The Dubious Ethics of the Veterinary Trade

If you are looking for an example of an "ethical infection that has never seen an antibiotic," you can do no better than a veterinarian's office.

As reporter John Russell, at the Indianapolis Star notes, the payola, kickbacks and off-label marketing practices that are illegal in the world of human health care are alive and well at your veterinarian's office, where there is no False Claims Act, no transparency, and not much legal recourse in terms of "wrongful death."

In recent decades, pharmaceutical companies have been investing billions of dollars in pet medicines for the promise they hold to launch new drugs quickly and profitably. And they treat veterinarians not just as medical professionals, but as an important distribution channel to be wooed every step of the way.

That was on full display at the Chicago conference in July 2013. A glossy, 124-page convention program was packed with ads for animal drugs, workshops sponsored by drug companies and lunchtime sessions, complete with free catered meals, courtesy of a drugmaker.

Russell notes that not only are there few or no laws preventing price-gouging, off-label marketing or per-patient payola to vets, but that many of the drugs veterinarians are prescribing come with very light FDA review.

One of the reasons Lilly and others are attracted to pet medicines is the shorter, less costly safety review by the U.S. Food and Drug Administration. But that abbreviated review comes with a cost, The Star investigation found. There is a greater risk of pet drugs entering the market with unforeseen side effects.

Russell goes on to note that the American Veterinary Association, an organization fronted by a former Pfizer executive, is at the head of the payola line:

The AVMA, the nation's largest association of veterinarians, with 85,000 members, accepts hundreds of thousands of dollars a year from drugmakers for its massive conventions.

The organization, based in Schaumburg, Ill., declined to give details about how much money drugmakers kicked in for the Chicago convention. "The AVMA does not make a practice of releasing the financial details related to our partnerships," spokesman David Kirkpatrick wrote in an email.

The AVMA said the conference's largest contributors, recognized as "Diamond Partners," generally gave more than $200,000, and lower-level contributors gave between $25,000 and $150,000.

Who are the big contributors? Drugmakers, mostly. The Diamond Partners at the Chicago convention were drugmakers Zoetis and Merial, along with Hill's Pet Nutrition, a maker of specialty animal food.

The Gold Partners ($100,000) were drugmakers Ceva Animal Health and Boehringer Ingelheim. Silver Partners ($75,000) were drugmaker Elanco Animal Health, pet-food company Nestle Purina and animal hospital chain Banfield Pet Hospital. Copper Partners ($25,000) were drugmakers Abbott Animal Health, Bayer Animal Health, Merck Animal Health and Novartis Animal Health and pet products manufacturer Hartz.

The AVMA said the pharmaceutical industry's contributions were used to "enhance continuing education and professional development opportunities" and could not be used to promote products.

But if the Chicago convention was any guide, the line between product promotion and professional development seemed blurred.

Read the whole thing -- it is an excellent piece.

That said, it this is only part of the story.

The rest of the story, as I have noted in the past, is that the American Animal Hospital Association, which sets the standards for care for dogs, cats and other animals, is also paid large sums of money by the drug companies, and they also sell the drugs in bulk directly, operating their own Pharmacy Benefit Management company selling only to vets.

Conflict of interest much?

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