwhichbecomesunavailableduetomanufacturerback-order,butisvitaltoourpatients.Orinthecaseofcats,althoughcantakeahuman-equivalentdrug,youcannotmakethedosesmallenoughtoappropriatelytreatsuchasmallbody.Inthatcase,compoundingisagainvitaltotreatingourpatients.
5/14/20132:09PM
227 Ownersappreciatehavingthemedicationonhandtotreatasickpetimmediately.Wecangivethefirstdoseintheofficetostartcareimmediately.
5/14/20131:46PM
228 Asafelineonlypracticecompoundedmedicationsareveryimportanttomypatients.Theeasiertreatmentisathomethebettercompliancewhichmaymeanthedifferenceofl ivingorbeingputtosleep.
5/14/20131:43PM
229 Itisindispensable.Particularlyforsmalldogs,catsandexotic patients.WithoutcompoundingIcouldnot,inanymeasureoftheword,effectivelytreatmypatients.
5/14/20131:41PM
230 Ican'ttreatverysmallanimalsquicklywithoutastockofcompoundedmedications,forexample50mgmetronidazoletablets.Isimplycannotwithholdtreatmentfordayswaitingonacompoundingpharmacisttobeavailabletomakeanimportantdrugforapet.
5/14/20131:39PM
231 Withouttheabil i tytoprescribecompoundedmedications,therearemanyanimals(catsinparticular)whowouldnotbesuccessfullytreatedbecauseavailablemedicationsareunsuitableforonereasonoranother.
5/14/20131:38PM
232 Somecompanionanimalswouldbeleftwithoutpropermedications/dosingfortheirsizeandneeds. 5/14/20131:36PM
233 oftenIwil l usethecompoundedmedic ineoninhospitalpatients. 5/14/20131:35PM
234 If 5/14/20131:27PM
235 VeryImportantforeaseofmedicating 5/14/20131:27PM
236 Duetothesignificantaboutofback-ordersthattakeplace,wesometimesdonothaveachoicetousesomethingotherthancompoundedmedications
5/14/20131:26PM
237 Toomanyofournecessarydrugsgoonbackorder,orareatthewrongstrength. 5/14/20131:25PM
238 Compoundeddrugsareimperativetomypractice 5/14/20131:22PM
239 Ittakestoolongtoorderdrugsindividuallyfori l l pets,especiallyiftheycomeinonaFriday.Nothavingthedrugsalreadyavailableandmeanthedifferencebetweenlifeanddeath.
5/14/20131:13PM
240 Certainmedicationsareonlyavailabletousasacompoundedmedications.Additionally,certainpetscannottakemedsintheir"traditional"formi.e.,pil lssuspensions,etc.Ifweareunabletoobtaincompoundedmedicationswewouldnotbeabletosuccessfullytreattheseanimals.Alos,manymedicationsarenotmanufacturedindosesthatcanbeusedforsmallanimals
5/14/20131:11PM
241 Therearetimeswhenwecannotgetmedicationsneededforpatientsinthestrengthsthatweneededorintheformsthatareuser-friendlyforourpatients.Compoundingallowsussomeversati l i tyinpatientcompliance.
5/14/20131:10PM
242 Iusecompoundedmedicationsinalargeanimalshelter.TheprimarymedicationwehavecompoundedatthistimeisdoxycyclinewhichistheONLYmedicationthatcurrentlytreatsthemycoplasmarespiratoryinfectionweareencounteringinourcats.Withoutthecompoundedliquiddoxycyclinewewouldbeeuthanizingthesecatsinsteadoftreatingandplac ingthemforadoption.
5/14/20131:07PM
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243 TowaitforcompoundingwhenIneedaproductimmediatelyisridiculous. 5/14/20131:07PM
244 Ipracticeexclusivelyoncatsandsmallexotic mammals.Drugformatsthatarelabeledforthesespeciesareprettyl imited,andinaddition,humanorcaninemedicationsusedoff-labelinthesespeciesoftenareunpalatableorunacceptabletothesespeciesandmustbedividedintosuchtinydosesthatdosingwithnon-compoundedmedicationsisimpracticalandpotentiallyunsafe.
5/14/201312:59PM
245 Mostofthetime,wecanordercompoundedmedsforourpatients,butsometimeshavingtheminhospitalmeansthedifferencebetweenlifeanddeath.
5/14/201312:58PM
246 Idispensealotoftransdermalmedicationsetctocatswhoareotherwisenoteasytomedicate.Thishassavedmanyl ives 5/14/201312:56PM
247 Manymedicationshavebeenbackorderedwhicharevitaltoanimalwellnessandareverymuchneeded,withoutthecompoundedmedicationwewouldnotbeabletotreatsomecaseswhichcouldbedevestatingtousasac linic aswellasourc lients.
5/14/201312:54PM
248 Itallowsustogetsmallerdosesofsomemedicationsthataresometimesneededforsomeofourexotic patients.Italsoallowsustousemedicationsthatarenotavailableotherwise.
5/14/201312:53PM
249 Therearetimes,especiallywiththeunavailabil i tyofcertainmedicationsthatweneedtotreatahospitalizedpatientnow. 5/14/201312:53PM
250 Foranumberofmypatients,it'sthedifferencebetweencomplianceandasuccessfuloutcomeversusnon-complianceandanunsuccessfuloutcome.
5/14/201312:48PM
251 IworkinanER&referralpractice.Exotic patients,criticalpatientsandpatientswithuncommondiseasesoftenrequirecompoundedmedicationsduetotherelativelylackingveterinaryformularyavailable.Havingcompoundedmedicationsregularlyavailableimprovespatientoutcome,ismoreconvenientforownersandoftensavesl ivesforlessmoney.IwouldsaythatcompoundedmedsareaNECESSITYforpropercare.Injectableapomorphineisaperfectexampleofacompoundedmedthatsavesl ivesand$1000sforowners.
5/14/201312:48PM
252 Weseemanypocketpetsandferrets,repti les.Havingasuspensioninthefrigereadytodispensecanmeanlifeordeathtothesesmallcritters.Ifwehavetowaittohavethedrugmadeupandthenshippedtousmanyofthemwoulddieastheownersaren'talwaysabletodeterminetheyarereallysickinatimelyfashion.
5/14/201312:47PM
253 Weareveryactiveincontinuingeducationandtryveryhardtomakethemostcurrenttreatmentmodalitiesavailabletoourpatients.Frequentlynewertreatmentprotocolsuti l izemedicationsthatarenotreadilyavailable,especiallyinanimalfriendlyformulations,throughothermeans.
5/14/201312:46PM
254 Many"human"medicationsweuseforcatsandsmalldogsarenotavailableinaformthatcanbereducedtoasmallenoughdosagethatwecandispense.Inaddition,manycatswil lnoteasilytakeoralmedicationinatabletform,sohavingtheabil i tytohavemedicationscompoundedincreasespetownersabil i tytogivemedicationandinthelongrun,savespetl ivesthroughcompliance.
5/14/201312:46PM
255 Somedrugsneedtobekeptonhandforimmediateuse,suchasanalgesics,anti-nauseadrugs,appetitestimulants,etc.--thatcan'twaitadayortwoorthreetobereceivedfromanoutsidesource.
5/14/201312:45PM
256 Manypetownershavedifficultygivingmedicationsincertainformsandwecompoundtomakesureourpatientsaregettingthecorrectdose.Withoutcompoundingourc lientcompliancewoulddecreaseandputourpatient'shealthatrisk.
5/14/201312:43PM
257 Manyofthecompoundedmedicationsweuseareneededatthatverymoment.Thepatientcannotwait1-2daystostartthemedication.
5/14/201312:43PM
258 Therearemanyoccasionswherethequalityofcaretoourpatientswouldbedramaticallycompromisedifwedonothavetheabil i tytohavein-stockcompoundedmedicationsimmediatelyavailableforourpatients.Nottomentionthefinancialimpactitwouldhaveonourpractice&thepetownerifwehadtoordereachtimeapatientneededamedicationratherthantakingfromourofficestock.
5/14/201312:41PM
259 Someownersareunabletomedicatetheirpetwithouttheuniqueflavorsorshapesofthecompoundedmedications. 5/14/201312:39PM
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260 Withmedicationsconstantlygoingoutofproductionandonbackordertheveterinaryfieldneedsasolutionforwhenthatoccurs. 5/14/201312:38PM
261 Theabil i tytostockandusecompoundedmedicationisvitaltothedailypracticeofveterinarymedic ine.Therearemanyinstanceswhenanamebrandorgeneric medicationisonback-orderornotavailablebecausetheproductisnotmadeanymore.Intheseinstancesitisabsolutelycriticaltohavethecompoundedmedication.Alsotherearetimeswhenavailablemedicationsarenotavailableinadosageorformthatworksforourverysmallpatientssoweasveterinariansusecompoundedmedications.
5/14/201312:37PM
262 Compoundedmedicationisoftenputintoaformthatwil linsurethattheanimalactuallygetsthemedicationinthecorrectdosage.Thisobviouslygreatlyimpactsthesuccessofoutcome.
5/14/201312:34PM
263 Especiallywiththeincrediblenumberofdrugshortages,ifwehavetorelyonFDAapprovalforcompounding,it'l l throwusbacktothedarkagesofveterinarymedic ine.Wereallymusthaveaccesstothesedrugsevenwhennotcommerciallyavailable.Faceit,i fwereallyscrewup,wewil lbel iable.Althoughouractionsmightnotbestric tlyregulated,wewil lcertainlybecontrolledbymarketandlegalforces.Idonotthinkthemajorityofveterinariansabuseormis-usecompoundeddrugs.Wearetrainedinpharmacologyandweuseourexpertiseeverydaytodecidedwhatanimalswil lbenefitfromwhatdrugs.
5/14/201312:34PM
264 Somemedicationsneedstobestartedimmediatelyforthewellbeingofthepatientandarenotcommerciallyavailable. 5/14/201312:33PM
265 Cats&dogsofdifferingsizesoftenneedmedic inesinformulationsordosesthatarenotmetbyeitherAnimalHealthdivisionsorthehumanhealthdivisionsofpharmaceuticalcompanies.Plus,thispastyearhasseenmanyextremelyimportantdrugsbecomeunavailable.Ifveterinarianscouldnotobtainthesedrugsfromcompoundingpharmacies,manyofourpatientswoulddie.Ihopenevertohavetoexplaintomyc lientsthattheirpethashadtodiefromaoutrageous&stupidregulation
5/14/201312:32PM
266 Ikeepal imitedstockofdrugsbuttheabil i tytokeepdrugsandcompoundthemispriceless. 5/14/201312:32PM
267 Whenthereareshortagesordiscontinuatrionsofmedication,itcanmakeahugedifferenceinqualityofl i feforourpatientswhetherornotwecangetthosemedscompounded.
5/14/201312:28PM
268 Medicatingsomepetswouldbevirtuallyimpossiblewithoutcompoundedmedications.Iftheywerenotavailable,thesepetswouldnotreceivethetreatmenttheyneedtol ivehealthyqualityl ives.
5/14/201312:27PM
269 wecallinwhatweneed,sinceIammoreworriedaboutpreparedcompoundsgoingoutofdatebeforebeingusedformostthings 5/14/201312:26PM
270 Veterinarymedicationrequirestreatingdifferentspeciesandverydifferentpatientsizes.InordertodosemypatientseffectivelyIneedtheabil i tytousecompoundedmedications(i.e.differentconcentrationswithdifferentflavorsandroutesofadministration,etc.).
5/14/201312:23PM
271 Whenweneedamedicationforapatient,weneedittoday,notinaweek. 5/14/201312:22PM
272 Compoundedmedicationthatisnotontheshelfandavailableforanemergencysituationisuseless. 5/14/201312:22PM
273 DuetothenatureofsomebreedscompoundedmedicationsistheonlywayIcantreatsomepatients.Theirsuccessoftreatmentisduetothefactthatcompoundedmedicationswereavailable.
5/14/201312:22PM
274 Patientspecific prescribingdelaystreatment.Themedicationswekeeponhandtendtobe1)ophthalmicpreparations,2)medicationsreformulatedfordosingsmallerpatients[ie-l iquidmetronidazoleasthecommerciallyavailablepil lscan'tbecutintosmallenoughpiecesforsmallpatients)or3)hormonalpreps(DES;topicalmethamazole).Forsomeoftheseconditions,especiallyhormonalandophthalmic,the2-3daydelayinstartingtreatmentcansignificantlyimpacttreatmentsuccess&outcome.Theabil i tytostock&immediatelydispensethesemedicationsnotonlyisinthebestinterestofourpatientsbutalsoincreasesc lientconfidenceinourpractice&product.Afterall,howwouldyoufeelifyouoryourchildweresickandyouweretoldbyyourphysic ian,"Ihavetheperfectmedicationbut,sorry,you'regoingtohavetowait3-4daystostarttreatmentbecauseI'mnotallowedtostockthisinmypractice."I'mguessingyou'dbeprettyupset.
5/14/201312:21PM
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275 Compoundedmedicationsverycommonlymeanthedifferencebetweensuccessandfailureinourmedicalcases.Withoutthem,wewouldstruggletomanagecertaindiseasessuccessfullysuchasdryeyeorfungalkeratitis.
5/14/201312:21PM
276 ThemostcommoncauseIusecompoundedmedsisforcats,whocanbeverydifficulttoorallymedicate. 5/14/201312:20PM
277 Weneedtomaintainthestockofdrugsinourpracticebecausethehealthofourpatientsdependsonit.Withthenumbersofbackordereddrugstoday,wecan'tjustorderfromournormaldistributers.
5/14/201312:18PM
278 Anythingwecandototreatormaintainthehealthofourc lient'spetsisveryimportant. 5/14/201312:14PM
279 COMMERCIALLYPRODUCEDMEDICATIONSGOONBACKORDERORARENOTAVAILABLEDUETOMANUFACTURERSDELAYWENEEDTOBEABLETOPROVIDETHESEMEDICATIONSTOTREATDISEASEESPECIALLYIFTHEONLYMEDICATIONSAVAILABLEARECOMPOUNDED
5/14/201312:14PM
280 Iuselocalcompoundingpharmaciesformypatient'sspecialmedicationneedsandhavethemselldirectlytothec lient. 5/14/201312:14PM
281 Iworkatauniversityandhavenosayinwhatdrugstheycarry 5/14/201312:12PM
282 Therearemanymedicationsthatarenotavailableforhumans,thatareimportanttothehealthandmedicaloutcomeofcompanionanimals.Weneedtohaveeffic ientaccesstothesedrugsorwearel imitingourqualityofveterinarymedic ine.
5/14/201312:10PM
283 Weabsolutelyrelyoncompoundedmedicationsmore&more,becauseofthefrequentunavailabil i tyfrommanufacturersoftheprescriptiondrugsourpatientsrequire.
5/14/201312:10PM
284 wecanalmostalwaysfindanappropriatewaytomedicateapatientwithoutusingcompoundedmeds. 5/14/201312:07PM
285 Exotic animalshidesymptoms.Theypresentoftenveryi l l andneedimmediatetreatmentandhospitalization.Wecannotwaitforthesemedstobemadeandsent...especiallyonweekends.Compoundedmedsforemergencyusageisessential
5/14/201312:06PM
286 Oftenpatientsneedtreatmentimmediately.Waitingunti lthenextdayorlongerforacompoundingpharmacytopreparethemedicationcanbethedifferenceinlongerhospitalstays,longertreatmenttimes,additionaladjunctivetherapies,etc.whichincreasescoststoc lient.Inthemostseverecasesitcouldleadtopoorpatientoutcome.
5/14/201312:06PM
287 Wedon'tnow. 5/14/201312:06PM
288 Allcompoundingpharmaciesarec losedonweekend.Animalsgetsickeverydayandthesedrugsneedtodosedcorrectly 5/14/201312:06PM
289 Oftentimesmedicationisgivenopportunisticallysoifi t'snotinthehospitalatthattime,theanimalmaynotreceivethemedication 5/14/201312:04PM
290 Oftentimes,thereareurgentoremergentsituationswherehavingthemedication(eitherinl iquidformoradifferentconcentration)onhandtodispensetotheownertostartimmediatelyisimportant.Waitingforthemedicationtobeshippedtotheowner,orforadaytimepracticetoopen&compoundthemedication,couldmakethesituationordiseaseworse.
5/14/201312:03PM
291 manylifesavingandcriticalmedicationsarenotmanufacturedforanimals,andasaveterinarianIrelydailyoftheuseofcompoundedmedications
5/14/201312:01PM
292 Therearemanytimeswhendrugsareonbackorderfromoursuppliers(happeningmoreandmore!)andwehaveapetwalkinthatdesperatelyneedsamedlikemetronidazole,whichwasonbackorderfortabs,butthecompoundershaditinl iquid,andbecausewehadastock,couldtreattheanimal.Otherwiseweareupacreek.
5/14/201312:00PM
293 Idon'tusecompoundedmedsinoffice.Theyhavetobeprescribedtoaspecific patient. 5/14/201311:59AM
294 Themaincompoundeddrugsthatweusearebecausetheoriginaldrugisnolongeravailable 5/14/201311:59AM
HowVeterinariansUseCompoundingPharmacy
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295 Outsidepharmacieshavenoveterinarytraining.WhenIdoscriptoutdrugs,thescriptsareoftenmis-fi l ledandinappropriatesubstitutionsaremade....Substitutionsthatwouldbefineforahuman(egnaproxenformeloxicam)butaredevastingandpotentiallydeadlyforadog.
5/14/201311:57AM
296 Somecasesshouldnotwaitthe5-10daysittakesforustoorderamedication,thepharmacytocompounditandforthec lienttofinallyreceiveit.
5/14/201311:54AM
297 Ourpracticeworkswithalargevarietyofwildlifespecies.Theseanimalsdon'tgenerallyacceptdog/catpreparationsofcommonmedications.Compoundingallowsustoorderaformulationthatwil lallowhands-offadministrationtotheanimalandflavoringoptionstoincreasecompliance.
