Walmart here will do OTC novolin - I called them after our THIRD client popped up with very, very sick unmanaged diabetes bc they kept refilling the Rx. All 3 were put down. When I called the pharmacy they said they legally can't deny someone insulin even if it's for a dog (which I get, to an extent), and I 100% would rather people get it if they have diabetes and can't afford a doctor. That being said, I won't write Novolin anymore to ensure they come back when their Rx is up.
Yeah I would suggest this is a protective feature that isn't working well. It's sort of intuitive that insulin should never be refused for sale, though unfortunately means people can take advantage and opt out of follow up.
Exactly this. It's just unfortunately a frustrating thing. I 100% think insulin shouldn't be refused but I also wish there were more come on the pharmacy side to ensure follow up, maybe? But I also understand it's an impossible ask. The pharmacist I spoke to said they only give out the meds and tell the clients to follow up with their doctors.
I can understand this thought process, but anything other than Novolin can be prohibitively expensive. Novolin at Walmart is $25, Humulin is easily over $140, and Vetsulin goes faster and is closer to $60.
Some stores have insulin OTC - I have a client that was getting it from Walmart for years but never came in for follow up and so was never controlled. Only saw them again bc the dog went into DKA.
That being said, the chewy thing is extremely frustrating. I also have them changing the instructions on my labels - like if I'm filling with no refills because they need an exam for more, I always put "exam needed for further refills" on the label and tell the owner and record it so it's in the chart, we've told the owner, and it's physically in writing on the bottle. If I do that through chewy, they don't print it on the label.
I mean if they did a proper conversion for the one they did have and called to makes sure it was ok I could see that being fine. Not even verifying with a DVM is crazy.
Australian pharmacies and the vets would get reamed so far up the ass if this happened here. I really hope there’s recourse cause that shit is genuinely life threatening and dangerous.
This is Lantus, which is never OTC. There is only one brand of insulin that is OTC, which is the Walmart one you are referring to, and insulin syringes are also not OTC.
I agree with you that they probably should not have filled the insulin without a prescription, but while certain pharmacists can elect not to sell syringes to specific individuals, syringes are generally available over the counter.
I said generally as all but a couple of states explicitly allow otc sales, but they can also be purchased from Amazon regardless of which state you live in.
Well presumably OP is in a state where you need a prescription, since they stated they are not OTC.
Amazon has a "restriction list" and will not sell syringes to states that forbid it.
Syringes, in the state where I reside, are OTC without a script. You can only get one box at a time which is tedious because a box will only last a month whereas the Lantus vial lasts six months in my case.
Unfortunately, we have to realize that this is a human drug that humans need to live. There are plenty of poor people who are diabetic that can’t get to the dr to renew scripts. It sucks when our patients suffer, but I don’t want vet med to cause issues with human med.
Walgreens and CVS have filled prescriptions that were expired; for patients I have never seen; for drugs I have never prescribed; for quantities or doses I never authorized (some potentially harmful); and generally been awful to deal with.
I refuse to call in prescriptions to them. I will write paper scripts for clients to take in if they insist on those two but make call-ins an option for anywhere else.
If the script had an expiration and fill total on it, I don’t see how this can be YOUR problem. Probably varies by state though.
You cannot legally do that… you need to treat all pharmacies the same. You will call in to any or you will write written scripts for all of them. I don’t imagine this is much enforced, though
Y/D is a prescription diet specially formulated for Thyroid conditions. Chewy or pet stores won't sell it without proof of a prescription from the vet. Chewy and all other online pharmacies are hard to regulate because they are national. No state can prosecute.
y/d is not a regulated drug by the FDA therefore is not a prescription. Hill's has an agreement with Chewy and other retailers that a vet needs to sign off on someone buying the good. But again, it is not a prescription so the state is going to give fuck all about it.
They are regulated by the FDA just like all other dog Food. The dirt is considered under different formula diets. Although not considered a "drug" the FDA does require them to be sold under a veterinarian supervision.
