In his opening address Andrew Cairns, VPG Chair said there are huge and rewarding opportunities for pharmacists in the supply of veterinary medicine. Whether we are involved in the supply of medicines to pet owners or to livestock rearers the input of the pharmacist can be important. More than half the people who visit a pharmacy own a pet. There are many who also own horses.
Pet owners are as numerous in cities as in rural environments so every community pharmacist, wherever he or she is located, needs to be competent in the handling and supply of veterinary medicines for pets. So every community pharmacist now needs to have generalist knowledge of the Veterinary Medicines Regulations that govern veterinary products, this over and above the requirements of the Medicines Act and the myriad of rules that govern the NHS. It is a challenge but a challenge that must be met.
Supply of veterinary medicinal products
Martha Spagnuolo-Weaver, Head of Legislation at the Veterinary Medicines Directorate (VMD) gave a comprehensive review of EU and UK legislation as it affects the supply of Veterinary Medicinal Products. She explained that the Veterinary Medicines Directive 2001/82 sets out the controls on the manufacture, authorisation, marketing, distribution and post-authorisation surveillance of veterinary medicines applicable in all Member States. The Directive provides the basis for the UK controls on veterinary medicines, which are set out nationally in the Veterinary Medicines Regulation 2009 - SI 2297. These Regulations are normally re-issued annually but because of the UK general elections no new Regulations were issued in 2010. Mrs Spagnuolo-Weaver said that pharmacists were Registered Qualified Persons (RQPs) and had responsibilities at the time of supply to ensure that:
• The medicine is appropriate for the animal and condition to be treated – (e.g. if NFA-VPS, ask questions about last treatment, pet’s age, weight etc.)
• The client understands how to use the product safely (e.g. read warnings, wear gloves if directed etc).
• The medicine is prepared correctly.
• The medicine is labelled correctly if not in the original authorised packaging.
• The minimum amount required for treatment is given (except where packs can’t be split).
Dr Steven Kayne, Professional Director of the Veterinary Pharmacy Education Programme explained that even though delegates were RQPs by virtue of their pharmacy qualification, most colleagues would struggle to deal with enquiries from pet owners without undertaking extra training to supplement their knowledge. The RPS had teamed up with Harper Adams University College in Shropshire to provide a fully accredited suite of qualifications from certificates in Companion Animal and Equine health care and Large Animal health care right up to a Master’s degree in Veterinary Pharmacy. Full details are available at www.vpep.net. There was also a veterinary text book available for pharmacists.
Maggie Fisher, Shernacre Enterprise (a consultancy specialising in effective communication within the field of Veterinary Parasitology) discussed the topic of ecto- and endo-parasites in companion animals. She outlined how the treatments were carried out highlighting the spectrum of activity for different chemical entities. Ms Fisher presented a number of case studies reflecting scenarios that pharmacists might meet in daily practice.
Developing veterinary business
In a presentation entitled ‘Developing Companion Animal Veterinary Business in a Community Pharmacy, Raj Shah, Business Development Manager Sigma Pharmaceuticals plc explained that the value of the flea treatment market exceeds that of smoking cessation or hayfever and is twice that of sleeping aids and headlice treatments combined. The market for the product Frontline is almost three times that of a popular cough product. For this reason multiples and supermarkets are already involved. Mr Shah said that in order to develop the pet care business pharmacists need to
• Participate in personal and staff training schemes so they can give advice to pet owners.
• Concentrate on NFA-VPS products with high brand awareness.
• Engage customers by appropriate merchandising and alter their perceptions of what pharmacists can do.
• Start slowly and increase the range of products when trade rises.
• Work with other pet care providers.
Pharmacist Martin Shakespeare spoke on the relevance of zoonoses to pharmacists in practice. Mr. Shakespeare explained that a zoonosis is defined by the World Heath Organisation as being ‘Those diseases & infections which are naturally transmitted between vertebrate animals and man’ He said that as with many definitions, some of the conditions that are generally classifed as zoonoses may lie outside the strict definition. For example, Ciguatera and the related complex of shellfish poisonings are the result of ingested toxins, not an infective agent, and shellfish are invertebrates, however, as this condition is not easily placed into any other disease classification, and can be caused by eating fish, it is generally accepted as being a zoonotic.
Other afflictions, such as malaria, which most people assume to be zoonoses, are not. The malarial mosquitoes are only a vector for the disease with the reservoir of infection being infected humans, rather than animals. Delegates were told that approximately 80% of new diseases in during the last decade are zoonoses and that:
• They can potentially cause epidemics and pandemics.
• The threat potential of zoonoses depends on ease of transmission & pathogenicity.
• Zoonoses affect domesticated, companion, and wild animals.
• Zoonoses are important in food safety.
Pharmacists are in a position where they are ‘astride the line’ between human health and veterinary health. Much human zoonotic disease stems from a lack of knowledge, with children particularly at risk. Pharmacists can offer advice on hygiene and other measures that will minimise the risk of infection from animal and food born zoonoses, particularly in ‘at risk’ groups.
Large animal medicine
Veterinary Surgeon Alasdair King, MSD Animal Health, gave an overview of large animal veterinary medicine. He identified four types of large animal keepers, each with differing requirements and priorities:
• Highly professional automated farms.
• Traditional farms ‘doing things as they always did’.
• Small holdings with a few animals some of which may be kept as pets.
• Diversified farms, where keeping animals is only part of the operation.
Mr King stressed that it is vitally important to adopt an integrated approach to veterinary care in all situations; the whole health status of an animal must be considered when prescribing veterinary medicinal products. Opportunities do exist for pharmacists to become involved but they must understand the complex decision making process associated with farm management.
Ian Scott, Secretary General Animal Health Distributors Association gave the AHDA view of where pharmacy fits in to veterinary health care. AHDA and RPS members had a history of working against each other, but since the abolition of the Pharmacy only distribution category, relations had improved greatly and there were now 18 corporate pharmacy members of AHDA. Mr Scott explained the duties of Suitably Qualified Persons (SQPs) who mainly work on merchant’s premises and like pharmacists are able to prescribe and supply items classified as POM-VPS and NFA-VPS. He referred to the new anthelmintic, Monepantel, that had reached the market. Despite the fact that 85% of existing products in this therapeutic group are distributed through merchants and pharmacists it has been classified POM because of fears of resistance being built up. AHDA is gearing up to be ready should the classification be changed to allow its members to distribute the product. Mr Scott called for closer co-operation between RPS and AHDA in a number of areas, not the least being a joint continuing defence of our right to sell animal medicines.
Citation: The Pharmaceutical Journal URI: 11080573
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