5/14/201311:53AM
298 Especiallywhentreatingcats/smallpatients;speciallypreparedotic medicationsusedforcomplicatedearinfections. 5/14/201311:51AM
299 InVirginia,wearenotallowedtokeepofficestockofcompoundedmedications;Iwishwecould. 5/14/201311:51AM
300 Yadayada 5/14/201311:23AM
HowVeterinariansUseCompoundingPharmacy
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8.37% 86
33.17% 341
4.96% 51
Q4Howfrequentlydoanyveterinariansinyourpracticeprescribeorusecompoundedmedications?
Answered:1,028 Skipped:2
Oncedaily
Severaltimesdaily
Onceperweek
Severaltimesperweek
Oncepermonth
Severaltimespermonth
Onceperyear
Severaltimesperyear
Never
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Oncedaily
Severaltimesdaily
Onceperweek
HowVeterinariansUseCompoundingPharmacy
33/89
32.20% 331
2.63% 27
16.73% 172
0.19% 2
1.75% 18
0.00% 0
Total 1,028
Severaltimesperweek
Oncepermonth
Severaltimespermonth
Onceperyear
Severaltimesperyear
Never
HowVeterinariansUseCompoundingPharmacy
34/89
6.82% 68
50.95% 508
28.08% 280
7.32% 73
6.82% 68
Q5Howfrequentlydoyoudispensecompoundedmedicationstoananimal
ownerfromyourofficestock?Answered:997 Skipped:33
Total 997
Always
Frequently
Occasionally
Rarely
Never
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Always
Frequently
Occasionally
Rarely
Never
HowVeterinariansUseCompoundingPharmacy
35/89
1.50% 15
16.85% 168
20.16% 201
24.07% 240
37.41% 373
Q6Howfrequentlydoyoucompoundmedicationsinyourpracticeinsteadof
obtainingthemfromapharmacy?Answered:997 Skipped:33
Total 997
Always
Frequently
Occasionally
Rarely
Never
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Always
Frequently
Occasionally
Rarely
Never
HowVeterinariansUseCompoundingPharmacy
36/89
7.11% 71
54.01% 539
27.66% 276
5.81% 58
5.41% 54
Q7Howfrequentlydoyouordercompoundedmedicationsforofficestockthatyoulateradministertoapatient?
Answered:998 Skipped:32
Total 998
Always
Frequently
Occasionally
Rarely
Never
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Always
Frequently
Occasionally
Rarely
Never
HowVeterinariansUseCompoundingPharmacy
37/89
12.68% 126
59.05% 587
23.14% 230
3.92% 39
1.21% 12
Q8Howfrequentlydoanyveterinariansinyourofficeprescribecompoundedmedicationsforaspecificpatientby
name?Answered:994 Skipped:36
Total 994
Always
Frequently
Occasionally
Rarely
Never
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Always
Frequently
Occasionally
Rarely
Never
HowVeterinariansUseCompoundingPharmacy
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40.42% 403
18.56% 185
41.02% 409
Q9Doesthestateinwhichyoupracticerequirepatient-specificprescriptionsfor
compoundedmedications?Answered:997 Skipped:33
Total 997
# Pleasefeelfreetosaymoreaboutyourresponse. Date
1 Thereareonlyacouplecompoundedmedicationsweuseregularlythroughthec linic ,butweusethemonanalmostdailybasis.Wehaveothermedicationscompoundedforspecific patientswhoneedacertainsize,ortheyneedtobeaflavoredl iquidorchewtogetthepettotakethem.
5/23/20139:59AM
2 IdowhatIhavetodototreatthepatient. 5/22/201310:12AM
3 Justrecentlyweweretoldthatwhenprescribingcompoundeddrugthattheyneedtobeorderedspecificallyforthatpatient.Myunderstandingisthatwecangivepatientscompoundeddrugsinhospital,butcannotbedispensedunlessorderedspecificallyforthatpatient.
5/22/20139:15AM
Yes
No
Notsure
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Yes
No
Notsure
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4 Colorado 5/20/20139:00PM
5 Wepreviouslydispensedanumberofcompoundedmedicationsforourpatients,howeverduetostateregulationswehaveventuredawayfromthiswhichhasmadethingschallengingforouremergencypractice.
5/20/20132:18PM
6 Onlyforcontrolledsubstances.Forthemajorityofthemedicationswehavecompounded,theyarejustmedicationsthatareonbackorderfromthecommercialmarket.
5/20/201311:52AM
7 Weareabletocompoundmedsforexotic species 5/20/20137:21AM
8 Anditisasignificantchallenge. 5/19/201310:25AM
9 WefollowAVMA'smostrecentlypublishedguidelinesforcoumpoundedmedications. 5/19/20137:24AM
10 Justrecentlytheyhavestartedrequiringpatient-specific prescriptions. 5/18/201311:16AM
11 Yesforcontrolledsubstancesandhormones.athelminticscanbeorderedforinhouse. 5/18/201310:40AM
12 Thismaychangesoon 5/18/20139:11AM
13 IpracticeinKSandMO.KSdoesnotrequireit.MOdoes. 5/17/20139:59PM
14 Weareallowedtousecompoundedproductsthatourpracticepurchasesfromacompoundingpharmacyin-house,butarenotallowedtore-sellcompoundedproductsthatwepurchasefromacompoundingpharmacyto-go-home.Wecandispenseproductswecompoundin-houseto-go-home(causeTHATmakessense!)
5/17/20137:21PM
15 havingpatientspecific medicationregulationdelaysthebeginningoftreatmentforourpatients,thedayortwofordeliverydelaystreatment
5/17/20139:36AM
16 Ibelieveso. 5/17/20137:25AM
17 Don'tcarryofficestocksincehaveahousecallpractice. 5/16/201310:01PM
18 Recentlythestatechanged,byemergencyorder,topatient-specific prescriptions,butlaterrescindedtheemergencyorder.Iamnotsureatthispointwhattherulesare,butITHINKwecansti l l orderinofficestock....
5/16/20139:17PM
19 ThatisfinewithmethatthestateIpracticeinrequiresapatient-specfic prescriptionforcompoundedmediations.LikeIsaidbefore,Idon't"stockpile"anymedicationbeitcommercialorcompounded----inventorycostsapracticetoomuch.SoI'vegotapatientthatneedsamedicationthatIdon'tstock----IcallotherlocalveterinarianstoseeiftheyhaveadoseortwoofthemedicationneededuntilIcangetsomein.Theydothesame.
5/16/20137:28PM
20 Justrecently 5/16/20136:47PM
21 Ibelievethisistruebutwehavetoorderitaheadoftimetoendureitisavailableinourbusyemergencypracticewheremessareneededduringthemiddleofthenightorontheweekend
5/16/20134:31PM
22 Itwouldbesomuchmoreconvenienttobeabletostockmedicationswithoutaspecific prescriptionsothatmedic inewouldbeimmediatelyavailableforuse
5/16/20134:24PM
23 notforeverymedication,althoughrecentchangeshavemadeitmuchmoredifficulttohaveon-handsmalldosecompoundeddrugavailableinthec linic
5/16/20133:16PM
24 nowanditisabigproblem 5/16/20132:33PM
25 Thisisarecentchangeinlegislationforus.Upunti lrecently,wecouldordercompoundedmedicationsforofficestockthatcouldbedispensedasneeded.WeONLYstockedcompoundedmedicationsthatwecouldnotobtaininacommercialform.
5/16/201312:42PM
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26 No,Idon'tthinkafederally-run,federally-controlledpharmacyisinmyormypatients'bestinterest. 5/16/201312:39PM
27 Absurd!! 5/16/201312:25PM
28 Mostofthetimeweusepharmaceuticalcompanymedications.BUT,wesometimeshavenochoicetousecompoundedbecauseofdosingissuesorpalatabil i tyorthedifficultyinadministeringmedstoapatient.
5/16/201311:55AM
29 Thisisleftatthediscretionoftheprescribingveterinarian. 5/16/201311:32AM
30 Thec linic Iworkatcallsinindividualprescriptionsbuthassomeonhandtogetapatientstartedunti lthecompoundedmedicationarrives.
5/16/201311:28AM
31 Weencounterthisissuewithcertainoutofstatepharmacies. 5/16/201311:18AM
32 OhiojustswitchedtothiswhichisveryfrustratingbecauseIdon'thaveanythingonhandtogivemypatientswhoneedsomethingliketacrolimuseyedropsororalbuprenorphine.
5/16/201311:16AM
33 WehavetousesomeofthePatientSpecific prescriptionsforofficestockattimes 5/16/201311:01AM
34 Ithinkso,butI'mnotcompletelysure. 5/16/201310:57AM
35 Notonlydoesthiscauseusdistresswhentryingtoorderinhospitalsuppliesofmedicationforapatientwearemakingupsothatwecanhaveitonhand,wearenolongerabletotakeadvantageofaRefreshprogramthatwouldreplaceunusedexpiredmedicationsthatwehaveonhand.
5/16/201310:27AM
36 Wehavejustturnedintoa"re-distribution"ofcompoundedmedicationsstate.Itisextremelyinconvientashavingtoindividuallyrxeachdrug:1)costismoreforthepatient2)patienthastowaitdaysandsometimesaweekormoretoreceivethemedication,asapposedtoitbeingonthecounteralready.IfthedrugwasavailabletometobuynotcompoundedIwouldbuyitthatway,butwithallthedrugshortages,ithasreallyputveterinariansinabindtotreatpatientsappropriately.
5/16/20139:28AM
37 InCAweareallowedtohavecompoundedmedicationinhospitalstocktouseinhospitalorwecansendhomenomorethan72hours'worthforapatient.
5/16/20139:25AM
38 Patientspecific prescriptionsarehowwealwaysuti l izecompoundedmedications.Idonotknowifthisisastaterequirement. 5/16/20139:21AM
39 Thisisverydifficulforimmediateneedmeds.Ittakestimetocompoundanddiarrheaorpainmanagementcan'twaitthedaysneeded.Havingcompoundedcommonlyusedmedsonhandisnecessary.
5/16/20139:17AM
40 Exceptformetronidazoletinytabsandmethimazoletransdermalpens,allourcompoundingispatient-specific 5/16/20138:54AM
41 Mostveterinariansdonotrealizethatanytimetheymixtwodrugsinonesyringetheyarecompounding.Werecognizethathere.Also,manyveterinariansdonothavemuchofanideaaboutthelackofconsistencywithinandbetweenbatchesofcompoundedproducts(especiallythosestartingfrombulkingredients)becausethetherapeutic windowmaybequitelargeforthatdrugtobeginwith.Ialsowonderiftheuseofcompoundedantibioticshashadasignificantimpactoncreationofresistantpopulationsoforganismsduetothisvariabil i tyinpotencyandstabil i tyinherentincompoundedmedications?
5/16/20138:45AM
42 Patientspecific prescriptionsisgoodintheory,itisnotpossibleforeverydrug.Therearecertaindrugsforpainmanagementthatitisnotanoptiontonothavethemonhandwhenthepatientneedsit.Thisplacesaburdenontheveterinarian-theymustchoosebetweentheiroathinprovidingpatientcare,providingahighlevelofcare,andthelaw.Ourc linic orderspatientspecificcompoundeddrugsonalmostadailybasisasthedrugmanufacturerissuescontinuetoincrease.Itcostsourc linic asignificantamountoftimeandmoneytotrack,priceandorderthesedrugsinatimelyandappropriatemanner.Manytimeswewil lcallmultiplecompoundingpharmaciesinanattempttofindthemostaffordableoptionforthec lient.
5/16/20138:28AM
43 WewriteprescriptionsformedicaitonssuchasTacrolimus,methimazole,etc.Wedousemetronidazolethathasbeencompoundedintoal iquidsuspensionthatwedispensefromouroffice.
5/16/20138:25AM
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44 Thisisveryfrustrating.Wehavepatientsthatoftenneedtostartspecific drugsimmediately.Sometimesitiscriticaltotreatingtheiri l lness.Whenthisisdiscoveredonaweekendorintheevening,andnoinjectablealternativeexists,thepatientmustsufferunti lapharmacyopensbecausewecannolongerdispensecompoundeddrugsfroma"hospital"stock.Inveterinarypatients,especiallycats,havingcompoundeddrugsimmediatelyavailablecansaveananimal'sl i fe
5/16/20138:19AM
45 Iamdistressedthatkeepinghospitalstockofcompoundedmedicationsandthendispensingthemoutunderapatient'snamedoesnotqualifyas"patient-specific prescribing".Weareintheprocessofcomplyingwithourstate'spracticelawandwil lbeswitchingtohavingthec lientworkdirectlythroughthecompoundingpharmacy,butIdonotseehowthismakesanyimprovementtothissituation.IfIuseatrusted,authorizedcompoundingpharmacy,whycan'tIkeeptheirmedicationsonmyshelvesfordispensing?Thisdoesnotmakesensetome,thoughIdounderstanditisourstate'spracticelaw.
5/16/20138:04AM
46 Weonlycompoundwhenwecannotobtainthemedicationsweneedbecausetheyarenotavailablethroughtheregularpharmaceuticalcompanies.
5/16/20137:49AM
47 butweareallowedtodispenseafewdaystoananimaloutofourstock 5/16/20137:45AM
48 Thisisarestric tionthathurtstopetsmorethanthepractice.Wecannothavecompoundedmedicationsonhandandwefrequentlyneedthem.Asaresultofthispatientshavetowaitdaysbeforestartingonamuchneededcompoundedmediation.
5/16/20137:31AM
49 InTexas 5/16/20137:18AM
50 Thepatient-specific requirementisapointless'safeguard'.Myc linic cathasapparentlybeenonaplethoraofmedications... 5/16/20137:17AM
51 Patient-specific requirementshasdeeplydamagedourdutytokeepnecessarymedicationsin-stockandavailableformedicaltreatment.Thedelayinacquiringcompoundedmedicationbyorderingsolelyonapatient-specific basisistherootcauseofdelayinthetreatmentofi l lness,injuryandchronicconditions.Delaysduetopatient-specific requirementsaredirectlyresponsibleforunnecessarysufferingandourcompromisedabil i tytohaltormanagethediseaseprocess.Clientshavestrongandreasonableexpectationthatourveterinaryfac il i tystockthedrugsrequiredtobegintreatedofanimalimmediately.Anyandalllegislationkeepingcompoundedmedicationsfrombeingavailableonourshelvesalongsideourothermedicationsareshamefulbarrierstowardthehumanetreatmentofanimals.Limitationsonourabil i tytostockcompoundedmedicationsdirectlyharmsourabil i tytopracticeveterinarymedic ine.
5/16/20137:17AM
52 Theownersdoggetsalotofmedic ines...ifyouknowwhatImean. 5/16/20137:16AM
53 ThislegislationjustpassedinAlabamaunfortunately 5/16/20137:13AM
54 Ifindthistoberidiculous!Doctorsshouldbeabletodispensemedicationsthesamewaywhethertheycomefromadistributororacompoundingpharmacy.Ifsomethingisonbackorder&wecangetitcompoundedit'sridiculousthatwecanonlyorderonebottleatatimeorasweneedit.Especiallywithdoxycyclinesincewe'reinanextremelyLymeendemicarea.
5/16/20136:55AM
55 Wetendtohavethemcompoundedforspecific patientsbutIamnotsureifi tisrequired. 5/16/20136:54AM
56 Orderingmedicationsforaspecific patientratherthankeepingcertainmedicationsinstockisnotalwaysfeasibleasitisoftennotinapatientsbestinteresttowaitseveraldaystobeginmedications.
5/16/20136:52AM
57 Notsure 5/16/20136:44AM
58 seeaboveresponse 5/15/201310:35PM
59 Iwouldhopeitdoes. 5/15/201310:21PM
60 California 5/15/20136:54PM
61 rarelydispensingfromstockwehave,notorderinganymoreforofficestock 5/15/20136:49PM
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62 Wedouseinstock,compoundedmedstoanimalsthatinhospitalized. 5/15/20135:29PM
63 AlthoughIonlyrecentlyfoundoutthatthisisthecase.Wedidn'tknowthiswasalawandwereoccasionallydispensingcompoundedmedications,butwestoppeddoingthisoncewefoundout.
5/15/20135:18PM
64 IfallowedIwoulddispensecompoundedmedicationsfromthepracticeoccasionally,wedidupunti lrecentlywhenthelawchanged
5/15/20133:16PM
65 Recentlywehavehadtostartprescribingpatient-specific medications. 5/15/20133:10PM
66 wecompoundentirelyoutofstate 5/15/20131:21PM
67 wisconsin 5/15/201312:50PM
68 Weusedtokeepessentialmedicationsinstock,nowwecannot. 5/15/201311:57AM
69 Compoundingpharmaciescallourofficeafterweorder,tochecktheorder,patientnameandDVMname 5/15/201311:55AM
70 IbelievethestateofTexasdoes,butamnotpositive. 5/15/201311:26AM
71 Thisjusttookeffectinourstate. 5/15/201311:09AM
72 Virginia'sBoardofPharmacyjustmetwithourAttorneyGeneral'sOfficeandBoardofVetMedthispastMonday.TheconclusionisthatVamustenforcefederallawstatingthatcompoundeddrugscannotberedistributedbyveterinariansforsale.Thisprecludesproperpatientcareinsomec ircumstanceswherepatientsrequiretimelymedicationdispensingforl i fethreateningdiagnosedconditionsandcannotwaitthe2-4daysitoftentakestoorderformanoutofStatepharmacyandwaitfordeliverybyUPSormail...MDsfacethesameissueie;ophthalmologitsneedtoprescribeavastincompoundedforimmediateophthalmicuseorpatientscanbecomeblind.TheFederallawsimplydoesnotaccountfortheralityofproperpatientcare...
5/15/201310:56AM
73 MScurrentlyallows"officeuse"compounds. 5/15/201310:10AM
74 Iwouldlovetobeabletomaintainofficestockofcommonlyprescribedsizesthatarenotavailablecommercially.Ialsodorepti leandsmallrodentmedic ineandsometimeshavetocompoundinofficetogetthemstarted.Iwouldratheracompounderdothis.
5/15/201310:04AM
75 Thepolicyrecentlychanged-nothappyaboutthenewregulations. 5/15/20139:42AM
76 Wehavehadtoordersomeofficestockformedicationsthatwekeeptoprescribetopatientfortrialthatisnotavailablefromdistributorandthenfollow-upwithpatientspecific medicationprescriptionifpatientshowssignsofimprovement.Wehavealsoorderedsomedoxycyclinethatiscurrentlynotavailablefromourdistributordotoitbeingbackordered.
