OTTAWA — For years, when livestock farmers needed certain antibiotics, they could just pop down to the feed store and pick some up.
That changed in 2018 when Health Canada locked feed stores out of the business and kicked those over-the-counter meds to veterinarians. Now farmers need a prescription and a relationship with a veterinarian, meaning they need to know your herd.
The move kicked off a fresh round of conflict between the farmers who raise the animals and pay for the medications and the veterinarians that supply them.
The decision to restrict farmer access to certain medications to control antibiotic resistance brought them in line with other veterinary drugs and was the right decision, said Boehringer-Ingelheim veterinarian Dr. Rob Tremblay, a former clinical veterinarian who now specializes in infectious diseases.
The previous system was an odd fluke, he said. Not only were other medications prescription-only, but feed stores could dispense antibiotics more freely than veterinarians. Farmers could buy drugs from a 16-year old sales clerk at the feed store but needed a prescription from a veterinarian to get the same drug at the clinic.
The changes brought concerns, Tremblay said. Would farmers be able to source meds? “My experience, across the country, has been that it’s not an issue.”
It is for Kawartha Lakes beef farmer Martin van der Broek, who said he’s been having difficulties sourcing antibiotics, particularly terramycin. Normally when he buys a calf at the sale barn on Friday, he’ll start it with electrolytes and 4 to 5 ccs of terramycin. But now “come home at 3 p.m. with a calf, first time I can get meds is Monday.” If he calls on the weekend, the fee for the vet to come out is doubled: around $70 plus the cost of the medication, he said. “If I have to phone the vet and spend $70-plus for him to give meds I can do myself, there’s no money in it.” Other beef farmers have had similar issues, he said.
Der Broek has “six years ag education in Holland,” and a host of Dutch relatives with dairy farms to consult. His father managed a breeding station in Holland. “I have a lot of practical knowledge,” he said, and it frustrates him that veterinarians are stopping him from using that knowledge. “I could not understand when I phoned them up, then go down there, (they’d) have me wait another 15-20 minutes (and) give me just a syringe full of medication for one or two treatments,” when der Broek says he knows he needs more and will have to come back.
He added that he agrees that overmedicating animals is a problem but said that his records are available to the vets. They can check and be sure he’s not overmedicating, something he said he’s always been careful not to do. “I’ve been doing this for years.”
Dairy farmers are required to have a vet, so for them the problem hasn’t been access but cost. DFO board member and Mountain-area dairy farmer Nick Thurler said he’s noticed a 12 to 15 per cent price increase. “It’s a bit of a monopoly now,” he said, “and they’re going to have to do something about it.” It depends on the cow, he said, but “sometimes it’s cheaper to shoot her than treat her, because it can “cost too much for treatment.”
Some farmers have gone to significant lengths to save on drug costs. One farmer, who requested anonymity, said he’d had a deal with a veterinarian that worked for CFIA. The vet would sell him medications he needed for his herd at 10 per cent over cost. “I was saving 40 per cent on the drugs,” the farmer said. But the deal was off after the vet got a letter warning him to stop or his licence would be revoked.
Ottawa-area dairy farmer Peter Ruiter said his medication costs have increased by about 23 per cent in the last two years. The regulatory changes eliminated a source of competition, Ruiter said. “Vets know you can’t shop around, so they jack up the price,” he said.
Anyone who’s ever brought a piece of machinery in for repair knows that it’s labour, not parts, that really costs you. It used to be that way for vet services too, Ruiter said. Not anymore. “20 per cent of my veterinarian costs go toward the vet. 80 per cent is to the drugs.”
Some of the lowest drug prices Ruiter could find were in Southern Ontario. He assumes that’s because there are more vet clinics and more competition. Switching to a clinic near Brockville could save him as much as 30 per cent but Ruiter is south of urban Ottawa and it’s too far for the vet to travel, he said.
Ruiter would like to see a Quebec-style system where the province pays some of the veterinary bills and includes a price cap of 125 per cent of the wholesale price.
Farmers aren’t alone in wanting systemic change.
Rideau St. Lawrence Veterinary Services large animal veterinarian Dr. Henrikus Ceelen at Kemptville said many veterinarians would support a switch to a price cap system, if only so farmers would stop accusing them of overcharging.
“The thing that should be clear is that the veterinary profession did not lead the charge here,” he said. Nevertheless, the old system was a major loophole, he said. The majority of farmers that are having issues sourcing meds are hobby farms, ones that don’t have a good veterinary relationship, Dr. Ceelen said. They see the vet as little as possible, which limits the vet’s ability to prescribe medications.
Overuse of antibiotics isn’t the only problem: it’s also underusing them, or using them for the wrong duration or under the wrong circumstances, he said.
Ceelen argued the monopoly claim is an oversimplification and the marketplace for drugs in Ontario is very competitive between clinics. First off, if veterinarians were conspiring to price-fix, their licences would be revoked, he said. “A monopoly assumes that all vets got together to make a price, which isn’t true at all.”
That price variation is exactly what you’d expect to see in a competitive marketplace, he said.
While some clinics won’t tell you their prices over the phone, farmers can call their neighbours, he said. One of them is bound to have a different vet.
Complaints about price-gouging started long before the 2018 regulatory changes, Ceelen said. “I’ve been in practice 40 years. It’s always kind of there,” he said.
Hard data on prices are hard to come by but the annual Dairy Farm Accounting Project includes data on vet and drug costs. Vet and drug expenses in 2019 were, on average, $16,747 per dairy farm, about two per cent of expenses. That’s actually down from the previous two years: The 2017 average was $18,147. However, the average 2016 drug and vet costs were $14,855.
Pricing is up to individual clinics and there are no caps, only guidelines, on what clinics can charge for drugs. The recommended markup in Canada is 40 per cent. Registrar and CEO of the Ontario College of Veterinarians Jan Robinson said “the college does not get involved in setting fees for any veterinary service. That would be price-fixing.” The organization will investigate complaints of excessive fees, Robinson said, based on what other local clinics charge among other factors, but added that such complaints are uncommon.
Robinson said the regulatory changes were the result of “the federal government making decisions based on what they believe is in the best interest of the public.
“Our job related to that was not to comment one way or the other,” but “was (to) ensure this policy goes as smoothly, efficiently, and appropriately as possible.”