Who needs to keep up to date on veterinary medicines, and why?
Who needs to keep up to date on veterinary medicines, and why?
Medicines change all the time. In 2021, 85 new veterinary medicines were licensed in the UK by the Veterinary Medicines Directorate (VMD), around half of which are for small animals (mainly cats and dogs, and one for rabbits), half are for farm animals and a few are for horses. In the same year there were more than 150 changes to the product information of already-licensed products. Knowing about new treatments and acting on changes can make a difference to animal welfare (by improving treatment outcomes and reducing the likelihood of the unwanted effects), ensure you fulfil legal and professional responsibilities, and may increase profits.
Veterinary medicines licensed in the UK in 2021 by species group
The benefits of keeping up to date
Improve patient welfare. Few of the new veterinary medicines that come to market each year are completely new treatment options (e.g. the monoclonal antibodies Librela [bedinvetmab] and Solensia [frunevetmab]). New products that are not completely new therapeutic options (e.g. they contain a drug that is a new member of an existing therapeutic group or are new formulations of existing drugs, or new drug combinations) may also offer benefits overall or for certain patients. Knowing about new options potentially means being able to offer more effective, safer or more convenient treatments. But just because something is new doesn’t mean it necessarily offers benefits over already-available treatments. Sometimes claimed benefits are theoretical or so marginal as to not be important or are outweighed by disadvantages. So, it goes almost without saying, that it is important not to rely solely on information about a new medicine that has been supplied by the company selling the product.
Take advantage of beneficial features. Most of the veterinary medicines licensed are generics of existing brands (see the pie chart below for a breakdown of 2021 products). Generics are potential alternatives to the brands you currently use and they might have benefits, such as a longer in-use shelf-life, better palatability, wider range of tablet strengths, or a lower cost.
Prevent adverse effects. The summary of product characteristics/datasheet/package leaflet of a medicine is updated as more is learned about a medicine. Most changes concern adverse effects, because when a medicine is first marketed there is limited knowledge about the adverse effects profile, and continuous monitoring leads to better information about the range and likelihood of adverse effects as the product is used in a wider population. Occasionally information is added that helps prevent adverse events. For instance, the requirement (introduced in 2019) to supply disposable gloves for clients to wear when applying Bravecto spot-ons.
New business opportunity. A change in the supply a category from prescription to non-prescription can open up new selling options.
Comply with regulations. Some new products are the first veterinary licensed formulations of drugs that are already being used in veterinary medicine, either as human formulations (e.g. Stromease [acetylcysteine] or as veterinary specials (e.g. Vetoryl (trilostane]). As such they become the first step in the prescribing cascade when the drug treatment is indicated for a specific patient. Sometimes regulatory changes can mean more restrictions on the supply of a product (e.g. Pardale-V was changed from non-prescription to prescription-only in 2019).
Keep staff and clients safe. As well potential benefits, new medicines usually come with important warnings to ensure safe use. Several recently licensed products (Librela, Solensia, Nexgard Combo, Felisecto) come with warnings related to handling of the product by women who are, or might be, pregnant. (For more on safe handling see the blog Handling medicines and pregnancy – who is at risk? Being aware of these and taking appropriate actions ensures that people who handle medicines are kept safe.
Veterinary medicines licensed in the UK in 2021 for small animals by product type
Who needs to keep up to date?
In veterinary practice, veterinary medicines may be a part of everyone’s job in some way or other, but usually not all of anyone’s. Anyone in veterinary practice whose role includes any of the following responsibilities needs to keep up to date with aspects of medicines that are relevant to their role:
· Prescribing medicines
· Dispensing medicines
· Dispensary management
· Supplying medicines
· Making medicine purchasing decisions
· Handling medicines
· Communicating with clients about medicines
· Practice management with responsibility for staff safety and waste management.
How to keep up to date?
The VMD distributes a monthly medicines update, which is published by the veterinary media (Vet Record, Vet Times etc). Veterinary Prescriber’s monthly Medicines News, available to subscribers, includes information from the VMD’s update together with additional medicines news and explanatory information. With the job of collating the information made easier by these resources, the challenge is to ensure that it gets to the people who need to know. If one person in the practice is responsible for monitoring changes, these need to be communicated to other team members so that appropriate actions can be taken. In a busy practice environment, it is easy for such a task to be overlooked or forgotten despite having protocols in place. It is therefore important to allow dedicated time during work hours and the activity should be monitored as part of the delegated person's appraisal. A protocol for keeping up to date on medicines should include provision for when the activity is to occur as well as who is responsible for it and who is responsible in their absence.
The method of communication of any changes should be regular, predictable and trackable to ensure that all appropriate team members are aware of the changes and that proof of training in the updates is available. An efficient method of sharing medicines updates is via a process and training management system, such as Training-Progress which can be used to communicate medicines changes to team members and provide proof of training in the event of a VMD inspection or as part of a RCVS PSS assessment.
Related Veterinary Prescriber CPD modules (available to subscribers)
How to keep up to date on medicines
Deciding which medicines to stock
written by Andrea Tarr
Founder and Director, Veterinary Prescriber