5/15/20138:48AM
77 Iamnotsureonthisquestion,althoughwedocarrycertaincompoundeddrugsfordispensingatourVeterinaryHospital.... 5/15/20138:31AM
78 I'minGeorgia 5/15/20138:21AM
79 ThisisanewrequirementinourstateandhasmadetreatingourpatientsVERYdifficult.Manypatientsneedsmedicationsquicklytotreatseriousi l lnesses/issues.Waiting3daysfortheprescribedmedicationtobemadeandshippedistoolongforananimalwhoissufferingtowait.
5/15/20137:54AM
80 It'sarequirmentthatcompoundedmedicationsproducedinstateareforaspecific patient,butthatisaveryrecentchange.Marylandjustmadethatarequirementwithinthelastfewweeks.We'resti l l abletogethospital-usecompoundedmedicationsfromoutofstate.
5/15/20137:53AM
81 Asofrecentlyyes.Beforewewereabletoorderas'officeuse'sothatwecanhavemedicationsinstockwhenweneedthemtodispensetoc lients/patientswhenneeded.
5/15/20137:47AM
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82 ourhospitalusescompoundedmedicationswhentheFDAapprovedmedicationisonback-orderandnolongeravailableorwhenamedicationdoseneedstobespeciallymadetofitthepatient'sneeds
5/15/20137:28AM
83 Thismakesitverydifficulttokeepneededmedicationsonhand.Seepreviouscommentaboutexotics 5/15/20137:16AM
84 Unsure,butwealwayscallinscriptwithinstructionsonhowtouse/givetothepatient. 5/15/20136:35AM
85 recentlyaddedlaw 5/15/20136:16AM
86 Thishaspresentedfrustrationandproblemsattimes 5/15/20135:48AM
87 Iusein-housesuppliestodispenseacuteusemedicationsuchasanalgesicsandantibiotics.Ialwayshaveindividualprescriptionspreparedforchronicusemedications.
5/15/20135:28AM
88 RhodeIsland...Idon'tthinkso,butI'mnotentirelysureexactlywhatthismeans.Wetypicallyspecifywhichpatientacompoundedmedicationisfor,butwehavealsoreceivedsamplesofcompoundedmedicationsthatwehavekeptinthec linic (withinexpirationlimitsofcourse)touseinappropriatecases.
5/15/20135:24AM
89 Wecandispensecompoundedmedicationfromstockforshorttermuse,ortostartapatientonamedicationwhichwewil lhavespecificallycompoundedfortheminthenearfuture(chronicmedications).
5/14/201310:07PM
90 WeareabletostartthemedsfromtheinofficestockandthensendaRxtoanoutsidepharmacytocompletethecourseofthemeds 5/14/201310:00PM
91 recentattentiontoandasIunderstandit,enforcementofstateregulationsnowrequireapatientspecific prescriptionforallcompoundedmedications.thistremendouslyincreasesthecostofthesemedicationstothec lientandwil ll ikelyresultinc lientsdecliningtreatmentduetothecost
5/14/20138:23PM
92 Supposedly.Absolutelyabsurd. 5/14/20137:48PM
93 iorderthecompoundeditemsonl ine,havethemdeliveredtoourveterinaryhospitalsotheyareavailabletoourpatientsrightaway 5/14/20137:30PM
94 Ibelieveitdependsonthescheduleofthemedication.ForscheduleIIwemustalwaysspecifyaspecific patientfortheprescription,sothescriptisforthatpatientonly.
5/14/20137:05PM
95 Wecanorderforc linic useanddispenseal imitedamounttoaspecific patient. 5/14/20136:53PM
96 LAisrunbyRWNJ'sthatwanttokeepthe$$inthehandsofbiginsurancecompanies,andl imitdrugavailabiltytopatients.Also,theywanttocutoutanycompetiton!!
5/14/20136:08PM
97 Ihavealwaysassumedso 5/14/20135:27PM
98 Unsure 5/14/20134:41PM
99 Currentlytheuseofcompoundedmedicationsmakeabigdifferenceinthetreatmentofmanydifferentcommondiseasesseeneachday.Veterinariansaretrainedinhowandwhytousecompoundedmedic inesandwhichcompaniesarereputable.Limitingtheavailabil i tyofcompoundedmedic ineswouldbeverydeleterioustopatientcare.
5/14/20134:31PM
100 Notwhenorderedtotheoffice.Patientspecific whendispensed. 5/14/20134:04PM
101 Andit'sarealpainintherear-inskiforthec lientandpatient.Ofparticularconcernispainmedicationforcats.Humanbuprenexisinshortsupplyandextremelyexpensive.Weusethesteri lehumanforinjectibleuse,butasadispensedmedicationfororaluse,it'scost-prohibitiveformostpetowners.Theglassampulesareapain/dangerousfordosingaswell.Weandourc lientsfarpreferthe.5mg/mlcompoundedbuprenexfororalhomeuse,butwith"patientspecific"requirements,we'renotsupposedtostockitinthehospital.Whenacatneedsanemergencysurgerytoremoveapieceofswallowedyarnisthecatsupposedtowaitfourdaysforthepainmedicationtoarrivebymailorder?Ridiculous!
5/14/20134:00PM
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102 Dispensefromourownpharmacy-donotgiveoutprescriptionsforcompoundedmeds. 5/14/20134:00PM
103 Somecompoundingpharmaciesarerequiringthis,somearenot 5/14/20133:55PM
104 IbelievetheanswerisyeshereinPA 5/14/20133:01PM
105 JustrecentlyLouisianahasbecomeastatethatallcompoundedmedicationsaretobeorderedpatientspecific whichmakesitdifficulttoobtainanddispensestockcompoundedmedicationsforunexpectedhospitalizedpatients.Takingtimetoorderacompoundeddrugforasickpatientistimewasted
5/14/20132:39PM
106 TheonlytimewewouldorderastockofacompoundedmedicationwouldbeiftherewerenootheroptionavailabletousaswhenPrednisolonewasonindefinitebackorderandweordereda100countbottleofcompoundedPrednisolonetoholdusoverforawhile.
5/14/20132:26PM
107 Il iveinCalifornia,butI'mnotsurewhatthelawrequires.Weonlyprescribeonapatient-by-patientbasis. 5/14/20132:22PM
108 Isuspectthatitisrequired 5/14/20132:17PM
109 Havingcompoundedmedicationinstockpriortotreatingasickanimalbenefitstheanimalbecausewecanbegintherapyimmediately.
5/14/20131:58PM
110 Iamnotpositivebutisuspectitissupposedtobepatientspecific .Iwouldl ikeittowherecompoundedmedscanbepurchasedinbulkanddispensedtomultiplepatients.25mgmetronidazoleorflavoreditraconazoleareperfectexamplesofmedsyoul iketohavehandyratherthanorderforspecific patients.
5/14/20131:57PM
111 Ibreakthelaweverydayinordertoprovideahigherstandardofcareformypatients. 5/14/20131:40PM
112 Texas 5/14/20131:31PM
113 Nootherwaytopractice. 5/14/20131:27PM
114 Ioverseenonhumanprimatebreeding.Manytimes,wecannotobtaintheproperdrugorstrengthneededunlesswehaveitformulated.Anditseemsthatinrecentyears,backordersonroutinedrugsfrommanufacturershasforcedustousecompoundingagenciesmoreandmore.
5/14/20131:21PM
115 Thisisratherdifficultattimessinceittakes2-5businessdaystoreceivemedication.IfweorderinadvanceofsurgeriesthatMAYneedacompoundedmedandthenwecan't/don'tuseit,weareoutthemoney.Itcostssmallbusinessesquiteabitinwastedmedsanddelaysnecessarytreatment.
5/14/201312:55PM
116 OneofthecompoundingpharmaciesIuserequirespatient-specific prescriptionsanyway. 5/14/201312:51PM
117 Ithinktheyrequirepatient-specific prescriptions.IfIhaveapatientthatisgoingtobeonadrugformorethanashortcourseoftreatment,I'l l usuallyhaveaspecific prescription.
5/14/201312:48PM
118 Recentchange,whichcomplicatesthingsforus,especiallyforbuprenorphine.Theregularmedicationhasbecomesoexpensive,butweuseanddispensetheoralcompoundedbuprenorphineeveryday.
5/14/201312:48PM
119 Wenowarerequiredtohavethemedicationcompoundedonanasneededbasisinwhichourpatientsthenhavetowait24-72hourstoreceivetheirmedication.Whenc lientsforgettocallforrefi l lsorifapetneedsamedicationonanemergencybasisitisnolongerreadilyavailabletothem.
5/14/201312:46PM
120 Sometimesthismakesitverydifficulltbecausethepatientneedsthemedicationimmediatelyandwehavetowaitforittobecompoundedbecausewecannotkeepthesemedicationsinstockwithoutorderingforac linic petandthenkeepinginstock.
5/14/201312:42PM
121 Thismakesorderingyourc linic stockofmedicationsverydifficult.Ifyouareorderingtofi l l yourstockandnotforaspecific patientyouaresti l l requiredtouseapetname.
5/14/201312:40PM
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122 Someofthemedicationswecompound(e.g.metronidazole)isnotcommerciallyavailableinaform/sizethatissafeforuseincats.Withoutcompounding,we'deithernotbeabletousethedruginthisspeciesinspiteofits'historyofsafetyandefficacy,orwe'dbesplittingtabletsinthebackroomandprovidingverypoordosing.
5/14/201312:38PM
123 Allcompounded(andnoncompounded)medicationsrequireawrittenprescriptionbyourveterinarians. 5/14/201312:34PM
124 Icangetofficestockcompoundsforuseinmyc linic withoutapatientnamebutanythingIsendhomewiththec lienthastobecompoundedforthatc lient'spet.
5/14/201312:31PM
125 Manymedicationshavebeengoingonbackorderoverthelastfewyears.Compoundingmedicationshasallowedustosti l l beabletogivemypatientsthesemedicationswhileonbackorder.
5/14/201312:27PM
126 PrettymuchtheonlytimeI'l l orderapatientspecific formulationiswheneither1)itssomethingrarethatwedon'tstockor2)I'mhavingitshippeddirectlytothepatient.I'dmuchprefertohavec linic stockofthemedicationsweusecommonly.
5/14/201312:22PM
127 LABEL 5/14/201312:15PM
128 Weareazoosoweownouranimals-therearenoc lients.However,wedispensemedicationtoourownanimalsjustl ikeinaregularhosptial,withavalidprescription,writtenbytheoverseeingveterinarian,giventothekeeperforaspecific animal.
5/14/201312:12PM
129 wehaveofficecompoundedmedsforemergencyuse.Beyondthat,compoundedmedsarecalledinforspecific patients 5/14/201312:08PM
130 Thefactthatitmaybecomeil legalformetokeepasmallstockofcompoundedmedsforpatientsyetitislegalformetomakemyowncompoundedmedicationsinhouseisridiculous.Muchmorel ikelyforerrorstooccurthatway.Medsshouldbecompoundedbyal icensedcompoundingpharmacistandthenonlythebriefstorageandprescribingouttopatientsshouldbelefttous.
5/14/201312:08PM
131 Thisisahassle,wepreferhavingitinstock 5/14/201312:07PM
132 Anotherdumblawthatmakesnosenseandbenefitsnoone. 5/14/201312:06PM
133 TapazoleBaytri l c isaprideMetacamFlagylReglan 5/14/201311:59AM
134 MN-notsure 5/14/201311:59AM
135 Justrecently 5/14/201311:58AM
136 Thismakesitdifficulttomaintainhospitaluseproducts 5/14/201311:52AM
137 Yadayada 5/14/201311:23AM
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25.33% 251
12.82% 127
61.86% 613
Q10Moststatescurrentlypermitveterinarianstodispensemedicationstopetowners;manydonotdifferentiatetherulesfordispensingFDA-approveddrugsandcompoundeddrugs.Doesyourstate
permitdispensingcompoundedmedicationstopetownersforafee?
Answered:991 Skipped:39
Total 991
# Pleasefeelfreetosaymoreaboutyourresponse. Date
1 IdowhatIhavetodototreatthepatient. 5/22/201310:12AM
Yes
No
Notsure
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Yes
No
Notsure
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2 IfIamprovidingamedicationthattheycan'tget,itrequiresmetoknowhowtodiagnoseaconditionandhowtotreatit,whatmedicationisneeded,howorwheretogetit/howtodoseit/howtolableitandtimetocalli tin-IbelieveIshouldbeabletochargeadispensingfee.
5/20/201310:02PM
3 Exceptifusingexactsamefeeforregularscriptsorthemedswemixinhospitalbecausethereisnootheroptions.....andthesearechargednormalrxfeesnotaseperatecompoundingfee
5/20/20137:21AM
4 Wedonotchargeafee. 5/20/20136:31AM
5 IwouldassumenotasthisquestionmakesitsoundlikeIamdispensingfromofficestockwhichwearenolongerpermittedtohave. 5/19/201310:25AM
6 Wemayordercompoundedmedicationsforapatientandhavethec lientreimburseusforthecostofthemedicationplusaprofessionalfeeforhandlingtheorderingandproperstorageofthemedication.
5/19/20137:24AM
7 Notsureofthisquestion.Ifyoumeandoesourc linic chargeformedicationwecompoundyes.Thereisnotahigherfeeforthisconvenience.
5/18/201310:40AM
8 Thismaychangesoon 5/18/20139:11AM
9 Ithinkso? 5/17/20139:59PM
10 AsfarasIknow,wecandispensecompoundedmedicationstopetowners. 5/17/20139:45PM
11 InthestateofOhiowearepermittedtousecompoundedmedicationsbutasfarasIknowthereisnoassociatedfee. 5/17/20132:59PM
12 Idon'tdispensedirectlytotheowner.Iuseacompoundingpharmacy. 5/16/201310:01PM
13 IassumethatthestatepermitsitbutIamnot100%sure.IftheydonotIamunaware. 5/16/20139:32PM
14 Notsure 5/16/20139:09PM
15 Ibelievemystateallowsaminimalmarkupofthecompoundedmedicationthatisnomorethan33%overthecostofmyc linicobtainingthecompoundedproduct.Inpracticetermsthisisn'taverylargemarkuponmedicationsbutthatis,asiunderstandinmystate,the"letterofthelaw".Sobeit.Iassumethis33%markupl imitinc ludestheshippingfeeaswelltogetthecompoundedproducttomyc linic---soImarkupthecompoundedmedicationat133%ofmycosttohavethatcompoundedproductarriveatmyclinic .example:costofthecompoundedmedicationandtheshippingcosttomyc linic totals$100.00,thec lientcostorischarged$133.00.That'snotalotofprofittomyc linic .SohowdoIattempttostayinbusinessandstayprofitable?Iama"service"basedveterinarian.Ichargemoreforservices:exams,physicals,lameness,repro,ultrasound,radiographs,sheathc leanings,dentals,healthcertificates,labworkandinterpretationoftheresults,ect.thatmostdoinmyarea.WhydoIstructuremypracticebasedonthis?Thedaysofdispensingmedicationsforanydegreeofsignificantprofitinveterinarymedic inearelonggone.Furthermore,Idon'twanttomakemymoneyasa"drugdealer"Iwanttomakemymoneyformyprofessionalexpertiseinevaluatingapatientandusingmyknowledgeandskil lstodetermineandconcludewithadiagnosisandtreatmentplan.Myc lientspayapremiumformyexpertiseandgetthemedicationsatminimaltonoprofittomypractice."Paymeformyknowledgeandnotforthepaste,pil ls,l iquid,ect."Itallevensoutintheend.Lowcostexamanddiagnosticspricesbutveryhighmarkuponmedicationsvs.highercostexamanddiagnosticsbutlowmarkuponmedications.Intheendit'sthesame.Ifyouwanttoknowsomeinsighttothisthough---Peopleappric iatethe"services"farmorethananymedicationsyoudispense.That'swhypeoplel ikethispracticeconcept.Theyknowthey'repayingforprofessionalservicesandnotbeingbentovertotakeitintheshortsformedications.Peopleknowwhatdrugscostsarethesedays---theyjustgoonlineandlook.Idon'tgetmanycallsaboutmymedicationscostsevenafterpeoplehavelookedonlineandcompared.Irarelyevergetanybadfeedbackaboutmyprofessionalservicesfeeseither----theyknowtheygottheirmoney'sworthbecausetheyneededaprofessionaltodiagnosetheproblemandtheyonlycalledmebecausetheirfriends,therepsychic,theirtrainer,theirfarrierandeventheirchiropracter/accupuncturistcouldn'thelptheirhorse
5/16/20137:28PM
16 I'mnotsureIunderstandthequestion-doyoumeanafeetothestate?allmedicationsprescribedordispensedwouldhaveacosttotheownerandthedispensingpharmacy
5/16/20133:16PM
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17 Wedochargeafeeforcompundinginhospital.Asfarasthepharmacies,Iamunsure. 5/16/20133:03PM
18 anddon'tcare?Generally,Iletthepharmacybil l thec lient.Istayoutofthatloop. 5/16/201312:39PM
19 GoshIhopeso...Ihonestlydon'tknow. 5/16/201311:55AM
20 Not100%surebutthinkso. 5/16/201311:34AM
21 Petownersusuallyhavetopayfortheirmedications.Iknowofnolawstatingwemustdispensemedic ineforfree. 5/16/201311:18AM
22 Iwil lhavetocheckintothisasIhadnotideathatanystatesdifferentiatedbetweenmedicationsbasedontheirorigin 5/16/20138:54AM
23 Thisisnotc larifiedinmystatelaw.Itneedstobe. 5/16/20138:45AM
24 Iamunsureofthequestions,therefore,Ioptedfor"Notsure". 5/16/20138:21AM
25 Seelastanswer.Wecannotdispensecompoundeddrugs.Thiswasalossinrevenueforus,butjustasmallone.Moreimportantlythepatientssufferneedlessly
5/16/20138:19AM
26 AsIsaidabove,wehavebeendispensingcompoundedmedicationsnotknowingthiswasnotincompliancewithourstate'spracticelaw(theabovespecific permissionwasaddedinFebruary2013),andweareintheprocessoffullcompliance.Thatsaid,IremainfrustratedthatitmakesanydifferencetotheFDAsincethisisnotaproblemforthenation'shealth.Itseemstometherearemuchmoreimportantproblemstobetryingtosolve.