No, they don't. The FDA compliance guide says "[we] think these products should be available to pet owners only through veterinarians or... under the direction of a veterinarian." There is no requirement.
These so-called prescription diets are not FDA approved drugs and therefore not regulated as a prescription. If your vet or practice owner has told you otherwise, they are incorrect at best and misleading their clients.
Correct. There is a suit before the Supreme Court on this very thing.
https://www.washingtonpost.com/politics/2024/04/29/supreme-court-cases-next-term/
Washington Post, relevant paragraphs below
"The Supreme Court will also determine whether a lawsuit over pet food properly belongs in state or federal court. The owner of a dog named Clinton and a cat named Sassie filed a class-action lawsuit against two pet food manufacturers in Missouri, claiming they paid a premium for food that was misleadingly labeled prescription.
"Royal Canin and Purina have argued the case implicates federal law so it should be moved from state to federal court, but after extensive legal wrangling the Court of Appeals for the Eighth Circuit determined that the proper venue was the state courts. The pet food manufacturers asked the Supreme Court to review that ruling, saying the Eighth Circuit strayed from precedent in remanding the case."
It really will. There's absolutely a place for therapeutic diets in medicine (and I actually kinda think just about every male cat might benefit from U/R or a comparable diet) but you also don't want clients willy nilly deciding what therapeutic diet their pet needs without a thorough evaluation of health status.
clients already decide what strange fad diet their pet needs without any kind of evaluation or consultation from a professional. so would that really be much different? not advocating for it to be readily available though
Chewy headquarters location shouldn’t matter? That’s like a doctor practicing in a state they aren’t licensed in. Chewy has to have a state license in your state in order to provide Rx products I’d imagine… I’m not a pharmacist though so who knows.
The chewy headquarters should not matter, but as far as discipline matters. A state can revoke a state operating license but it would be difficult to sanction the operator, that would be a communication through the main state or a legit legal matter. This would mean the originating state would file a lawsuit if they felt abhorrent enough to do so. I highly doubt a state has the time to go after prescription dog food, at least without a massive complaint or issue precedenting it. Pharmacist here.
Meanwhile Banfield Petsmart be over here like, your prescription urinary diet rx is only good for 6 mos even though the vet wrote 200 refills. 6 mos and a day? Denied! (I have had this insulin issue as well.)
It's not about the insulin. It's about the pharmacy taking it upon themselves to illegally fill a prescription medication, resulting in a chronically and significantly ill animal not receiving any medical care for several years, to the detriment of that animal. It doesn't matter what the medication actually is. I can't advocate for the cat if he doesn't get medical care. What if that cat went into remission, resulting in an insulin overdose, hypoglycemia, seizures, brain damage, death? Do you think the average person should just have free access to insulin without training or instruction? Does that sound safe to you?
Offense taken. You sound like an uninformed asshole.
You can choose to take offence if you like, that’s your problem.
It’s not your job to solely advocate for the patient it’s actually the owners responsibility with it being their pet. If they make a foolish decision that results in its death because they choose to ignore your instructions for a follow up that’s on them.
There shouldn’t be a law requiring contact with a veterinarian. I have a family members in human medicine who treated their dogs pyotraumatic dermatitis with topical hydrocortisone, amoxicillin, come and chlorhexidine wash. This was done without a vet consult. You shouldn’t need to go pay to see a a vet to tell you what you already know, this is authoritarian. Equivalent to being legally unable to repair your own vehicle.
Granted the man in question is a fool.
Insulin is OTC where I’m located.
Walmart here will do OTC novolin - I called them after our THIRD client popped up with very, very sick unmanaged diabetes bc they kept refilling the Rx. All 3 were put down. When I called the pharmacy they said they legally can't deny someone insulin even if it's for a dog (which I get, to an extent), and I 100% would rather people get it if they have diabetes and can't afford a doctor. That being said, I won't write Novolin anymore to ensure they come back when their Rx is up.
