Big-Box Pharmacy Challenge
Nothing makes my blood boil faster than a flashy marketing campaign that promotes partial truths in the pursuit of the almighty dollar. They promise anything from weight loss without exercise to overnight fortune without any actual work, knowing full well these aren’t the norm. We know it too, if we use our brains and remember what our parents taught us; “If it’s too good to be true, it probably is!” So why then, do these campaigns exist? Because they work! There’s nothing new about these tactics, they’ve been around since the days of town-to-town snake oil salesmen. Only now, it’s brought to you via the Internet and Social Media. All of it tailored to you, using your search history and social media ‘Likes’ to bring you to the realization that you really do need to order you and your dog matching pajamas.
Okay, so matching doggie pajamas are pretty harmless, but what about the advertisements that are directed towards the health of our patients? The ones that advertise the exact same medications as your veterinarian, but at a much cheaper price! The ones that advertise that all their medications are 100% guaranteed! What about those advertisements? Are those harmful to our patients? I would argue yes! (Well, possibly!) Our clients have no problem calling us, talking with us, and emailing all kinds of questions about their pets. But when it comes to finding a cheaper route to fill their pet’s medications, it’s rare to find an owner that comes to their veterinary office to ask questions first. I suppose conversations about money are difficult, or maybe they feel like they’re cheating on us when they fill their pet’s medication somewhere else. Whatever the case maybe, it’s a conversation that needs to be had and the veterinary staff must be the ones to begin the dialog.
I know some of you are thinking, why is this a big deal? Do we really need to spend staff time talking to clients about something they don’t really want to discuss? It really is a big deal, especially when there’s a medication failure. We all know most heartworm preventatives come with a manufacturer’s guarantee. If a pet is diagnosed with heartworms, after an owner has been diligently giving prevention every month, the manufacturer will cover most of the treatment costs, right?? They absolutely will, IF all of the criteria for the guarantee have been met. They’re all fairly similar, with some slight differences, but in general the guarantee requires that dogs have regular Heartworm testing and maintain a solid purchase history of that manufacturer’s preventative (meaning you can’t switch from preventative to preventative.) Some manufacturer’s do honor their guarantee when products are purchased outside of the veterinarian’s office or related online pharmacy (VetStreet, VetSource, etc.), but a large majority do not. So that $20 a year saving through the big-box pharmacy equates to giving up an essentially free insurance plan for your pet, in the event of preventative failure. The question is, do your clients know this and if they did would they care?
I was recently tasked with opening a case with the manufacturer, for two different pets that were diagnosed with Heartworms. One was a long-time patient of ours; fortunately, she had the most textbook perfect Heartworm prevention purchase history, Heartworm test history, and all of it was done through our hospital. Grant it, it was quite a bit of paperwork on our part, but her treatment costs were completely covered by the manufacturer. The other, was a new patient. When the Heartworm test came back positive, the owner was shocked. He explained that his dog had been on regular prevention for years and that he had records to prove it. After many hours of going between owner, Heartworm preventative manufacturer, and previous veterinarian; the claim was denied due to the prevention being purchases through an online pharmacy that was not authorized by the manufacturer, thus voiding his guarantee. The dog still ended up being treated, but not without a very angry client. They were angry at the previous veterinary hospital and not at us. The previous veterinary hospital was only guilty of not starting the Big-Box Pharmacy conversation. He had no idea that in saving $20 annually on his dog’s Heartworm prevention, he was actually giving up a $1,500 insurance policy.
It takes time, it takes resources, and it takes patience, but we are talking about patient health here. The conversation needs to start in the exam room, when the doctor or technician realizes that the owner is declining to fill preventatives and is likely going to go home and order through one of the big-box guys. That’s the time to mention this issue. Inevitably, you will still have those big-box pharmacy prescriptions come through for approval. Don’t just approve the prescription and ignore the conversation. This is your opportunity to have a conversation. Have one or two people in charge of this area, so that they can stay on top of this area. I keep a spreadsheet of all our preventatives and their manufacturer’s guarantee policies. I call the manufacturer’s regularly, and update as needed (and they do change!) When a big-box prescription refill request comes in, call the owner and let them know what their options are. Say something like “Mrs. Jones, I was calling to chat with you about Fluffy’s prescription for Heartworm preventative through 888-Dog-Pills Pharmacy. I wanted to let you know that we have spoken with the manufacturer of Heartflexis and they have let us know that they do not sell their product to this pharmacy and several other online pharmacies. Since they don’t sell to this pharmacy, they are unable to track the product to ensure that it is legitimate and that it was handled properly. Because of this issue, they are unable to guarantee this medication when purchased through this pharmacy. (If appropriate you can say…) Right now Fluffy has a guarantee through the manufacturer, since you have been purchasing your Heartflexis here at our hospital. If you fill through 888-Dog-Pills Pharmacy, it will void the guarantee. We can still process your prescription through this pharmacy if you would like, but we needed to make you aware of the risk. Or we can certainly fill it here if you prefer.” Of course the conversation would need to change depending upon the individual prescription and that manufacturer’s guarantee.
Our big-box prescriptions have gone down significantly, and so can yours. It is amazingly helpful to be well versed in what the policies are for the major preventative brands. Identify someone (or two) in your practice that can take on the big-box challenge.
Sometimes price matching can help combat the big-box guys as well. But frankly, I rarely have to do that anymore. The vast majority of the time, once a client is educated; they choose to spend a few more dollars to gain peace of mind. I would urge you to resist the temptation to price match unless absolutely necessary.
Keep in mind, you won’t win every battle (I feel like a piece of my soul goes with every approved big-box prescription! Ha ha!) and you certainly don’t want to lose a client over it, by harassing them every time they try to fill a prescription. Once this conversation is had, document it and don’t keep calling every time a prescription comes through.
The key is to keep the conversation light, stick to the facts, and don’t judge. The majority of your clients will appreciate the time you’re taking to keep their pet safe. But for most clients, if choosing the big-box guys costs them peace of mind, the cost is too high.