5/16/20138:04AM
27 Reallydoesn'tapplyasIpracticeinashelterenvironmentandtechnicallyalltheanimalsareownerbytheshelterandallareundermycareforthedurationoftreatmentwithfulldiscretiononmypartastowhatmedicationbestsuitsthepatientsneeds.
5/16/20137:16AM
28 Wedoit,Iassumeitislegaltodoso. 5/16/20137:16AM
29 Recentchangeinlawinthisstate(VA) 5/16/20136:51AM
30 exotic practicerequiresalargenumberofcompoundedmedicationstoproperlytreatthepatientsappropriately. 5/15/201310:35PM
31 Iwouldthinkitdoes. 5/15/201310:21PM
32 Ihavebeenleadtobelievethatiswhatisrequired. 5/15/20132:45PM
33 wisconsin 5/15/201312:50PM
34 Seeabovecomment 5/15/201310:56AM
35 Compoundedproductscannotberesold,thatis,theycannotberelabeled,repackagedanddispensed.Dispensedcompoundedmedicationsmustbeintheoriginalprescriptioncontainerfromthecompoundingpharmacyandlabeledforanindividualpatient.
5/15/201310:10AM
36 Ourstateallowsit,butnotforanadditionalfee-notsurewhatthatmeans 5/15/20139:11AM
37 OftenIwil l ordercompoundedmedicationsfromapharmacy.Thepharmacysendsthemtomyofficeandtheownerpicksupthemedicationsattheofficeforthesamepricethatthepharmacybil ledmeinc ludingshippingcostsifapplicable.
5/15/20137:16AM
38 Tothebestofmyknowledgewearepermittedtodispensesmallamountsforacuteuse,suchaspost-oppainmedication. 5/15/20135:28AM
39 notabsolutelysure,butIdon'tthinksowithoutacompoundingl icense 5/15/20132:28AM
40 exceptforthefirstdose 5/14/201310:00PM
41 Notsure 5/14/20139:20PM
42 Againthisisoutrageous 5/14/20137:48PM
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43 I'mwonderingifthisquestionreferstomixingmultiplemedicationstogetherintheofficetomakeacombinationthatisnotFDAapproved.Wevirtuallyneverdothisinourpractice.
5/14/20137:05PM
44 Wefrequentlyencountersituationswheredrugsgoonbackorderorarecostprohibitive.Thislegislation,ifpassed,wouldcausemypatientstogowithoutmedicationsthatarenecessaryandneeded!Doxycyclineisagoodexample.Weusethisdrugeveryday.Itiscurrentlycostprohibitive.
5/14/20136:29PM
45 California,weareonlyallowedtogive3daystreatment,thenmustdirectc lienttoobtainontheirown.Wealmostneverknowiftheremainingprescriptionisgiventothepet.
5/14/20135:53PM
46 Unsure 5/14/20134:41PM
47 Mostofthetimeourcompoundedmedicationsaredispenseddirectlytotheownerbythepharmacy.Theexceptionswouldbeearmedicationsandinjectablemedications.
5/14/20133:08PM
48 IbelievetheanswerisnohereinPA 5/14/20133:01PM
49 Yes,butitdoesnotpermitveterinarianstodothecompounding.So,forinstance,ifapatientneedsacompoundedmedication,l iketransdermalmethimazole,andthec lientdoesnotwanttodealdirectlywiththecompoundingpharmacy,wecanorderithereandselli theretothec lient;itcomeslabeledforthatpatient.
5/14/20132:26PM
50 I'mneversureifthecompoundingpharmacyusedormixedthemedicationproperly. 5/14/20131:56PM
51 Wedispensecompoundedmedications,butIamnotsureifthereisanadditionalfee. 5/14/20131:30PM
52 Aslongastherearenoethicalproductsavailable. 5/14/20131:06PM
53 Regardlessofwhetheriti tpermissibletochargeafeefordispensingcompoundedmedicationstopetowner,Idonotchargeanyadditionalfees.Petownersarechargedthecostofthemedicationandareasonablemark-up.
5/14/201312:51PM
54 Recentchange,whichcomplicatesthingsforus,especiallyforbuprenorphine.Theregularmedicationhasbecomesoexpensive,butweuseanddispensetheoralcompoundedbuprenorphineeveryday.
5/14/201312:48PM
55 Wearesupposedtochargethesamethingthatthecompoundingpharmacychargesusforaccompoundedmedicationbutofcoursewecanchargewhateverwewantfornon-compoundedmedicationsthatwestock.Thisdoesnotseemtobetherightwaytodothis-it'sourbusinessandourabil i tytochargewhatthemarketwil lbearandthatitshouldbethesameforallmedications.
5/14/201312:42PM
56 Nocompoundedmedicationiseverdispensed/prescribedforfreebyourpractice. 5/14/201312:34PM
57 Mystatespecificallysaysthatunlessacompoundwasmadeforaspecific patientthatitcanonlybeusedinmyoffice.Icanorderacompoundforaspecific patientandthendispensethatcompoundtothatc lientbutnottoanyotherc lient.
5/14/201312:31PM
58 Again,notaspecific concernforourorganization(zoo)soIhaven'tlookingintostatelawonthisissue.Iwouldthinkthatitwouldbecomeveryconfusingiftherulesweredifferent.
5/14/201312:12PM
59 emergencyusage 5/14/201312:08PM
60 Butmycompanydoesnotallowthis,weareonlyallowedtodispenseenoughunti ltheirprescriptionisfi l led. 5/14/201312:07PM
61 Yadayada 5/14/201311:23AM
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Q11TheSenatelegislativeproposalcontainselementsthatmayormaynotaffecthowyoupracticemedicineandtheavailabilityofcompoundedpreparations.
Foreachoftheseproposals,pleaseindicatetheimpactitwouldhaveonhowyouprescribeand/orpatientoutcomesifit
werethelaw.Answered:951 Skipped:79
Limitactivepharmaceutic...
Requireyoutodocumenton...
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Restrictyourabilityto...
Openthepossibility...
Allowfederalofficialsto...
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78.08%741
18.44%175
3.06%29
0.11%1
0.32%3
949
64.21%610
28.00%266
7.05%67
0.32%3
0.42%4
950
80.04%758
16.16%153
3.59%34
0.00%0
0.21%2
947
ALargeNegativeImpact SomeNegativeImpact
NeitherPositiveNorNegativeImpact SomePositiveImpact
ALargePositiveImpact
Allowfederalofficialsto...
Allowonlypatient-spec...
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
ALargeNegativeImpact
SomeNegativeImpact
NeitherPositiveNorNegativeImpact
SomePositiveImpact
ALargePositiveImpact
Total
Limitactivepharmaceuticalingredientsthatcanbecompoundedtoanumberthatcouldbemuchlowerthanthe250+incommonusenow,forexampleadozenortwo.
Requireyoutodocumentoneveryprescriptionwhythecompoundedmedicationwil lmakeasignificantdifferencetoyourpatientcomparedwithamanufactureddrug.
Restric tyourabil i tytoordercompoundsforofficeuse.
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758 153 34 0 2 947
81.22%770
16.03%152
1.79%17
0.53%5
0.42%4
948
90.60%858
7.71%73
1.06%10
0.21%2
0.42%4
947
73.21%694
20.25%192
5.38%51
0.74%7
0.42%4
948
62.63%595
25.47%242
10.63%101
0.53%5
0.74%7
950
# Pleasefeelfreetosaymoreaboutyourresponses. Date
1 Withthelargevarietyofspecieswetreat,wecannotberestric tedtocompoundingonlycertaindrugs.Weneedtohavealloptionsavailable!Forexample,withanantibiotic ,weneedtousewhatantibiotic wil lbesttreatthebacteria,andifthepatientissensitivetothatantibiotic andcannottolerateit,weneedtohavetheabil i tytouseotheroptions.Also,withsomespeciesl ikerabbits,therearealotofantibioticswecannotuse,ortheywil lbefatal.Sowearealreadyl imitedonourchoicesfromthebeginning.
5/23/201310:07AM
2 Animalsarenotalwayseasytomedicate-flavoredl iquids,transdermals,chewiestremendouslyhelpmyc lientstohelptheirpets.Compoundingalsohelpsmepracticemedic inewhenmanycompanieshave"maufacturebackorders".Byhavingsomestocksuppliesofmedicationsthatarenotavailable(ie:DES)Icantreatpatientsasneededwithoutaweekwait.
5/20/201310:10PM
3 Iwouldl iketoseethierveterinarymedicaldegreeortheirpharmacydegreebeforeIgivethemtheauthoritytodecidehowtotreatpatientsanddecidewhogetwhatandhowdoesn't.Wearemovingfartherandfarthertowardssocializedmedic ine!!!!!
5/20/20139:02PM
4 Compoundingforthehospitalbyawellregulatedcompoundingpharmaciesallowsustodispenseneededmedsthatmaynotcosttheowneralotofmoney.Toooftencommondrugsthatwehaveregularpharmaciesdispenseareremovedfrmthemarketmakingthetreatmentofcertaindiseasescostprohibitiveforowners
5/20/20138:58PM
5 Restric tingcompoundedmedicationsl ikethiswouldbedevastatingtomostpractioners.Andhavingpeoplewhoarenotindailyprivatepracticeisevenworse;theycannothaveanyideahowthesedecisionaffectthedaytodayofveterinariansandtheirpatients.
5/20/20131:00PM
6 Manydrugsarebecominglessandlessavailable(backorderandthel ike),ortheyarenotavailablecommerciallyinanappropriatesizeorformforaspecific patient.Ifcompoundingpharmacieswereunabletoprovidethemedicationsthattheydo,manypatientswouldbeunabletogetthemedicationstheyneed,whichsometimescouldresultinal i fethreateningsituation.
5/20/201311:58AM
7 Asashelterveterinarian,compoundedmedicationsarecrucialtocombacttickbornediseases,contagiousupperrespiratoryil lnesses,etc.
5/20/201310:24AM
8 Nothavingmedicationsreadilyavailablejustaboutmakespracticeimpossible.....ticksoffpetowners.....steelsrx'stolocalpharmacieseventhoughpeopledon'tnecessarilywanttogoelsewheretopickupsomethingelse.
5/20/20137:23AM
9 Idonotunderstandwhyitshouldbeaproblemforaveterinarypracticetostockanddispensecompoundedmedicationssuchasmetronidazoletablets.Thedrugisnotavailablecommerciallyinappropriatedosagesforoursmallanimalpatients.Conditionsforwhichthisdrugisprescribedoftencausedebil itatingdiarrheaandrequireimmediatetherapy.Thesepatientswouldsufferunnecessarilyifforcedtowaitforanindividualprescriptiontobepreparedandshipped.Whyisitaproblemformetohaveitavailableforimmediateuse?Iwishsomeonecouldexplainthistome.
5/19/20137:53PM
10 ItwouldtakealargeamountoftimetocompoundmedicationsinmyofficeforeachpatientthatIuseinhousecompoundedmedicationsin.ThiswouldultimatelyreducethenumbersofcasesIcanseeduringtheday,reducingmyincome.
5/19/20131:46PM
Openthepossibil i tyforafederaloffic ialtodefinewhatmakesa“significantdifference”forapatientbetweenamanufactureddrugandacompoundedmedication.
Allowfederaloffic ialstorestric toreliminatecompoundinganyvariationofamanufactureddruginc ludingchangingthedoseordosageform.
Allowfederaloffic ialstodecidewhethercompoundsfordogs,catsandhorsesmustbemadefrommanufactureddrugsinsteadofbulkactivepharmaceuticalingredients.
Allowonlypatient-specific prescriptionsforcompoundedmedications.
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11 Mystatelegislationisalreadyhavingasignificanteffectonseveralofthese. 5/19/201310:27AM
12 TherearealreadyguidelinesinplaceaspublishedbyAVMAtodealwithcompoundedmedicationsandIbelievetheyareprettyexhaustive.Insteadofmakingthewholeprocessmorecomplicatedwhydoesthegovernmentjustholdcompoundingpharmaciesandveterinariansaccountableforwhatisalreadyinplace.And,asacompoundingpharmacy,whydoyounotupholdthelawinsteadoftryingtoincreaseyourrevenuebyfi l l ingmedicationandadvertisingmedicationthatyouknowarebeingrequestedinanil legalmanner.Thesepracticesare,inpart,whathasledtothissituation
5/19/20137:28AM
13 Compoundinghasawidedefinition.forexampleifImixthemanufactureddrugwithpedialyteinsteadofwaterthatiscompounding.Idon'tfeelIhavetodocumentareasonwhy,justthatIuseanalternativediluent.
5/18/201310:43AM
14 TherearemanyreasonstousecompoundedmedicationsthatIdonotfeela'federaloffic ial 'isalwayscompetenttomakeappropriatedecisionsregarding.Thepracticeofmedic ineshouldbeleftinthehandsofveterinarians.ManyofthedrugswecanusethatareFDAregulatedaresti l l offlabelandwehaveabetterunderstandingofourpatientsneedsandrisks.Unti lthereareveterinaryspecific pharmacistsavailableincommonpharmaciestonotepatientsafetyatacosteffectivepricethiswil lmakemanytreatmentoptionscostprohibitiveforc lients.Thedelayformailorderisalsodangerousformanyconditions.Whowil lbepayingfortheoversightofthislaw?
5/18/20139:15AM
15 Doctorsshouldbegiventheauthoritytodeterminethebestcarefortheirpatients,notlawyersandlawmakerswithnomedicaltraining.
5/17/201310:32PM
16 Ifourpatientswereallthesamespeciesandsamesize,thiswouldbelessofanissuebutgiventhatourpatientsweighfromouncestotons,weneedtohavetheabil i tytouseourtraininganddiscretiontoprescribeaccordingtothepatient'sneeds.
5/17/20139:50PM
17 Caughtmeatanegativetime.MoreBigBrother. 5/17/20133:49PM
18 Manyofthemedicationsusedareformulatedforhumansandwithoutcompoundingitcanbeincrediblydifficult,i fnotimpossible,toproperlydosethesemedications.Thesearequalityofl i feandqualityofcareissuesandtheseanimalsandtheirownersdeservethebestpossiblemedicalcare.Limitingcompoundingwouldcreateahugenegativeimpactontheveterinarymedicalcommunitiesabil i tytoprovidethebestcarepossibleandcouldleadtounnecessaryeuthanasia.
5/17/20133:03PM
19 Iftherewasn'tsuchaproblemwithmanufacturedproductbackorderstherewouldn'tbesuchaneedforcompoundedmedications.Theimpactofnothavinganalternativetoturntowouldhaveahugenegativeimpactonthepatientshealth.
5/17/20131:59PM
20 thegov'tisTOOinvolvedwithcompoundingmedsforpets.....thereaseonweturntocompundingpharmaciesisbecausethegov'tkeepsremovingitemswehaveusedforyearsandthenwhenthearebackonthemarket,theitemsare3-10timesmoreexpensivethantheywereoriginallyandhavebeenforyears.Weturntocompoundingpharmaciesalsotomakeitmoreaffordableforourc lientstotreattheirpets---otherwisetheycan'tandthentheyeuthanizetheirpet......
5/17/201310:52AM
21 Weareveterinaryprofessionalsandwantthemosteffectivedrugforthebestpriceforourpatients.AnddoingalotmorepaperworktogettxforthemisNOTneeded
5/17/20138:56AM
22 Somanyanimalswouldloseaccesstol i fe-savingtreatmentsbecauseoftheserestric tions. 5/17/20136:34AM
23 AgainIfeelitisthedoctorsresponsibil i tytodeterminewhatisthebesttreatmentoptionforapatientbasedoneachindividualcase.Duetothevarietyofspecies,optionsareveryl imitedtoveterinariansandduetothecostsofdevelopingandmarketingalternativedrugs,varyingdosages,drugforms,andespeciallyapprovalbyspecies,unlikethehumanfield,wemustbeabletodevelopeffectivetreatmentsforourpatients.Morel imitationswil ljustpreventusfromeffectivelytreating,andforcemoreveterinarianstocompoundil legallytobeabletotreat.
5/16/201311:38PM
24 Manytimespatientsneedmedications"rightnow"ifIcannotstocksomeofthesemedicationsitcouldputananimalsl i featrisk. 5/16/20139:36PM
25 Whentreatingi l l patients(especiallyavianpatients)thedelaytoobtaincompoundedpatient-specific medscouldbefatal. 5/16/20138:36PM
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26 Intheruralareawherewepractice,itcantakeaweekorlongertoreceivecompoundedmedications.Ifwemustorderacompoundeddrugforthespecific patientratherthanpre-purchasingastrengthweexpecttouseincertaindiseaseprocesses,thedelaycouldbedetrimentaltothehealthofthepatient.
5/16/20135:55PM
27 Somemedicationsarenottheappropriatesizeforsomeofthesmalleranimalsandthereforecompoundingissaferandmoreaccurate.Also,withallthedrugshortagesourpatientswil lsufferifwecan'tgetthemedicationweneed.
5/16/20135:36PM
28 Compoundedmedicationsarelessexpensivethanmanufacturedmedications,andIunderstandtheneedofthepharmaceuticalcompaniestoprofitfromtheirresearch/developmentinvestments.Ialsoamwaryaboutthequalitycontrolandconsistencyofcompoundedmedicationsbasedonstudiesdone,forexample,oftri lostane.Ifeelcompoundingisessentialformanycatsthatcannototherwisebemedicated.Ican'tl ivewithoutleave-ineartreatments!
5/16/20132:53PM
29 Thegovernmentshouldstayoutofourprofession.Wealoneweretaughtpharmacology,notthem.Thegovernmentistheworstorganizationforcompetencyandhonesty.
