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Q1 How Important to Your Practice Is Having Access to Compounded Medications When You Believe They Are Necessary?

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Q1 How Important to Your Practice Is Having Access to Compounded Medications When You Believe They Are Necessary? How Veterinarians Use Compounding Pharmacy: 2019/2020 Q1 How important to your practice is having access to compounded medications when you believe they are necessary? Answered: 2,039 Skipped: 0 Importance of access to... 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Very Important Important Neither Important nor Unimportant Somewhat Unimportant Not at all Important VERY IMPORTANT NEITHER SOMEWHAT NOT AT ALL TOTAL WEIGHTED IMPORTANT IMPORTANT UNIMPORTANT IMPORTANT AVERAGE NOR UNIMPORTANT Importance of 92.40% 6.96% 0.29% 0.25% 0.10% access to 1,884 142 6 5 2 2,039 4.91 compounded medications 1 / 165 How Veterinarians Use Compounding Pharmacy: 2019/2020 # PLEASE FEEL FREE TO SAY MORE ABOUT YOUR RESPONSE. DATE 1 We have many patients in the veterinary world who refuse to take available veterinary or 1/13/2020 3:30 PM human generic medications that can literally mean life or death. The ability to compound a medication for easier administration is imperative to those patients. There are also drugs such as apomorphine which is only available through a compounding pharmacy that is absolutely a life saving drug when it's needed. It is much safer than the alternative of administering peroxide by mouth since peroxide aspiration can severely damage lungs and its effects are reversible with currently available medications. 2 One example of a case we have now-the dog has mersa. and another skin infection, nothing 1/13/2020 2:08 PM has worked on it-being able to get the drugs we need to treat cases such as this is what makes it so we can treat and bring relief to the pet, instead of euthanasia 3 Allows us to tailor medications to provide the best treatment possible. 1/13/2020 10:58 AM 4 So many pets are hard to medicate and having access to specific types of medications, 1/13/2020 9:58 AM dosages, and different types of compounds are vital to treating these pets. 5 There are certain conditions, both acute and chronic, for which a compounded medication is 1/13/2020 9:43 AM medically necessary. Restricting access to these medications would have negative implications for the veterinary industry AND for pet owners. 6 In some situations it is the only option for obtaining a medically critical medicaiton for treating 1/13/2020 9:06 AM my patients. 7 A lot of medications are compounded to make the dosage appropriate for patients that are 1/13/2020 8:05 AM smaller or bigger than the allotted milligrams available for medications. 8 For feline and small breed dogs compounded medication is vital to ensure proper dosing. 1/12/2020 1:24 PM 9 This is especially important in our feline patients because we do not recommend forcing a pill 1/12/2020 1:01 PM down their throat. The compounded medications can be flavored and even crushed and added to food. This allows us to avoid pilling our feline patients. 10 As medical professionals treating patients ranging from less than 2 pounds to over 150 pounds, 1/11/2020 4:59 PM the few available concentrations offered commercially are not sufficient. Compounded medications are crucial for delivering appropriate dosage. In addition, non-humans are often not interested in ingesting medications as they do not have the capacity to see the benefit. If we are unable to provide incentive (palliative options), compliance is low. 11 Most compounded drugs are essential for treatment and we would not be having them 1/11/2020 7:46 AM compounded if there were other options available. Since these drugs are not available in a FDA approved form or in the form needs, especially for cats or exotics, we would not have any medication for treatment. This would SERIOUSLY affect the treatment capabilities of veterinarians that deal with these species. 12 Given the lack of access to certain drugs which may be on back order, sometimes compounded 1/10/2020 6:54 PM medications are the only option. Also certain compounded medications are the only way some owners can get the medications into their pets. 13 Without compounded medicine we will be very limited in our medical choices. 