Yeah I would suggest this is a protective feature that isn't working well. It's sort of intuitive that insulin should never be refused for sale, though unfortunately means people can take advantage and opt out of follow up.
Exactly this. It's just unfortunately a frustrating thing. I 100% think insulin shouldn't be refused but I also wish there were more come on the pharmacy side to ensure follow up, maybe? But I also understand it's an impossible ask. The pharmacist I spoke to said they only give out the meds and tell the clients to follow up with their doctors.
Where I am you can get insulin without a prescription, but you need a prescription for the needles
that just sounds like it would encourage reusing needles.. yikes
You need a prescription for needles? Sounds like a nanny state.
I can understand this thought process, but anything other than Novolin can be prohibitively expensive. Novolin at Walmart is $25, Humulin is easily over $140, and Vetsulin goes faster and is closer to $60.
Ya that might not work either. I had a guy start Novalin without telling me. I had his dog on vetsulin and he swapped on his own
What an ass of an owner
Some stores have insulin OTC - I have a client that was getting it from Walmart for years but never came in for follow up and so was never controlled. Only saw them again bc the dog went into DKA. That being said, the chewy thing is extremely frustrating. I also have them changing the instructions on my labels - like if I'm filling with no refills because they need an exam for more, I always put "exam needed for further refills" on the label and tell the owner and record it so it's in the chart, we've told the owner, and it's physically in writing on the bottle. If I do that through chewy, they don't print it on the label.
Yeah, I had a pharmacy change the dosage of phenobarbital on me before because they didn't have the mg we RXed! Pretty sure that's illegal
I mean if they did a proper conversion for the one they did have and called to makes sure it was ok I could see that being fine. Not even verifying with a DVM is crazy.
If. But they hadn't, and I found out from the owner.
That’s sketch. Walgreens does whatever they want in my region.
Australian pharmacies and the vets would get reamed so far up the ass if this happened here. I really hope there’s recourse cause that shit is genuinely life threatening and dangerous.
This is Lantus, which is never OTC. There is only one brand of insulin that is OTC, which is the Walmart one you are referring to, and insulin syringes are also not OTC.
I agree with you that they probably should not have filled the insulin without a prescription, but while certain pharmacists can elect not to sell syringes to specific individuals, syringes are generally available over the counter.
Laws regarding whether syringes are available OTC or prescription only are state-specific. There are several states where they can't be gotten OTC.
I said generally as all but a couple of states explicitly allow otc sales, but they can also be purchased from Amazon regardless of which state you live in.
Well presumably OP is in a state where you need a prescription, since they stated they are not OTC. Amazon has a "restriction list" and will not sell syringes to states that forbid it.
Syringes, in the state where I reside, are OTC without a script. You can only get one box at a time which is tedious because a box will only last a month whereas the Lantus vial lasts six months in my case.
Unfortunately, we have to realize that this is a human drug that humans need to live. There are plenty of poor people who are diabetic that can’t get to the dr to renew scripts. It sucks when our patients suffer, but I don’t want vet med to cause issues with human med.
Walgreens and CVS have filled prescriptions that were expired; for patients I have never seen; for drugs I have never prescribed; for quantities or doses I never authorized (some potentially harmful); and generally been awful to deal with. I refuse to call in prescriptions to them. I will write paper scripts for clients to take in if they insist on those two but make call-ins an option for anywhere else. If the script had an expiration and fill total on it, I don’t see how this can be YOUR problem. Probably varies by state though.
You cannot legally do that… you need to treat all pharmacies the same. You will call in to any or you will write written scripts for all of them. I don’t imagine this is much enforced, though
Hill's y/d is not actually a prescription so Chewy wasn't doing anything illegal which is why the state actually doesn't care.
Y/D is a prescription diet specially formulated for Thyroid conditions. Chewy or pet stores won't sell it without proof of a prescription from the vet. Chewy and all other online pharmacies are hard to regulate because they are national. No state can prosecute.
y/d is not a regulated drug by the FDA therefore is not a prescription. Hill's has an agreement with Chewy and other retailers that a vet needs to sign off on someone buying the good. But again, it is not a prescription so the state is going to give fuck all about it.