5/16/20132:04PM
30 Thesearealldecisionsthatshouldbemadeforthespecific patientbytheattendingveterinarian. 5/16/20131:39PM
31 Ithinkthereshouldbemoreofafocusonensuringthestockofcompoundedmedicationsisformulatedcorrectlyandfromappropriateactiveingredientssothewhenhospitalsdoneedthemforstockbottles,wecanrestassuredthemedicationsaresafeandeffective.Thefactremainsthoughthatwedo,asawholeprofession,continuetohaveaccesstoin-housecompoundedformulationsformedical,humaneandfinancialreasons.
5/16/20131:37PM
32 Ithinkitwouldbedifficultforfederaloffic ialstounderstandhowtodefinenewlawswithouthavingtodealwithtreatingpetsonadailybasis.Theycouldnotpossiblyknowwhathurdlesveterinariansmaycomeupagainstforindividualpatientneeds.
5/16/201312:46PM
33 IwishIhadsomethingsarcastic tosaythatwouldmakelightofthissituation.Mrobamahaslotsofothercountrieshecouldl iveintoru(i)n.
5/16/201312:42PM
34 Havingpolitic iansdictatehowIusecompoundedmedicationsinmypatientsisaoutrageous.Thisisasridiculousashavingsomeonelikeme(whosetrainingisinsc ienceandveterinarymedic ine)headingtheCIA.Ifeelcertainthatmostpolitic ianshavelittleunderstandingofwhyweneedcompoundedmedications.Ialsofeelcertainthatmostpolitic iansdonotrealizetheimpactthislegislationwouldhaveontheaveragepetowner.Forsomeofmypatients,theinabil itytochangetheformofadrug(fromaregular5mgtabletintoa5mgchicken-flavoredtablet)wouldhavecostthemtheirl ives.Ichallengethelegislatorstoadministerapil l toanunhappycateverydayfortherestofit'sl i fe.Thepolitic iansneedtofocusonthingsthattheyactuallyhaveknowledgeof,andnotpunishtheaveragepetowner.Ittakesaveterinarianordevotedpetownertounderstandtheuniquechallengesweface.Successfullytreatingmanyconditionsinanimalsrequirestheabil i tytogetthedrugintotheanimal,theabil i tyforthepetownertoaccessthedruginatimelymanner,andtheabil i tytoaffordthemedication.Alltheproposalsl istedabovewil lgreatlyimpairtreatmentofanimals,andleadtounnecessarydeathandsufferingoftheanimalsweareheretoprotectandcarefor.-KristyBaranik
5/16/201312:28PM
35 Irefertomyoriginalstatement 5/16/201312:26PM
36 1.Compoundedmedicationsimproveownercompliance.2.Manyanimalsaretreated,thatwouldsufferifcompoundingwererestric ted.
5/16/201311:52AM
37 Justsubstitutebigpharmaforfederaloffic ialthenthissurveymightgetc losertotheTruth! 5/16/201311:48AM
38 Somecompoundeddrugsarecommonlyusedl ikeDES.ItusedtobeavailableasahumandrugbutnowisonlyaVeterinarydrug.Therefore,humanpharmaciesnolongercarrythismedic ine.
5/16/201310:35AM
39 Tothinkthatsomeonenotdirectlyinvolvedinthedecision-makingprocessofapatient'scarecanmakereasonabledecisionsregardingthatpatient'scareisaskingforsignificantproblems.
5/16/201310:20AM
40 Myhospitalworksonavianandexotic species.Sotherearenodrugsavailableotherthancompoundeddrugs.Soitwoulddestroymypracticeandmakealotofanimalsnotgetthepropercaretheyneed.
5/16/201310:20AM
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41 Ifthefederaloffic ialsinc ludedveterinariansandtheirinputwastakenseriously,Idon'tseehowtheywouldallowsomethingl ikethistohappen.
5/16/201310:04AM
42 Alloftheseinitiativesseemtobeforthebenefitofthepharmaceuticalcompanyandarec learlynotdesignedtosupportthehealthneedsofourcriticalcarepatients.
5/16/20139:38AM
43 Thiswouldbeanightmare.I'mnotsurewhytheywanttodothisbutitsoundsl iketheonly"good"itwil l doiscostmoney,taketimeandmakeitmoredifficulttoappropriatelytreatourpatients!
5/16/20139:27AM
44 Veterinariansneedtobeabletomakethedecisionsforindividualpatients,notnonmedicalpersons.Notevenphysic ians. 5/16/20139:19AM
45 Iwantsaidlegislatorstotrytogiveanirate,sickcatwithallc lawsandteethsomeMetronidazole.ThatoughttoshowthemWHYweneedalternateformatsformedications,especiallywhenmultiplemedicationshavetobegiven.
5/16/20139:04AM
46 MyGod,thelastthingweneedissomenumbnutfederaloffic ialdecidingwhata"significantdifference"means.WelcomeBigBrothertotheNannyState
5/16/20138:52AM
47 Availabil i tyofmanufactureddrugshasbeensporadicrecentlywithmanybackorders.Compoundingallowsustodealwithinterruptionsinavailabil i tyandrestric tsdrugcompaniesfrommonopolytactics.
5/16/20138:48AM
48 Youmisspeakinusingtheterm"significantdifference"sincetheproposedlegislationusestheterm"c linicaldifference"andthatiswhatveterinariansshouldbestrivingforanyway.Your5thpointisfalse-compoundingpharmacieswil lbeabletocompoundvariationsofmanufactureddrugs.Asaprofession,weneedtotakemoreresponsibil i tyforouractionsrelatedtorecommendationanduseofcompoundeddrugs.Theproposedlegislationisabigstepintherightdirection.
5/16/20138:45AM
49 Itisobscenetothinkfederaloffic ialscouldtietheveterinarianshandsinwhattheydetermineshouldbeavailableorindicatedforpatients.Thereisasimpleanswer-iftheywantto"Fix"theincreaseduseofcompoundingpharmacies-thefocusshouldbeontheongoingdramatic increaseinbackorders,drugsnolongerbeingmanufactured(criticalandnoncritical),nonsubstantiatedpriceincreasesthatrenderthemanufactureddrugunusable.Noc linic wantstousemorecompoundeddrugs.Ittakesfromourbusinessbottomlineineveryway.ItistheONLYwaytoprovidethetreatmentourpatientsneed!!
5/16/20138:38AM
50 Idon'tknowwhattheimpactofthel imitationofwhatmedicationscanbecompoundedsinceIdon'tknowwhatmightbeonthel ist.Itmayhavenoaffectonme,orcouldbesignificant.Thesameistrueforsomeoftheotherrestric tions-theymayhavenoimpactonhowIpracticeormayhaveagreatimpactdependingonwhatthoserestric tionsaretobe.
5/16/20138:28AM
51 Compoundedmedicationsarevitaltothecareofcompanionanimals.Typingtheprescribingofthesemedicationsupwithredtapeoreliminatingtheiravailabli l i tywil llowerthestandardofcareforcompanionanimals.Thesepetswil lexperiencelongerandmorepainfulrecoveryfromsurgeryandi l lnessandanoveraldecreaseinqualityofl i fe.
5/16/20138:26AM
52 Unlessthedrugcompaniesaregoingtodrasticallyexpandthevarietyofmanufactureddrugsinc ludingdosageformsandsizes,compoundingwil lcontinuetobeessentialfortheeffectivepracticeofveterinarymedic ine.
5/16/20138:13AM
53 Therestric tionswil ldramaticallyl imitavailabil i tyandvarietyofdrugsinotherformsandconcentrationsthatwil limpactanimalhealthnegativelyinalargeway.Animalswil ldiesimplybecausetheirownersarenotabletomedicatethemwithamanufacturedoraldrugandhavenoalternativeformsthatcanbecompoundedandadministered.Otheranimalswil ldiebecauseasitisdrugsareexpensivetocompoundinmanycasesandsuchregulationwil lmakeitcostinhibitiveforownerstocontinuetherapiesthatkeeptheirpetsalive.Verysad.
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54 Itisveryimportantthatweveterinariansretainourabil i tytotreatnumerousspeciesofwidelyvaryingsizestothebestofourabil i ties.Thismeansmaintainingtheabil i tytoadministerandprescribecompoundedmedications.
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55 TooMUCHGOVERNMENT!!! 5/16/20137:50AM
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56 alreadythedocumentationthatwearedoingistakingasignificantamountoftimetodoonadailybasis-thereareonlysomanyhoursinmydayandthepatientscomefirst!
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57 Theselawsareessentiallymakingmakinglawmakersbreakthelawbyhavingthempracticemedic inewithoutal icense. 5/16/20137:40AM
58 Iamalreadyrequiredtousepatientspecific Rxs 5/16/20137:19AM
59 Thislegislationisjustmakingourjobsharderandaddinglotsofunnecessarypaperwork.Theyneedtojustletuspracticemedic ineandstopputtingl imitationsonhowwepractice.Itisbadenoughtheyaretyinghumandoctor'shands.
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60 WhatinGod'snamewouldhaveusthinkthatfederaloffic ialscanbetrustedtomakeagooddecisionfromoutpatients'pointofview?
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61 WhydoIgetthefeelingthateitherbigcorporatedrugmoneyand/orObamacareisbehindallthisnonsense!!justanotherefforttoputmomandpopoutofbusiness.Tellthesementalmorons(senators)whohavebeenboughtandpaidforinreturnforpoliticalfavors,thatidon'thearmypatientscomplaining.WhatIseeismypatientsgettingbetteroristhatnotimportanttothesecretins(senators).Afterfluroshingfor2000yearsnowIknowwhytheRomanEmpirecollapsedandfailed:theytoohadasenate!!
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62 Ittakessomuchtimetohaveamedicationcompoundedtospecific patientsthatitmayimpactsurvivalofthosepatientsneedingitimmediately.
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63 seeabove 5/16/20136:57AM
64 Weseealotofexotic animalsforwhichtheproperdosagedoesnotexistwithoutcompounding.Inaddition,maycatownersareunabletogivepil lstotheircatsinwhichcasecompoundingadrugtol iquidformiscrucial.
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65 Clinicallyitismuchbettertohavesomeofthesemedicationsonhandforpatientsthatneedthemnowandnothavetowaitforthemtobemadeandsenttothec lient.
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66 compoundedmedicationisneededtoadequatelytreatmanyexotic species.PleasedoNOTlimittheirusage 5/15/201310:38PM
67 Idon'tfeelthatthepeoplemakingthesedecisionshaveagoodworkingknowledgeofveterinarymedic ineandhowitdiffersfromhumanmedic ine.Ahumandoctorprescribesamedicationandthepatientpicksitupfromthepharmacy.Withanimalpreparations,pharmaciesarenotthatwidespreadandthusoftentimesthepreparationsmustbeshippedandthelagtimefromdiagnosistotheonsetoftreatmentcanbedevastating.
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68 Patientsoftenrequireimmediatetreatmentandcannotwait1-2daysformedication.Howobviousisthis? 5/15/20135:43PM
69 Aslongasthebulkpharmaceuticalsingredientsaresafeorinspected,ItrustthecertifiedcompoundingpharmacisttomakethedrugsIaskfor.Theyhavebeenagreatboontofelinepracticeandhealth.Itwouldbeverydifficulttopracticemedic ineotherwise.Catsarenotsmalldogs,whobythewayalsobenefitfromcompoundedmedications.Regulatetheingredientsnotthedistributors.
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70 Therewasalreadyalargenegimpactwhenourstatestoppedallowingcompoundsforofficeuse 5/15/20133:19PM
71 Backorderedmedicationsandpatientdosingaccordingtotheirweightarethebiggestreasonswecompound.Sickorinjuredpatientscannotalwayswaitunti lthereprescriptionisfi l ledatacompoundingpharmacy.Itispreferredtostartthemonmedicationinourhospitalandthenhaveitcompoundedtothespecific patient.
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72 Allofthesewouldnegativelyimpactourabil i tytotreatourpatients.Iunderstandtheconcernswithcompoundingpharmaciesbutweshouldleaveitinthehandsofthecompoundingpharmacytouptheirstandardstopreventissuesl ikecontaminationandletveternariansmaketheirowninformeddecisions.
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73 Thisisabsurd!Ourveterinariansarefarmorequalifiedtoprescribeandadministermedicationsthana"federaloffic ial"whohasnoideaofindividualpatientneeds.Thereisnoproblemwiththecurrentsystem,sothereisnotrueneedtocreateadditionallegislationtol imittheavailabil i tyofmedicationsandcompoundsthatareoftendifficulttoobtainthroughpharmaceuticalcompanies.
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74 Tohavefederaloffic ialsl imitcompoundingwhenthereisalsomanufacturingisahugenegative.TheMOnowistoremoveamanufacturedproductfromthemarket,thenputitbackonatahugelyinflatedprice.Thelegislatureworkswiththemanufacturertokeeptheproductfrombeingcompoundedifthereissomeonemanufacturingit.Thisisinterferencewithfreetradeandcommerce,butthelegislaturedoesitbecausetheyarebeingbribedwithcampaigncontributions.
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75 Ibelievepatient-specific prescriptionsallowgreateraccountabil i tyfortrackingprescriptionmedications,ensuringthatexpiredmedicationsarenotdispensed,andl imitingtheamountofpharmaceuticalwastefromapractice.
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76 Whilethereshouldbesomeexceptions(perhapsamaximumofa48-72hoursupplyofmedsdispensedfromofficecompoundswhenthevetneedstogetapatientstartedonamedbeforeitcanarrivefromthecompoundingpharmacy),Ibelievethatcompoundedprescriptionsshouldbefi l ledforanindividualpatientaccordingtospecific patientneeds.
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77 Iamonlyallowedtodopatientspecific prescriptionsandcannotmaintainofficestock,thereforitisadrawonthosetwoquestions.Iwouldlovetobeabletodobothofthosethingsthough.
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78 Wearealreadystrugglingwithshortagesofpharmaceuticaldrugs.Forexample,manymedicationsarenotavailableduetomanufacturingproblems.Nowthereisgoingtoberestric tionsoncompoundedmedications?!?MyhandsaregoingtobetiedandIwil lnolongerbeabletopracticemedic inewithoutsupplies.
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79 Theverylastthingthisgovernmentneedstodoistobecomelarger,moreintrusive,andtofurtherinhibitthepracticeveterinarymedineandfurtherrestric tsmallbusiness.Idonotseeanyproblemwiththewaythingsarenow,sowhyintroducemorecumbersomeandcostlyregulations?
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80 Ourprimaryreasonforuseofcompoundeddrugswouldbethatitiscommerciallynotavailablefromdistributor/manufacturerduetobackordersituationsandnoproductthathasbeenmanufacturedforpurchase.
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81 Ifyoul iveinanareawithoutanimmediatelyavailable,24hourlocalcompoundingpharmacy,patinet-specific prescriptionsrequireusingamail-orderpharmacytodispensecompoundedmedications.Bydoingso,patientsmaybedelayedinreceivingtheirprescriptionsby1-7days.Forsomemedications,thisisnotcritical.Butforantibioticsorl i fe-savingmedications,thisdelaycouldmeanthedifferencebetweentreatmentsuccessandfailure,andcertainlythedelaywouldcontributetoreducedqualityofl i feforthepatient.Bybeingallowedtodispensecompoundedmedicationsfromhospitalstock,thisdelayiseliminatedandpatientscanbetreatedeffic ientlyandeffectively.
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82 SomearetheseresponsesaredifficulttogaugeunlessIknowhowthefinalbil l wil l beputtogether..Allinall,anychangeinthewayweusecompoundeddrugscouldbeproblematic toourc lientsandtheirpets
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83 Thisiscrazy.Anyoneoftheseproposalsbeingimplementedwouldhaveaterribleimpactonthepetsthatwecarefor.Weneedcompoundedmedicationsinorderto1)havesuchmedicationson-handforemergencycases,2)helptocureinfectionand/orreducepainimmediately,and3)allowourc lientstoobtainthesemedicationsoutsideofourhospitalatareasonablecost.
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84 Theseproposalswouldchangemuchmorethanjusthowac lient/patientgettheirrequiredmedications.Manyoftheseproposalswil laddasignificantamountoftimeneededtoprescribemedicationstothosewhoneedit.Theserequirementsareaskingforfartoomuchtime,morethananybusyVeterinarypracticecanspare.Ifeelthatthepatientswil lbetheoneswhosufferthemostasmostVeterinarianswil ltrytofindnewwaysofdealingwithi l lnessesthatwil lbypasstheserestric tions.
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85 Itwil l ultimatelydrivecostsofpracticeup. 5/15/20137:44AM
86 Youcan'tgeneralizeveterinarymedic ineacrosstheboard.Eachpatientisuniqueandtheirneedsarespecific tothem.Veterinariansneedthefreedomtodoseeachpatientasseenfitforthatcase.
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87 Theimpactofrestric tionswouldbeprofound....andwhatisthemotivatingfactor?Istheresomethingbrokethatweareunawareof? 5/15/20135:49AM
88 Itiscriticalthatwebeallowedcompoundedanalgesicsforanesthetic use. 5/15/20135:30AM
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89 Anytimegovernmentandnon-medicalindividualsattempttoregulatemedic ine,itisNEVERapositiveoutcome.Ifailtoseethebenefitofrestric tionswhichwouldmakeitMOREdifficultformetoofferhelpfulmedicationstomypatients.
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90 Ithinkthemedicaldecisionsforjudic ioususeofcompoundedmedicationsarebestlefttoveterinarianswithoutregulationfromagovernmentagency.Asapractitioner,Iunderstandthel imitationscompoundeddrugshavecomparedtonon-compoundeddrugs/formulations.Becauseofthis,Ichoosetousecompoundedmedicationsforc lientsoccasionally,whenthereisnootherchoice.Non-veterinariansinthegovernmentthatareproposingthislegislationmaynotrealizethatvirtuallyallzoospecieswil lbeleftwithoutanytreatmentforvariousdiseases,becausethereisnolabelledproducttouse,thisallowinglargescalediseaseandsuffering.Animalshelterswil lbeunabletoeffectivelyorhavefundstotreatthesufferingandsuckanimalsintheircare,leadingtomanymoreeuthanasiasthanisnecessaryThisisahugestepbackwards.
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91 Humanscomeinsmall,medium,andlarge.Theyallhavethesamephysiologyandcanusethesamedrugsinjustafewstrengths.Butinvetmedthatisnotatalltrue.Youcan'tdosedownahumandrugforacanary.Andyoucan'tfeedanelephant750tabletsthreetimesaday.WeneedtobeabletocompounddrugstomeetaHUGEvarietyofpatients.