1/10/2020 4:44 PM 14 Most of our patients don't fit standard human sizes on doses and require compounded 1/10/2020 1:00 PM medications 15 There are times when an important medication is not commercially available like currently 1/10/2020 11:58 AM vetmedin(pimobendan)for heart disease, or generic vetoryl (trilostane) or tacrolimus for dry eye disease. these are meds that we cannot do without. it would be a crime against pet humanity not to be able to have these important meds. with the shortage very commonly anymore and every day of the commercially available forms of many meds it is very important to have this alternative/option 16 There are drugs not available commercially for safely treating conditions for the health and well- 1/10/2020 11:27 AM being of our companion animals. One such drug is Ponazuril. This drug is a coccidia cidal agent that is commercially available for equines. The other treatment for coccidia is a coccidia static agent (Albon - which has been used for decades) and coccidia is resistent to this older drug. Also, there are some commercially available drugs that go on extremely long backorder. That is life threatening to some patients i.e., congestive heart failure drugs. 2 / 165 How Veterinarians Use Compounding Pharmacy: 2019/2020 17 I use them in at least 50% of my patients under 20lbs in weight, and I am a small animal 1/10/2020 11:15 AM exclusive practitioner. 18 We have many small animals on medication that needs to be compounded to the correct dose 1/10/2020 10:24 AM for them. Without compounding, these pets wills not be able to get the medication they need. 19 Not having immediate access to compounded drugs could cause potentially life-threatening 1/10/2020 10:15 AM results. Please do NOT put our patients in harm's way by restricting this access to us. 20 Pets need these medications available to them whether it is because the name brand is back 1/10/2020 10:11 AM ordered or because they offer tiny tabs/medi melts etc that help the owner give the medication easier. 21 Deal w major size differences in patients and dosing appropriately would not be feasible in 1/10/2020 9:49 AM significant number of individuals. 22 Many emergency medications are only available through compounding pharmacies. Also, when 1/10/2020 9:32 AM MANY drugs become unavailable due to back-orders, it can become a life-threatening situation if we can't prescribe a compounded replacement. 23 It is critical to have multiple methods of administration of medications for pets because 1/10/2020 9:25 AM administration to pets can be exceedingly challenging. What works for one, will not always work for another. In particular small dogs and cats are foremost in the patients that need multiple options but I know large breed dogs that do too. Transdermal, liquid, tiny tabs, chews, chew- able tabs are critical in the treatment of many long term chronically ill patients whose lives would be DRAMATICALLY shortened without these medications. Often it requires more than one form before we find the one that works. Having the option of combining medications in a single dose is also extremely helpful, particularly for heart disease patients. Imagine all the drugs a human takes 2-3 times a day and then trying to get that into a small dog that chews everything. It is a real challenge. Eliminating this option to veterinarians will be detrimental to patient health in a myriad of ways. 24 Due to size variations in patients, inability of the pet owner to administer tablet form 1/10/2020 8:31 AM medications, and back-ordered products, it is vital that we be able to have compounded medications as a stop gap for those patients who need it. 25 As an emergency facility, we have more than the average number of compounded medications. 1/10/2020 7:37 AM Our patients come in all sizes and limiting the compounded medications would inhibit our ability to save lives and ease pain and suffering in patients of smaller size. 26 Some of the medications we have compounded are frequently unavailable through commercial 1/9/2020 3:11 PM vendors 27 So many formulations and strengths vary from what is available 1/9/2020 2:51 PM 28 So many FDA approved formulations are not sized for use in small dogs and cats 1/9/2020 2:50 PM 29 Our practice sees exotic animals, many of which need much smaller doses of medications than 1/9/2020 2:32 PM commercially available. This law would definitely hinder our ability to care for these animals. 30 Many drugs from time to time are not available and many we need in different form so the client 1/9/2020 2:30 PM can administer appropriately. 31 I use compounded medications on a weekly basis because of difficulty accurately dosing 1/9/2020 1:21 PM human medications as well as difficulty giving medications in human forms to some patients. 32 In many cases, pet parents can't give medications to their pets easily, especially oral tablets. 1/9/2020 12:51 PM Having access to other forms, such as flavored liquids or trans-dermal gels, greatly increases owner compliance and the health and wellbeing of the patients.
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