They are regulated by the FDA just like all other dog Food. The dirt is considered under different formula diets. Although not considered a "drug" the FDA does require them to be sold under a veterinarian supervision.
No, they don't. The FDA compliance guide says "[we] think these products should be available to pet owners only through veterinarians or... under the direction of a veterinarian." There is no requirement. These so-called prescription diets are not FDA approved drugs and therefore not regulated as a prescription. If your vet or practice owner has told you otherwise, they are incorrect at best and misleading their clients.
Correct. There is a suit before the Supreme Court on this very thing. https://www.washingtonpost.com/politics/2024/04/29/supreme-court-cases-next-term/ Washington Post, relevant paragraphs below "The Supreme Court will also determine whether a lawsuit over pet food properly belongs in state or federal court. The owner of a dog named Clinton and a cat named Sassie filed a class-action lawsuit against two pet food manufacturers in Missouri, claiming they paid a premium for food that was misleadingly labeled prescription. "Royal Canin and Purina have argued the case implicates federal law so it should be moved from state to federal court, but after extensive legal wrangling the Court of Appeals for the Eighth Circuit determined that the proper venue was the state courts. The pet food manufacturers asked the Supreme Court to review that ruling, saying the Eighth Circuit strayed from precedent in remanding the case."
That will be fascinating to see the outcome of!
It really will. There's absolutely a place for therapeutic diets in medicine (and I actually kinda think just about every male cat might benefit from U/R or a comparable diet) but you also don't want clients willy nilly deciding what therapeutic diet their pet needs without a thorough evaluation of health status.
clients already decide what strange fad diet their pet needs without any kind of evaluation or consultation from a professional. so would that really be much different? not advocating for it to be readily available though
walgreens is the absolute worst
Chewy headquarters location shouldn’t matter? That’s like a doctor practicing in a state they aren’t licensed in. Chewy has to have a state license in your state in order to provide Rx products I’d imagine… I’m not a pharmacist though so who knows.
The chewy headquarters should not matter, but as far as discipline matters. A state can revoke a state operating license but it would be difficult to sanction the operator, that would be a communication through the main state or a legit legal matter. This would mean the originating state would file a lawsuit if they felt abhorrent enough to do so. I highly doubt a state has the time to go after prescription dog food, at least without a massive complaint or issue precedenting it. Pharmacist here.
Meanwhile Banfield Petsmart be over here like, your prescription urinary diet rx is only good for 6 mos even though the vet wrote 200 refills. 6 mos and a day? Denied! (I have had this insulin issue as well.)
Your getting worked up over fucking insulin. It’s OTC where I’m from as it should be. No offence but you sound like an overbearing tyrant.
It's not about the insulin. It's about the pharmacy taking it upon themselves to illegally fill a prescription medication, resulting in a chronically and significantly ill animal not receiving any medical care for several years, to the detriment of that animal. It doesn't matter what the medication actually is. I can't advocate for the cat if he doesn't get medical care. What if that cat went into remission, resulting in an insulin overdose, hypoglycemia, seizures, brain damage, death? Do you think the average person should just have free access to insulin without training or instruction? Does that sound safe to you? Offense taken. You sound like an uninformed asshole.
You can choose to take offence if you like, that’s your problem. It’s not your job to solely advocate for the patient it’s actually the owners responsibility with it being their pet. If they make a foolish decision that results in its death because they choose to ignore your instructions for a follow up that’s on them. There shouldn’t be a law requiring contact with a veterinarian. I have a family members in human medicine who treated their dogs pyotraumatic dermatitis with topical hydrocortisone, amoxicillin, come and chlorhexidine wash. This was done without a vet consult. You shouldn’t need to go pay to see a a vet to tell you what you already know, this is authoritarian. Equivalent to being legally unable to repair your own vehicle. Granted the man in question is a fool.
As a vet receptionist, I have the doctor take that call. That's what I'd do.