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92 Manyofthesefederaloffic ialsdecisionsandregulationsarel ikelytoresultinamarkeddecreaseinavailablemedicationsforanimalsinthatmanyofthecompoundedmedicationsareformerhumanmedicationswhichwerelegalforaveterinariantoprescribeoradministerwhentheywerebeingmade,buttheyarenolongerproducedonthehumanside.
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93 Asaneducatedperson,IfeelthatIshouldn'thavetoexplainwhyacompoundedmedicationwouldworkbetter.Whatawasteofmytime.
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94 Ireallydon'tbelievethefederaloffic ialsshouldhavesomuchsayinveterinarypracticeastheydon'thavethesamedegreeofeducationastheveterinarian,whoshouldbetheonemakingdecisionsforthepatients.
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95 Thepharmacythatcompoundedthecorticosteroidthatcausedfungalmeningitisc learlyhadotherissueswithsteri l i ty&procedures.That'swheretheregulationneedstobe.Alocalpharmacyheremadea1000xerroroncompoundedHWpreventative(ieMGvsMCG),sotraining&qualificationsarecritical.Makingmedsunavailabletocompoun[forprimarilysmallpets]isabsolutelyunacceptabletomylevelofpatientcare.
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96 "afederaloffic ial"-areyoukiddingme.I'vebeeninpracticeforover25years,howisthefederalgovernmentgoingtofindsomeonewill ingtoworkforthemwhoknowsanywherenearwhatIknowaboutcatdiseasesandwhatmedicationstheyneed...andalsoknowaboutbirds,andhorses,anddogs,and........arethey(deletetheexpletive)kiddingme!
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97 Aretheseoffic ialsgonnastarttell ingmehowtopracticeveterinarymedic inenext!Aretheyalsogoingtobethereorpublic allyexplaintoourc lientswhytheyfeeltheneedtomakemedicaldecisionsforus?Dotheydothisinthehumanfield,orareourmdsjustbetterequippedtounderstandwhentheyareactuallyusingcompoundedmeds?
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98 Withtheconstantshortagesandunreasonablewildlyincreasedpricesofmanycommondrugs;sometimescompoundingistheonlywaytoaccessthosedrugs.
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99 There'snothingthatwouldbemoredamagingtoourpatientshealthandourabil i tytocareforthem. 5/14/20137:50PM
100 Otherthanbigpharma,who/whatisdrivingthiscrazyrestric tions?Drugsareoftennotmanufacturedintherightsizesortherightmethodofadministrationtoallowustotreatanimalsofawiderangeofsizesandtypes.Howmanymedsarecommerciallymadeintuna-flavoredl iquid?
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101 Thefederalgovernmentdoesnothavetheknowledgeofthedrugs(unlesstheyhavebeenapractic ingveterinarianinthefield)northenegativeimpactonowner/parentstressofnotbeingabletotreattheirpetandl iterallythatmanypetswil lnotgettheproperdoseorwil lendureterriblestressordiewithouttheoptionofcompoundedmedications.Yesthereneedstobequalitycontrolregulationsandrepercussionsforthosethatdonotabidebyregulationsthatmaketheirproductsafe....iethemeningitisoutbreak...horribleandsadandshouldhaveneverhappened...buttoharmcountlessanimalsbecauseofacompanycuttingcornersandnotcaringaboutanythingbuttheirproductshouldnotoutweighthegoodthatcompoundingdoes
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102 I'dsayabout80%ofmycatpatientsneedcompoundedmedicationsbecauseeithertheavailablesizesaretoohighadoseorbecauseofthedifficultyinadministeringthemedication.Halfmyprescriptionswouldsay"Becauseownercan'tadministertablets"orsomesuchandtheotherhalfwouldsay"Becauseyoucan'tcutapil l into12piecestoaccuratelyadministerthedoserequired!
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103 Iworkinemergencymedic ineandtheprescriptionsIuseneedtobestartedbeforethelocalcompoundingpharmacywouldbeabletosupplyittotheownerdirectly.
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104 Talkaboutgovernmentalcontrols-thislegislationwil lbeanightmarefortheVets,andtheanimals,asitl imitswhatcanbedosedandyouwouldhavetobeexplainingwhyforeverydrugyouprescribed,onadailybasis!!
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105 Keepingcompoundedmedicationsallowustostarttreatment(s)immediatelyratherthenwaitingforthedrugtobefi l ledthendispensed
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106 Manyofourpatients,especiallycats,requiremedicationsindosagesthatarenotreadilyobtainableandmaybeinaccurate,orinformsthatthecatsWILLNOTtake,thusputtingthepatientcareinjeopardy.
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107 Ifwecan'tdoseproperlyortheownercan'tgetthemedic ineinitwil l haveamajornegativeimpactonmypatients 5/14/20135:30PM
108 Compoundingisadailynecessityinfelinemedic ine.Withoutcompoundedmedicationmanyofmypatientswouldl iveshorterl iveswithmoresuffering.
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109 Federaloffic ialsdon'thaveadoctor-patientrelationshipwithourpets.Theydonotknowourc lientsandtheirphysicalcapabil ities-iftheyhavedisabil ities,etcthatpreventthemfromgivingorstrugglingtogivetheirpetamedication.Ifweweretoberestric tedinusingcompoundingmedications,thiswouldadverselyaffectbusinessandl imithowwecanbenefitourpatientsandspeeduptheirrecovery.
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110 Pleaseallowlicensedveterinarianstotreattheirpatients.Donotallowagovernmentoffic ialtodecidewhatisbestforallwithoutanyrelationshiptothepatientsbeingtreated.Weseethepatientsandareresponsibleforthepatientoutcomes.Theseregulationswillhaveagreatnegativeimpactonveterinarymedic ineformanypatients.
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111 Asweareveterinaryprofessionalsandareeducatedandtrainedinourfieldofexpertise,andthe"federaloffic ials"arenot,the"federaloffic ials"donotneedtodic tatehowwepractice!
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112 Aslongasthecompoundingpharmacistsaren'tinventing"new"drugstoc ircumventtheFDAapprovalprocess,thereshouldbenoproblemhere.Ifveterinarianscan'tstockcompounded(read"incrediblylessexpensive")versionsofalreadyapprovedhumandrugssuchasbuprenex,pricesforpetownerswil lberidiculouslyhigh.Youreallycan'taskacatownertopay$75forfivedaysoforalpaincontrolafterhavingtheircatspayedorwaitfourdaysforthe$30medicationtoarrive.Unlessthereisarealhealth/safetyissuewiththesecompoundeddrugs...pleaseleaveitalone.
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113 Makingitmoredifficultforveterinarianstoprescribeadequatemedicationsfortheirpatientsisahugedisservicetothecommunity. 5/14/20132:42PM
114 Iwasinschoolfor8yearstomakethesedecisions. 5/14/20132:22PM
115 Dependswherethebulkmaterialisfrom;andwhatthequalityis. 5/14/20132:07PM
116 keepoutofmybusinessunlessyouaretrainedandl icensedthesameandareapartnerinthebusinessinsteadofaparasitethatdoesnotknowwhatishappeningintherealworld
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117 Adingmoreburocracytocompoundeddrugswil lhurtverterinarymedic ineandmyabil i tytocareformypatients. 5/14/20132:01PM
118 Thislegislationisnotonlyunnecessary,itaddsasevereburdentoveterinarypractitioners.Mostofusaresmallbusinesses,orsolopractitionersandarealreadystrugglingunderunduefederalgovernmentalbureaucracy.Donotaddmoreunnecessaryburdenstoourprofession.
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119 Restric tionsoncompoundedmedicationswil leffectivelyeliminatemefromtreating70-80%ofmypatients.Iseealargenumberofoldercanines,felinesandexotic animalsinmypractice.Manyofthemcanonlytakecompoundedmedicationsfortheiri l lnesses.Ifthislegislationisenactedintheformthatithasbeenpresentedtome,itwil l severelycurtailmyabil i tytoefffectivelyhelpmypatientsandwil lessentiallybeassigningadeathsentencetomanyofthem.Istronglyopposethesemeasuresfromallstandpoints.Quitefrankly,compoundedmedicationshaveallowedmetohelpmanymorepatientsthanIwouldbeabletoifIwasl imitedtoformulated,proprietarymedications.
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120 patientspecific rxswouldbeinconvenientbutnoatlargenegimpact.nothavingaccesstomedic inescompoundedappropriatelyforourvarietyofpatientswouldhaveahugenegativeimpact.Mostpharmaceuticalcompanieswil lnotseethevalueinprovidingformsanddosesthatweneed.Theirprofitisdirectedtowardthehumanrxneedswhicharen'tnec.thesame.IfinditunsultingthatIhavetojustifyacompoundingchoice.Thesearenotschedulei idrugs.
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121 Astheveterinarianthatistreatingthepatient,wefeelitisbestforustobeabletomakethedecisiononwhatmedicationthepetneedstobeprescribed,notapersonsoremotelyremovedfromthesituation.
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122 Dogsandcatsarenotpeople.Theycomeissomanydifferentshapes&sizes,it'simpossibletodoourjobwithouttheuseofcompoundedmedications.
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123 Governmentshouldnotinterfere. 5/14/20131:28PM
124 Feell ikethelargedrugcompaniesarefuelingthisfire!Compoundedmedicationsareveryimportanttomypractice,theimpactwouldbeforallofuswithhigherpricesonourpet'smedicationandprobablyoursaswell.
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125 Ithinkbetweenprofessionalpharmacistsandprofessionalveterinarians,wecanfigureitoutwithouttheregulatoryinputfrombureaucrats.
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126 PleaseaskallmembersofCongressandtheirfamiliesaswellasrepresentativesoftheFDAandtheirfamilieshoweasytheyhavefoundittomedicatetheircats,ferrets,rats,guineapigsandrabbitswithpil ls.Dotheycareatallaboutourc lientswhoownthesespeciesanddependonusforpracticalsolutionstomedicationproblemsfortheirpets.Iestimatethatabout80%ofourpractice'spatientpopulationwouldexperiencesignificantmorbidityandpossiblymortalitywithoutaccesstocompoundedmedications.
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127 Withdrugshortagesanddifferencesindosingfromhumans(ifaveterinarydrugisnotavailable)nothavingaccesstocompoundedmedicationswouldbeharmfultopatientsandpractice.Also,beingabletoofferdeliveryoptionstoensuremedicating(especiallyincats)hasbeenal ifesaverinmanyinstances.Theprescriptiondrugrulesarehardenoughonpractic ingveterinarians,manyregulationstakingupunnecessarytimeandresources(whichultimatelyhasanegativeimpactonpatientcareandfinances)
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128 Itisalwaysdangerousforsomeone(afederaloffic ial)tomakeorchangelawswhentheydonotworkinthefieldbeingaffected.Inthesameway,itisdangerousforinsurancecompaniestorefusetopayforatestorprocedurethatadoctorconsidersnecessary.Itisaveryfinel inebetweendoingtheirjobandpractic ingmedic inewithoutal icense.
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129 Iftheytakethisawayfromus,thentheyneedtoforcebigpharmatocomeupwiththerightsize,type,andformofmedicationsweneed.WeKNOWwho'sbehindthis--Pfizer,Merck,Elancotryingtoforceustousetheirmedications.
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130 Wedon'tknowaheadoftimewhatsmallcrittersmaycomethroughourdoorandrequiremeds,beingpatientspecific wil lreallycrampwhatourdoctorscando.
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131 Thisisanexampleofanover-reaching,burdensomefederalgovernment. 5/14/201312:51PM
132 Veterinariansspendthetimeinschoolandpractic ingtobeabletoproperlyhelptheirpatients;federaloffic ialsdonothavetheschoolingtoknowwhatmedicationsareappropriate.Weareheretohelpanimals,notharmthembutdenyingthemneededmedicationormakingthemwaitforitcanjeopardizetheirhealth.
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133 Willourgovgetoutofourl ivesIthoughtweare/wereafreeNation.IhatepeoplemuchlessIntell igentthanmetell ingmetheWrongthingtodo.
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134 TheFDAneedstodifferentiatefoodanimalsfromcompanionanimals.Companionanimalsmayneedawiderangeofcompoundeddrugsfortreatment.Treatmentwithdrugsthataredifficulttodoseornotreadilyacceptabletothepatientmayresultinadverseoutcomesduetoimproperdosingorinabil i tytoadministerthecorrectdose.Compoundingeliminatesmanyoftheseobstaclestopatienttreatment.
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135 Eachpatientisdifferent.Size,metabolism,andactivitywhichallaregoingtoaffectyourdosingneededandvariesbytheingredients/medications.Ifyoul imitthisyouwil lbetakingawayalloptionsforveterinarymedications.Humanmedhasfirstaccesstomedicationsandwegettheleftoverssowecameupwiththesolutionofmakingourownandhavefollowedalltherulesthathavebeencreatedovertheyears.Addontheproblemofcompetingwiththeonlinepetpharmaciesitmeanscompoundingisoneofthelastwaysthevetshavetokeeptheirc l inic compete-ablewiththeonlinebignames.
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136 Alloftheabovewouldhaveanegativeimpactonhoworwhatweprescibeforourpatients.Ifapatientissmallandthemedicationthatisneededforthehealthofthepetisnotcapableofbeingdoseddowntothecorrectdose,thepetmaygettoomuchortool ittleandneitherofthoseareanoption.Youhavesomepetsthatarenoteasytoadministermedicationto.Ifapetishardtomedicate,thec lientwon'tmedicateandthatcompromisesthepetshealth.Ithinkweshouldhavetheoptiontocompondthemedicationforthehealthbenefitofthepatient.
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137 Itishardenoughpractic ingveterinarymedic ineasitis.Whydoesthegovernmentwanttomakeitevenharder? 5/14/201312:38PM
138 Weoftenusecompoundingpharmaciesbecausewecan'tgetthemedicationasamanufactureddrug-orinthequanitythatweneed!Fromthesecomments,itimpliesthattheyaretakingthediagnosingandprescribingoutofthehandsofthetrainedveterinarianwithasolidvet-c lient-patientrelationship-NOTagoodidea.Willthefederaloffic ialsmakedecisionsonexotic animalsaswell?Willallthisregulationdriveupcostsofalreadyexpensivemedication?
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139 IfIwerenotabletocompoundcertainmedicationsIwouldhavepatientsthatwentuntreatedbecausenootheralternativewasavailable
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140 duetothesizeandsensitivityofourpatients,compoundingisanecessity.A4poundsickcatdoesn'ttakethesamedoseasalargeranimal,andmostmedicationscan'tbecuteffectively(Ihavetriedtogeta16thofatablettoproperlydoseacatbefore).Andformanyanimals,catsespecially,beingabletotailorthedoseandaddingflavoriscriticalfortheownertobeabletomedicatethepet.Ihavehadownersthatcouldn'tpil l theirhyperthyroidcat,butthecatwouldbegforthetriple-fishflavoredcompoundedmedication.Ourpracticeisnotone-size-fits-all,andourmedicationsshouldn'tbeeither.
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141 Again,withoutcompounding,someofourpatientswouldbevirtuallyimpossibletotreatwithneededmedications. 5/14/201312:31PM
142 Theuseofcompoundedmedicationisbeneficaltothetreatmentofmanypatients.Limitingaccesstotheseprepartionswil lhindersuccessfulrecoveryandpossiblypreventrecoverycompletely.
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143 Thisdoesmorethangivethepowertoafederaloffic ial.Itgivesthepowertothelobbyistsforthebigdrugmanufacturers. 5/14/201312:28PM
144 Manyofourpatientsrequiredosagesthatareunobtainablewithoutcompounding. 5/14/201312:28PM
145 Forwhateverreason,somanydrugsononindefinatemanufacturersbackorder.Compoundeddrugsc losethatgap.Thegovernmentneedstostepawayfromthisindustry.
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146 Iassumethatthe6thpointmentionedherewouldhaveasignificantfinancialeffectonthecostofcompoundedmedications. 5/14/201312:25PM
147 Everysingleoneoftheseproposalswouldmakelifemoredifficultforvets,theirpatientsandc lients.Whomeverwrotethisc learlydoesn'tunderstandhowthemajorityofveterinarypracticesruntheiroperationortheirpharmacydispensing.
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148 Unlesstheindividuals"ontheHil l"areroutinelymedicatingdogs,cats,birds,etc.,theyreallyneedtoreexaminetheirmotivesforintroducinglegislationthatmakesadifficultprofessionMOREDIFFICULTtotreatit'spatients.
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149 Untilthegovernmentaloffic ialswhowanttoregulatethisgotoveterinaryschool&obtaintheirDVMdegrees,theyhavenobusinesstell ingmehowtopracticemedic ine,andwhatisbestformypatients.Yetanotherformofgovernmentburocracyatitsworst!
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150 Idonotbelievethefederalgovernmentshouldberegulatingmyabil i tytoprescribemedicationsformyveterinarypatients.Instead,theyshouldbeallowingusmoreFDAapprovedmedicationstoimproveourscopeofpractice,insteadofl imitingitfurther.
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151 Regulatethequalityofproduction/certificationbutdonotpenalizethemill ionsofanimalsthatdependoncompoundedmedicationfortheircare.Ifpharmaceuticalcompanieswouldaddressourneedsthenwewouldn'tneedcompounding..unti lthathappensweneedthealternativesfothesegmentofveterinarypracticethatlargedrugcompaniesrefusetoserve
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152 Thechangesproposedwouldsignificantlynegativelyimpactourprofession.Itwouldlowerthestandardofcareandincreasescostofcarel ikelytoasignificantdegree.
5/14/201312:10PM
153 Veterinarianstreatanimalspeciesthatrangefromlessthanapoundtothousandsofpounds.Inaddition,eachspeciesmetabolizesmedicationsdifferentlyfromeachotheranddifferentlyfromhumans.Theinabil itytocompounddrugsintousableformsfordifferentspeciesanddifferentpatientswouldhaveanincredibleimpactonourabil i tytoproperlytreatourpatients.Thepatientsandc lientswil lultimatelysufferthegreatest,aseasilytreatablediseasesmaybecomefatal,duetheinabil itytoobtainaproperdrugconcentrationorformofdrugthatthepatientwil laccept.
