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Changes to Antimicrobial Drug Access in Canada: A Rural Veterinary Perspective (Part 2 of 3)

nov. 24, 2017

The Veterinarian-Client-Patient Relationship (VCPR)

This is our second of three articles submitted with the assistance of the Saskatchewan Veterinary Medical Association (SVMA) to inform livestock producers and pet owners in our area about why these changes are happening, where they are coming from and how they affect rural veterinary clinics along with the clients and patients they serve.

The changing regulations around prescribing livestock and pet medications in Saskatchewan is currently a touchy subject in rural veterinary practice. When we choose to inform our clients of these regulations, some are excited to be a part of the innovation and ensuring safe access to antimicrobials for generations to come, while others consider them a personal attack by their local clinics. They seem to think that we don’t consider them “good clients” or that we are “changing everything” or that we are simply doing a “money grab”. This article is intended to shed light on where these regulations are really coming from.

We are all entitled to our own opinions, but as the mission of our practice includes a focus on client education and increasing producer knowledge, we thought it best to live up to our word and ensure our clients are among the first to know what is going on in our country, and are not left in the dark about the regulatory changes that will affect their livestock and pets’ veterinary care, and potentially their livelihoods.

What is a VCPR, why does it matter to livestock and pet owners, and why is it so important for access to antimicrobials and other prescription drugs?

  • The VCPR is based on documented evidence that the veterinarian has undertaken the steps necessary to establish medical need and consequently prescribe and subsequently dispense pharmaceuticals.
  • The VCPR is not a signed contractual agreement but rather a working connection and interaction between veterinarian, client and a specific animal patient or group of animals.
  • The VCPR is not in and of itself an entitlement to prescribe and subsequently dispense.

According to Saskatchewan Veterinary Medical Association Bylaws, a legitimate VCPR is only considered to exist if medical records of a veterinary practice contain sufficient evidence of relevant and timely interaction between veterinarians, animal owners and their animal patients. These interactions may include, but are not limited to: farm or home visits, clinic appointments, consultations, direct animal examinations (individual or groups of animals), laboratory reports and/or production record reviews.

For a valid VCPR to exist, ALL of the following conditions must be met:

  1. The veterinarian has assumed the responsibility for making clinical assessments and recommendations regarding the health of the animal(s) and the need for medical treatment.
  2. The veterinarian has sufficient knowledge of the animal(s) on which to base the assessment, diagnosis and treatment of the medical condition of the animal(s). This means that the veterinarian has recently seen and is personally acquainted with the keeping and care of the animal(s) by virtue of an examination  of the animal(s) or by medically appropriate and timely visits to the premises where the animal(s) are kept.
  3. The client has agreed to follow the veterinarian’s recommendations and prescription.
  4. The veterinarian is available or has arranged for follow-up evaluation, especially in the event of adverse reactions or failure of the treatment regimen.

How VCPR Influences Prescription Drug and Antimicrobial Access in Canada

What medications CAN ONLY be sold WITH a valid VCPR and prescription in Saskatchewan? 

All prescription drug sales require a VCPR. Prescription drugs include any drug having a Pr symbol on their label, all antimicrobials and controlled substances. Extra label drug use (ELDU) of any medication will need a prescription. What this means is medications that are to be used in species other than those specified on the label are being used ELDU and will require a prescription and therefore a VCPR.

What medications CAN currently be sold WITHOUT a VCPR in Saskatchewan?
Vaccines (except for Rabies) and non-prescription medications can be sold without a VCPR as long as they are used according to label directions.

Animal owners need to know that veterinarians are bound by professional obligation to follow these regulations set out for them, and that examination and diagnoses required for a proper VCPR are necessary to create a safe and effective plan for any antimicrobial use in animals.

NEXT IN THE SERIES: WHO REGULATES ALL THIS AND HOW DO WE KNOW WE ARE MAKING THE CORRECT CHOICES IN MEDICATION SELECTION?

The Canadian Veterinary Medical Association thanks the writer, Dr. Klea-Ann Wasilow of Maple Creek Veterinary Services, and the Saskatchewan Veterinary Medical Association for permission to share this important information. Download a PDF here.