5/14/201312:10PM
154 Asstatedearlier,therearedrugbackordersALLthetimenowinourfield.Withoutaccesstoinhousestock,WECANNOTTREATANIMALS!!!Acatthatcannottakeoralmedsneedtransdermalmethimazole.Acatinpainneedsl iquidgabapentin,becausethecapsulesaretoostrong.Aspecific dogthathasvomitinganddiarrheaCAN'Twait3daysforthepatientspecific metronidazoletobeshipped.WHYOHwhywouldyouwanttoinitiatetheserules?Weneedaccesstomedic ines,manytimesthatthepharmacieseitherdon'thaveinsmallenoughsizes,orthattheydon'thavetimetocompoundforus.Pleaseleaveustheabil i tytoorderandusethesemeds-wedon'twantClassIVdrugs-butitemslikemetronidazole,andgabapentin,andamlodipine,arebasics.
5/14/201312:09PM
155 Itwouldgreatlyaffectmypracticeifwewereputundersuchrestric tionsforcompundedmedications.Howcanfederaloffic ialsdictatetheuseandregulastionofcompoundeddrugsiftheydonothaveaDVMbehindtheirname.Notallmedicationsworkforeverycaseandwestrivetofindthosemedicationsthtadoworktohelpourpaitents,thatinc ludesgettingmedicationsfromcompoundingpharmacies.
5/14/201312:06PM
156 Ibelievethereareafewmedsthatneedcompoundingforofficeuse...MetronidazoleforcatsandsmalldogsandmethimazoletoaliquidformationforcatsandSRbuprenexarethethreethatcometomind.Icontinuetogetdifferentinterpretationsofthelaw,soIchoosenottocarryfortheofficeasIwon'tl ieandsaytheyarefor1patientwhichmostcompoundingpharmaciesask.Whateverhappens,Ihopeitatleastc larifiestherules!!
5/14/201312:05PM
157 somecatsrefuseoralmeds!itscompoundedtopicalhyperthyroidmedsordeath.IfZoetiswantstocomeoutwithatopicalmethimazole,great,butunti lthenrestric tingmyaccessisgoingtokil l mypatients.
5/14/201311:59AM
158 Thetypicalturnaroundtimeforacompoundedpreparationtobereceivedinthec linic is2-4days.Thisistoolongformanypatientstowait,giventheirc l inicalconditions.Patientcarewil ll ikelysufferduetolackoffollowupbypetowners(ie,returningtopickupmedsorhavemedsapplied).
5/14/201311:54AM
159 Ineedtobeabletoprescribethemedic inethatIfeelisbestformypatients,intheformthatbestsuitsmypatientsandtheirowners. 5/14/201311:54AM
160 Somemedicationsareonlyavailableasbulkactiveingredients 5/14/201311:52AM
161 Yadayada 5/14/201311:24AM
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Q12Today,compoundingpharmaciesareregulatedbytheindividualstates,with
FDAoversightfocusedonhowchemicalsarestoredandused.IftheFDAweretohavesignificantlygreaterauthorityovercompoundingpharmacies,whatdoyouthinkwouldbetheimpact?Indicatethedegreetowhichyouagreeordisagree
witheachofthesestatements.Answered:940 Skipped:90
Theselectionand...
Thecostofcompounded...
HowVeterinariansUseCompoundingPharmacy
65/89
Therewouldbeapositive...
Patientcompliance...
Theadministrati...
HowVeterinariansUseCompoundingPharmacy
66/89
52.66%495
29.68%279
13.72%129
2.23%21
1.70%16
940
58.72%552
28.40%267
8.62%81
1.81%17
2.45%23
940
51.28%481
28.78%270
15.88%149
3.09%29
0.96%9
938
51.34%480
25.45%238
21.18%198
1.50%14
0.53%5
935
54.15%509
27.45%258
12.66%119
4.04%38
1.70%16
940
41.59%388
25.72%240
20.69%193
9.32%87
2.68%25
933
# Pleasefeelfreetosaymoreaboutyourresponses. Date
1 Anytimethegovernmentisinvolved,itmeansmoreproblems,redtape&cost.Obviously,thereneedstobeoversightonchemicalstorage&usage,butthegovernmentshouldn'tbeabletodic tatewhat,how&whythechemicalsareusedASLONGAStheyarebeingprescribedbyal icensedveterinarian.
5/23/201310:25AM
2 Iwil lfollowtherulesandregulationswhetherIagreeordisagree,butthemoreregulationsoutthere,theharderitistogetthebestpatientcare,affordablemedic ineandownercompliance.
5/22/20133:54PM
DisagreeStrongly Disagree NeitherAgreeNorDisagree Agree
AgreeStrongly
IwouldnotchangehowI...
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
DisagreeStrongly Disagree NeitherAgreeNorDisagree Agree AgreeStrongly Total
Theselectionandavailabil i tyofcompoundedpreparationswouldincrease.
Thecostofcompoundedmedicationswoulddecrease.
Therewouldbeapositiveimpactonanimalsinmypractice.
Patientcompliancewouldincrease.
Theadministrativeburdenonmeandmystaffwouldnotchange.
IwouldnotchangehowIprescribecompoundedmedications.
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3 WhileIunderstandandagreethatmaybemoreoversightiswarranted,Ifeell ikethiswouldscarecompoundingpharmaciesintonotmakingasmanydrugs,ormakeitfinanciallydifficultforthem.SoI'mnotsurehowIfeelwithoutknowingexactlywhat"significantlygreaterauthority"means.
5/20/20131:02PM
4 Compoundeddrugsneedtobecarefullymade,thereisnoquestion,butasforthecontentofthesedrugsandtheiruse,pleasemakeitaseasyaninexpensiveaspossibleforme.Thiswil lsavel ives.
5/20/201310:26AM
5 Idon'thaveagoodfeelforwhattheFDAmightwanttoregulateinregardtocompoundingpharmaciessoIcannotsaywhattypeofimpactitmighthave.
5/19/201310:29AM
6 ThecostsforoversightwouldneedtobeveryminimalorIfearpric ingmedicationsforpetsoutofthemarket.Wearestrugglingasaprofessioninthiseconomytogainc lientcompliance.Costandconveniencearekeytotreatmentsformanypets.
5/18/20139:18AM
7 Becausepharmaceuticalcompanieschoosetomanufacturedrugsbasedonprofit,someveterinarydrugsarediscontinuedorbecomecostprohibitiveforc lientstopurchase.Thisnotonlyrestric tsthequalityofmedic ineIcanprovidebutalsorestric tsthecareanownercanprovidefortheirbelovedpet.
5/18/20135:26AM
8 Iwil lalwaysstrivetoprovidethebestcarepossibleformypatients,unfortunatelyourgovernmentthinkstheycandothatbetterfromtheirdesksthanthoseofusinteractingdirectlywithourc lientsandpatients.
5/17/201310:32PM
9 I'mnotc learonthis.AslongasFDAisensuringqualitywithoutimplementingrestric tions,Iamforthis. 5/17/201310:03PM
10 AlthoughIdon'tmindhavingqualitycontroltomakesurethatharmfulingredientsarenotusedandthatpropercompoundingtechniquesareuti l ized,Ithinkthiswouldbemoreofaheadachethanabenefit.
5/17/20139:53PM
11 IwouldnotchangethewayIprescribecompoundedmedications,unlessthemedicationswerenolongeravailableincompoundedform.
5/17/20137:27AM
12 I'mreallynotsurewhataffectthischangewouldhave. 5/17/20136:36AM
13 Youknowtherewouldbemorehassles. 5/16/20139:09PM
14 Additionalregulationsandbureaucratic redtapewil lincreasecostofmedications,increasepaperworkandthusmyoverheadcostsnegativelyaffectingmyc lientsbyincreasingcostsforthepetowner.Thiswil ldecreaseownercompliancebycausingmorepetownerstodeclinetreatment.IhaveaselectfewreputablepharmaciesthatIrelyonformycompoundingneeds.Thesepharmacieswillalsobenegativelyimpactedbymoreredtapeandmaynotbeavailabletocompounddrugsinthefutureiftheydecidethehassleandexpenseisnolongerworthcontinuingtoprovidecompoundingservices.
5/16/20136:02PM
15 TheFDAdoesnothavetheknowledgebaseordatatoaccesstheseneeds,andIfeartheywouldimposeregulationsthatwouldbeoverlyprohibitiveandaddadditionaladministrationtotheprocess
5/16/20133:31PM
16 howandwhatIwoldprescibewouldbedeterminedbythisfutureunknownlegislation,soIcannotpredicthowitwouldchangemyprescibingunti lIknowthedetailsofthelegislationproposed
5/16/20133:20PM
17 Woulddependonwhattheauthorityentails. 5/16/20133:10PM
18 Addingthese"extrasteps"ismoretimeandcostsmore. 5/16/20133:06PM
19 Iwouldprobablyusefewercompoundedmedicationsifmypaperworkburdenexceededthecostandcompliancebenefitstomyclients.
5/16/20132:54PM
20 Onlyal icensedveterinarianshouldhavethefinalwordinhowtotreathis/herpatients.Telltheineptgovernmenttostickwithwhattheyarebestatielying,cheatingandstealing!
5/16/20132:09PM
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21 Assaidbefore,Iseealotofexotic patients(repti les,rabbits,hamsters,guineapigs,birds,etc)aswellasplentyofsmalldogsandcatsthatareforcedtotakecompoundedproductstobeinasafeandeffectivedoserange.Orwon'ttakepil lsandmusthavel iquidsortransdermalsavailablebecauseunlikepeople,theydon'talwaysknowwhat'sbestforthem.TheFDAdoesn'tseemtounderstandallofthesenuancesfully.
5/16/20131:40PM
22 Thiswouldbeahugeburdenontheindustrycausingpricestoincreaseduetotheaddedadministrativeburdenandconstraints.Thecostwil lbepassedontoconsumerswhoalreadycomplainaboutthecostofveterinarymedic ine.
5/16/201312:48PM
23 At4:00(quittingtimeatthegovernmentoffice)mycasewouldhavetowaitpatientlyforwhoknowswhat.Pleasetellthegovernmentformeto"getal i fe-andleavemealone!
5/16/201312:46PM
24 ThatdependontheFedsabil i tytoregulatetheindustryeffectivelywithoutimpedingitsabil i tytoprovidetheneededavailabil i tyofmedications.
5/16/201312:30PM
25 IdonotknowhowmoreFDAoversightwouldaffectmybusiness,IcanonlyassumeitwouldbenegativebutIhavenoinformationonwhichtobasethisdecision
5/16/201312:08PM
26 Havenoopinionhere. 5/16/201311:55AM
27 thiswouldputanundueburdenonalreadyoverburdensmallbusinesses,whichmostveterinarypracticesare...Itwil l ,asaresult,increasethecosttothepetowner....botharenegativesinabigway
5/16/201310:47AM
28 Compoundingpharmaciescansti l l makemistakesregardlessofwhethertheUSGovernmentoverseesthings.Ithinkthatlessgovernmentinouraffairsisalwaysbetter.Isti l l havetodomyjobtoprotectthewelfareoftheanimalandthereforethepublic .
5/16/20139:07AM
29 ThemoreinvolvedtheFDAis,theworseitisforallofus 5/16/20138:53AM
30 Youmissthepointofthiswholesituation.ThebasicreasonfortheoriginalFederalFoodDrugandCosmetic Actwastotryandensurethatwhatwasinacontainerofmedicationwasactuallywhatitc laimedtobe.Compoundingpharmaciesandespeciallycompoundingmanufacturershaveskirtedaroundthisforyearsanditistimethatcomestoahalt.
5/16/20138:51AM
31 Again,Compoundingisthattheproblem-itwoulddecreasedramaticallyifthetheissueswiththedrugcompanieswouldbedealtwith.IhavenoideahowtheFDAwouldactuallyimpactcompoundeddrugsinourpractice-Icanonlyassumemorelegislation,moreredtape,morecosts.Wearegoingtodothebestwecantocomplywithlawssurroundingcompoundedmedications-ultimatelywewil lchoosewhatweneedtodototakecareofourpatientsinanethical,humaneandresponsiblemanner.
5/16/20138:42AM
32 IpersonallyamnoteducatedonhowFDAauthorityvsstateauthoritywouldchangethings.Howeveringeneral,Idonotfindfederalcontroltotypicallybenefitanyone.
5/16/20138:14AM
33 TOOMUCHGOVERNMENT!!!! 5/16/20137:51AM
34 Financialimpactonc lientswouldbeenormous.Effectivemedicationswouldbehugelyl imited. 5/16/20137:43AM
35 Ifthegovernmentisconcernedwithmakingmoreaffordabledrugsavailableforthepopulationtheyshouldbetargetinglargecorporationdrugmanufacturers,notpharmaciesorprivatepractitioners.Itishardenoughtohaveprescriptionsfi l ledforpatientswithexistinglaws,wedon'tneedittobeharder.
5/16/20137:00AM
36 ifIcannotusecompoundedmedication-Iwouldnotbeadequatelyabletotreatmypatients 5/15/201310:39PM
37 Federalintervention/regulationwil lpossiblyincreasethecomplianceofsmallercompaniesforsafety,butthecostwil lprobablyincreaseandthenumberofcompoundingcompanieswil ldecrease.
5/15/201310:29PM
38 Ithasbeenmyexperiencewhenthefederalgovernmenttakesoverforourstategovernmentsitequalsmoreexpenseandmoreheadacheforusasveterinarians.
5/15/20137:36PM
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39 Themorefederalgovernmentinvolvement,theworsetheoutcome. 5/15/20137:18PM
40 IftheFDAallowedcompoundedmedstobedispensedfromthec linic andthatoverridesthecurrentstatelawtherewouldbeapositiveimpactonanimalsandpatientcompliancewouldincrease
5/15/20133:22PM
41 Lastthinganyoneneedsistohavesomegovernmentbureaucrattell ingmeASADOCTOR,howIshouldusemedicationformypatients.Manyofmypatientsareverysmallandmostmanufacturedmedicationsareinformsthataretoolarge.SoIneedtohavealotofmedicationscompoundedtoaformthatisreasonabletoadminister.
5/15/20132:54PM
42 Biggergovernmentandmoreregulationisnotnecessarilythesolution.Biggergovernmentandbiggerbureaucracyallowsformorecorruptionandineffic iency.
5/15/20132:16PM
43 Again,additionallegislationisnotneeded. 5/15/201312:45PM
44 Iequatenationaloversightwithbetterconformityinproductavailabil i ty,quantity,andprice,whichIbelieveitbenefic ialtopatientsandtheirprescribersoverall.
5/15/201311:29AM
45 Ithinkanytimethegovernmentgetsinvolvedfurther,costsgoupandconveniencegoesdown.IthinktheFDAneedstoconcentrateonwhattheyshouldhavebeendoingbetter.Inpreviousinjurioussituations,thecompoundingpharmaciesinvolvedhaddecidedtostartmanufacturingonalargescaleandtheFDAdidnotdetect/addressit,i fIunderstandcorrectly.Ithinktheyneedtoaccomplishthejobtheyaresupposedtobedoingbeforetheytakeonotherjobs.Therearebadcompounders/situations,justastherearebadmanufacturers/situationsanddoctorsthatmakepoordecisionsbasedonlyonmoneyissues.
5/15/201310:11AM
46 IfIunderstandthesestatementscorrectly,anyadditionaloversight/authority/regulationsonlycomplicatestheprescriptionprocessofusingcompoundedmedications.
5/15/20139:01AM
47 AgaintoughtogaugeunlessIknowfinalbil l byFDA..... 5/15/20138:40AM
48 Iwil lcomplywithanynewfederalregulations.IwouldstronglyhopetheCenterforVeterinaryMedic inewouldbeguidingtheprocess.
5/15/20135:31AM
49 Thesearekindofano-brainer... 5/15/20135:27AM
50 Again,leavethemedicaldecisionsandjudic ioususeofcompoundedmedicationstothediscretionoftrained,ethicalveterinaryprofessionals.
5/15/20135:18AM
51 Italldependswhattheyowiththeirauthority 5/14/201310:07PM
52 Don'tfixwhatisnotbroken!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 5/14/20139:48PM
53 Ireallydon'tknowhowthiswouldaffectme. 5/14/20139:42PM
54 Whetherit'sthepeanutbutterplantfi l ledw/mold&SalmonellainNMorthepharmacyinNewEnglandthatcontaminatedthecorticosteroids,thoseareareasthatneedtoberegulatedforsafety,steri l i ty,productstorage&handling,etc.
5/14/20138:58PM
55 Whatweneedtolearnaboutrecenttragiceventswithcompoundedmedicationsisthatweneedtoregulatetheconditionsunderwhichcompoundedmedicationsareprepared.Regulatingwhichdrugs,orwhichspecies,orhowmuchcompoundedmedicationcanbedispensedwon'tchangethesafetyissue.Thisisc learlyaqualitycontrolissue.
5/14/20138:31PM
56 Wetookanoath.Politic ianscouldn'tcarelessaboutthat. 5/14/20137:52PM
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57 Icannotpredicthowindividualsinthegovernmentwil lvoteorchangethings...unfortunatelythereisnotusuallyassimplebil l orchangethatdoesnothaveanegativeimpactsomewhere.Idonotthinkpricesshouldincreasealthoughthereisalwaysinflation...butthereisalargevarianceinprices...buteaseandcorrectdosageout-weighsthatformany.However,assomeonewhosejobistodonoharmandtohelp...Idonotwantsomeonewhomayhaveothemotivesoral imitedunderstandingofpharmaceuticalstobethejudgeofwhatisbestformypatients.Idothinkthatthereshouldbequalitycontrolmeasuresthatarestric tlyfollowedsothatnothinghappensagainl ikethedeathsthatoccurredwiththemeningitisoutbreak..oranyi l lnessforthatmatter.Wecannotcontrolanindividualsreactiontoaspecific medication,compoundedornot,butwemustnotatethat...andinhistoryhowmanytimeshasamain-streampharmaceuticalcompanyhadmajorrecalls?Allthetime!
5/14/20136:39PM
58 TheFDAneedstostayOUTofthecompoundingpharmaciesunlesstheyarenotmeetingInspectionstandards. 5/14/20136:11PM
59 ThereasonwehavetousecompoundingpharmaciesISbecausetheFDAdecidedcertaindrugsweren'tbenefic ialtohumansanymore-penic il l inampic il l intabletstonameafew.Justl ikewhenTorbutrolusedtobereasonablypricedunti lthegovernmentcausedthepricetoincreasedramatically.
5/14/20134:43PM
60 Havingmoregovernmentregulationswouldinnowayimprovethequalityofcareandwouldsignificantlyincreasethecosts. 5/14/20134:37PM
61 Nodoubtaboutit,thiswouldhaveaverynegativeimpactforallconcerned. 5/14/20134:12PM
62 IdonotthinktheFDAshouldhaveANYgreaterauthorityovercompoundingpharmacies. 5/14/20134:09PM
63 Idon'tknowifbysayingtheFDAwouldhaveoversightthatitwouldbebetterorworse.Iwouldthinkthatiftherearestandardsthataremaintainedacrossthecountrythatthosestandardsmightbemorefair,butthestandardsshouldbesc iencebased,writtenbypharmacists,notbylegislatorsornon-pharmacistlobbyists.
5/14/20133:12PM
64 Iunderstandtheneedforcompoundingpharmaciestobeheldaccountableforqualityandsafety.HavingworkedfortheUSDAIseriouslydoubttheabil i tyoftheFDAtoregulatethisindustryinasafeandeffectiveway.I'mnotsurehowtheiroversightwouldaffectsomethingsbutIamsuretherewouldbesignificantlymorepaperworkandsignificantlymoredelayinobtainingcompoundedmedications.
5/14/20133:04PM
65 Neverseenanythingthefedsgotintothatdidn'tcosttwiceasmuchand10timesthepaperwork.WhynotjusttiethistoObamacare. 5/14/20132:52PM
66 governmentinvolved=lessgoodhappeningforanyone 5/14/20132:08PM
67 Morecostwouldbeassociatedwithcompoundeddrugsandmypatientswil lsuffer. 5/14/20132:02PM
68 I'mokaywithFDAoversight,aslongastherearepractic ingveterinariansandcompoundingpharmacistsrepresentedintheoversight 5/14/20131:53PM
69 Furtherregulationofcompoundingpharmacies,inmyview,isnotnecessary.Theyalreadyadheretospecific regulationsandhavingfurtheroversightisredundantandonlywil limpedeoutabil i tytoeffectivelytreatourpatientsusingsafeandeffectivecompoundedmedications.
5/14/20131:48PM
70 Moreregulatoryburdenwouldonlyincreasecostsanderrors. 5/14/20131:30PM
71 costisaBIGissue,thiswouldincreaseourcost,andthenincreasethecostforeveryone 5/14/20131:29PM
72 Federalregulationveryrarelyimprovesonserviceandcertainlydoesn'tbringdowncost.FDAapprovalwouldobviouslydecreaseavailabil i tyortheywouldn'tberegulating!
5/14/20131:26PM
73 IdonotknowhowFDAoversightwouldeffectmeandmypatients. 5/14/20131:15PM
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74 IftheFederalGovernmentisconcernedenoughaboutitsbudgettoallowthe"sequester"tobecomeeffective,whyaretheysobusyfiguringoutmorewaystoextendtheregulatoryauthorityoftheFDA,whichnotonlywouldbeaburdentoveterinarypractices,butsurelywouldbesubsidizedbythetaxpayeraswell?AlsoalotofwhatIhearfromCongressishowtheyaresosupportiveofbusinesslargeandsmall.Thisproposedlegislationwil lplaceaheavyfinancialandlogistic burdenonveterinarypracticeswhichareoftenmarginallyprofitablesmallbusinessesemploying3-20people.SoisCongressreallybusiness-friendlybutjusttoBigPharmaandtherestisjustl ip-serviceandgrandstanding?IamaveterinarianinasmallfelinepracticeandIvote.Ialsotalktoothervoters--alot.
5/14/20131:13PM
75 Notsurehowitwouldimpactthings,butIamconcerned.Don'twanttoassumetheworstwithoutknowing... 5/14/20131:03PM
76 ItseemsthatwhentheFDAisinvolved,iftheydon'tthinkit'simportant,ittakesforever(ifatall)togetanythingapprovedordone.It'sonemorehugehurdleofgovernmentalbureaucracyforveterinarianstojumpthroughandgettangledupin.
5/14/20131:02PM
77 Theonlyoptionlefttouswouldbetotrytocutdosesofcommerciallyprepareddrugsandmixthemuphereatourhospitalwhichwouldbeverytimeconsumingandexpensive.
5/14/201312:57PM
78 Moregovernmentisnevertheanswer. 5/14/201312:51PM
79 AlltheabovequestionsdependonwhattheimpactFDAwouldhaveoverthemedicationsthecompoundingpharmacieswouldhaveaccessto.
5/14/201312:44PM
80 Theimpactremainstobeseenonhowcompliantpatientsareandhowtheveterinarianscouldorcouldn'tprescribe.Thereisaspeculationinmanyofthesequestionssooveralldifficulttoanswer.
5/14/201312:39PM
81 Theabil itytomakepreparationsthatarepalatableisveryimportant.Tobeabletogetthemedicationintotheanimalisfirstandforemost.IhaveNOstaff,i tisjustme.Tokeepupwiththerecordkeepingwouldbeanightmare.
5/14/201312:39PM
82 Theproblemwithbureaucratic oversightisthat99%ofthoseinvolvedareuneducatedinwhatisbeingregulated.Ihaveahardenoughtimewithpharmaciesfi l l ingincompoundedmedsformypatientsbecausetheydon'tknowwhatit'sfororwhatwearetreatingandquestionmyRX.
5/14/201312:37PM
83 FDAregulationwouldmakelifeverydifficult.ImaynotchangehowIprescribebecauseifi tsmyonlyoptionbutIamcertaincostswouldincreasewhichwouldthenbepassedontothepetowner.
5/14/201312:25PM
84 Mypatientswil lbetheoneswhosuffer,ifIamforcedtodiscontinueusingcertaincompoundeddrugsforthembecauseIamover-burdenedbyunnecessaryextraregulations.
5/14/201312:20PM
85 Itisobviousthatfederaloversightintocompoundingpharmacieswouldincreaseadministrativeburdenforeveryone,increasepricesformedication,decreasec lientcomplianceduetoincreasedmedicationcost,andultimatelyreduceourabil i tytopracticequalitymedic ine.
5/14/201312:19PM
86 IhighlydisagreewiththeFDAhavinggreaterauthorityovercompoundingpharmacies. 5/14/201312:14PM
87 Takingawayorhugelyreducingtheavailabil i tyofcompoundedproductswil lruintreatingcats,andsendusbacktothedarkagesinfelinemedic ine.Pleasedon'tcrippleus.
5/14/201312:12PM
88 manypetownerscan'tpil l theirpets.Compoundedmedicationsareamatterofl i feanddeath. 5/14/201312:12PM
89 I'msurethatthewholeprocesswouldbemorecumbersome. 5/14/201311:55AM
90 Yadayada 5/14/201311:24AM
HowVeterinariansUseCompoundingPharmacy
72/89
57.37% 537
42.63% 399
Q13Beforeyoulearnedaboutthissurveyofveterinarypractices,wereyouawarethataSenateCommitteehadreleasedalegislativeproposalregardingregulating
compoundingpharmacy?Answered:936 Skipped:94
Total 936
# Other(pleasespecify) Date
1 Ihadanideabutnotsureexactlywhatwasproposed 5/17/20137:20AM
2 IheardthismighthappenattheFVMAconference. 5/16/201310:06PM
3 Ihadheardaboutitbutnottotallyawarewhatitwasabout 5/16/20139:40PM
4 wasnotawareofthedetails 5/16/20137:07AM
5 Iwil lbeattendingaCEmeetingregardingtheproposal. 5/16/20136:59AM
6 Onlybecausemycompoundingpahrmacymademeawareanditbecameaburdentomyc lientsandmyselftochangehowmedswereordered.
5/15/20133:49PM
Iwasaware.
Iwasnotaware.
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Iwasaware.
Iwasnotaware.
HowVeterinariansUseCompoundingPharmacy
73/89
7 Artic lesinAVMA 5/15/20138:42AM
8 byinternet 5/14/20135:58PM
9 justfoundout 5/14/20131:34PM
10 Ihadheardsometimeagobutdidn'tknowthetimeframetoenactit. 5/14/201312:59PM
11 Iknewitwasanissuebeforecongress,butnotitsstatus 5/14/201312:00PM
12 Yadayada 5/14/201311:24AM
HowVeterinariansUseCompoundingPharmacy
74/89
74.52% 699
0.32% 3
10.66% 100
2.35% 22
0.00% 0
7.46% 70
4.69% 44
Q14Whichofthesemostaccuratelydescribesthenatureofyourpractice?
Answered:938 Skipped:92
Primarilycompanion-an...
Primarlyfood-chain...
Mixedlarge-and...
Catsonly
Dogsonly
Equineonly
Board-certifiedmedical...
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Primarilycompanion-animal
Primarlyfood-chainanimals
Mixedlarge-andsmall-animal
Catsonly
Dogsonly
Equineonly
Board-certifiedmedicalspecialty
HowVeterinariansUseCompoundingPharmacy
75/89
Total 938
HowVeterinariansUseCompoundingPharmacy
76/89
Q15Howmanyveterinariansworkfullorpart-timeinyourpractice?
Answered:936 Skipped:94
1
2
3
4
5
6
7
8
9
10
Morethan10
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
HowVeterinariansUseCompoundingPharmacy
77/89
30.02% 281
21.05% 197
17.09% 160
10.36% 97
5.98% 56
3.85% 36
2.99% 28
1.71% 16
1.39% 13
0.96% 9
4.59% 43
Total 936
1
2
3
4
5
6
7
8
9
10
Morethan10
HowVeterinariansUseCompoundingPharmacy
78/89
7.49% 70
36.19% 338
35.87% 335
11.03% 103
9.42% 88
Q16Withhowmanycompoundingpharmaciesdoesyourpracticedo
business?Answered:934 Skipped:96
Total 934
1
2
3
4
Morethan4
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
1
2
3
4
Morethan4
HowVeterinariansUseCompoundingPharmacy
79/89
73.42% 685
6.43% 60
1.82% 17
5.25% 49
13.08% 122
Q17Whatisyourprimaryroleinyourpractice?
Answered:933 Skipped:97
Total 933
# Other(pleasespecify) Date
1 Pharmaceuticalpurchasingagent 5/23/201310:26AM
Veterinarian
VeterinaryTechnician
OfficeStaff
PurchasingAgent
PracticeManager
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Veterinarian
VeterinaryTechnic ian
OfficeStaff
PurchasingAgent
PracticeManager
HowVeterinariansUseCompoundingPharmacy
80/89
2 VetAssistantalso 5/22/20139:21AM
3 owner 5/20/201311:22AM
4 Surgeon 5/20/201310:27AM
5 CVTprimary,inventorymanagersecondary 5/20/20137:26AM
6 PracticeownerandMedicalDirector 5/19/20137:30AM
7 AndPurchacingAgent 5/18/201311:21AM
8 andowner 5/18/201310:45AM
9 andRVT/ECC 5/18/20138:45AM
10 Owneralso 5/18/20136:33AM
11 owner-soleproprietor 5/18/20135:27AM
12 SeniorVeterinaryTechnic ian,Mgmt 5/17/201310:55AM
13 PracticeManager/Owner 5/16/20136:19PM
14 purchasingmanager&officemanager 5/16/20136:04PM
15 CVTandManagement 5/16/20133:07PM
16 Owner 5/16/20132:54PM
17 InventoryManager 5/16/20132:21PM
18 Iamalsoal icensedveterinarytechnic ian 5/16/201312:50PM
19 IalsohaveaHouseCallPractice-IamtheonlyVet/owner/purchaser 5/16/201311:31AM
20 CVTalso 5/16/201311:04AM
21 Owner 5/16/201310:58AM
22 owner 5/16/201310:45AM
23 owner 5/16/20139:11AM
24 Owner 5/16/20139:10AM
25 Idoeverythingasfarasapprovingorders. 5/16/20139:08AM
26 Owner 5/16/20138:25AM
27 VeterinarianandMedicalDirector 5/16/20138:07AM
28 owner 5/16/20138:06AM
29 Owner/Partner 5/16/20137:59AM
30 LVTsupervisor 5/16/20137:34AM
31 owner,purchaser,officemanager 5/16/20137:01AM
HowVeterinariansUseCompoundingPharmacy
81/89
32 Internist 5/16/20136:59AM
33 PurchasingAgent 5/16/20136:56AM
34 Owner/administrator/manager 5/16/20136:52AM
35 CEO/CFO 5/16/20136:51AM
36 owner 5/15/20137:01PM
37 andpurchasingagent 5/15/20136:41PM
38 Owner 5/15/20133:49PM
39 VeterinarianandOwner 5/15/201311:29AM
40 Owner/Director 5/15/201310:59AM
41 HospitalAdministrator 5/15/201310:39AM
42 Pharmacistataveterinaryteachinghospital 5/15/201310:17AM
43 Owner-veterinarian 5/15/201310:11AM
44 owner 5/15/20139:33AM
45 alsoaCertifiedVeterinaryTechnic ian 5/15/20139:26AM
46 owner 5/15/20138:59AM
47 AssociateVeterinarianandpreviousownerofHospital 5/15/20138:42AM
48 OfficeManager 5/15/20138:19AM
49 Pharmacymanager 5/15/20138:01AM
50 Pharmacy&Inventorymanager 5/15/20137:30AM
51 Owner 5/15/20136:18AM
52 owner 5/15/20135:51AM
53 Practiceowner 5/15/20135:28AM
54 Owner 5/14/20139:25PM
55 practiceowner 5/14/20139:17PM
56 owner 5/14/20138:32PM
57 owner 5/14/20138:00PM
58 Owner,aswell 5/14/20137:11PM
59 owner 5/14/20136:06PM
60 Iamalsotheowner 5/14/20135:53PM
61 Owner 5/14/20134:13PM
HowVeterinariansUseCompoundingPharmacy
82/89
62 owner 5/14/20133:33PM
63 Owner 5/14/20133:22PM
64 Andpracticeowner 5/14/20133:10PM
65 Owner 5/14/20133:07PM
66 Inventory 5/14/20132:58PM
67 Veterinarian,PracticeManager,andowner 5/14/20132:29PM
68 owner 5/14/20131:46PM
69 InventoryControl 5/14/20131:44PM
70 Owner 5/14/20131:09PM
71 Owner 5/14/201312:50PM
72 PharmacySupervisor 5/14/201312:42PM
73 Zoo-exotic practice 5/14/201312:41PM
74 mostlyretired,workonedayamonth,butworkedfulltimefor16yearsbeforethen 5/14/201312:36PM
75 owner 5/14/201312:33PM
76 practiceowner 5/14/201312:30PM
77 Andanythingelsetherewastochoose,ie,purchasingagent,officestaff,etc.,etc. 5/14/201312:24PM
78 workforapublic aquarium,university,andexotic animalsanctuaryaswellas3privatepractices 5/14/201312:14PM
79 owner 5/14/201312:13PM
80 PharmacyManager 5/14/201312:10PM
81 InventoryManager 5/14/201312:04PM
82 Owner 5/14/201311:59AM
83 Yadayada 5/14/201311:24AM
HowVeterinariansUseCompoundingPharmacy
83/89
Q18InwhatstateorU.S.territoryisyourmainpracticelocated?
Answered:931 Skipped:99
Alabama
Alaska
AmericanSamoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
DistrictofColumbia(DC)
Florida
Georgia
Guam
HowVeterinariansUseCompoundingPharmacy
84/89
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
HowVeterinariansUseCompoundingPharmacy
85/89
Nebraska
Nevada
NewHampshire
NewJersey
NewMexico
NewYork
NorthCarolina
NorthDakota
NorthernMarianas...
Ohio
Oklahoma
Oregon
Pennsylvania
PuertoRico
RhodeIsland
HowVeterinariansUseCompoundingPharmacy
86/89
1.83% 17
0.32% 3
0.00% 0
SouthCarolina
SouthDakota
Tennessee
Texas
Utah
Vermont
Virginia
VirginIslands
Washington
WestVirginia
Wisconsin
Wyoming
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
AnswerChoices Responses
Alabama
Alaska
AmericanSamoa
HowVeterinariansUseCompoundingPharmacy
87/89
0.97% 9
0.54% 5
6.23% 58
2.26% 21
1.93% 18
0.21% 2
0.32% 3
7.20% 67
3.44% 32
0.00% 0
0.32% 3
0.43% 4
3.33% 31
1.61% 15
0.86% 8
1.07% 10
1.18% 11
1.83% 17
0.86% 8
3.44% 32
3.01% 28
4.19% 39
3.54% 33
0.75% 7
0.32% 3
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Distric tofColumbia(DC)
Florida
Georgia
Guam
Hawaii
Idaho
Il l inois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
HowVeterinariansUseCompoundingPharmacy
88/89
0.43% 4
0.54% 5
0.21% 2
0.75% 7
3.22% 30
0.32% 3
7.30% 68
0.11% 1
0.00% 0
0.00% 0
3.01% 28
1.29% 12
1.72% 16
5.59% 52
0.00% 0
0.43% 4
1.72% 16
0.11% 1
2.04% 19
5.48% 51
0.32% 3
0.86% 8
5.59% 52
0.00% 0
3.11% 29
Montana
Nebraska
Nevada
NewHampshire
NewJersey
NewMexico
NewYork
NorthCarolina
NorthDakota
NorthernMarianasIslands
Ohio
Oklahoma
Oregon
Pennsylvania
PuertoRico
RhodeIsland
SouthCarolina
SouthDakota
Tennessee
Texas
Utah
Vermont
Virginia
VirginIslands
Washington
HowVeterinariansUseCompoundingPharmacy
89/89
0.21% 2
3.33% 31
0.32% 3
Total 931
WestVirginia
Wisconsin
Wyoming