Poor dispensing practices are costing clinics money and risking patients’ health

At a busy walk-in clinic outside of Atlanta, a wall-mounted dispenser stores single doses of every brand of preventative on the market. Each time receptionists break open a pack to fill the bins of single doses, they record opened packs in a log. The inventory manager is frustrated that single doses never reconcile.

Although parasite products are in high demand at this five-doctor hospital, single-dose dispensing is killing compliance. During my consultation, I found that 19 percent of preventatives were sold as single doses – that’s nearly 1 in 5. Only 43 percent of dogs were getting year-round protection, with 5 months as the average number of doses sold per active dog. Among cats, only 12 percent were on preventatives year-round, and one month was the average number of doses. The choices of multiple brands and single dosing was confusing clients and wrecking compliance.

Why clinics shouldn’t sell single doses
Some practice owners and managers argue that single dosing is a necessary strategy in today’s economy. But are they costing clients more money in the long run? Single dosing is sporadic at best, with clients repurchasing only after they’ve seen fleas or “just remembered” that the dog needs its heartworm pill. Breaks in prevention could lead to flea-allergy dermatitis, hot spots, intestinal parasites, zoonotic risks, heartworm disease, and expensive treatments.

Here’s why hospitals shouldn’t sell single doses:

• Internet pharmacies don’t sell singles.
• VCA and Banfield hospitals nationwide don’t sell singles.
• Staff labor is costly to track, break packages, and dispense singles.
• Clients should be called at Day 20 before the next dose must be purchased and given at Day 30.
• Client satisfaction declines if the perception is that the product isn’t working, even though inconsistent use may be to blame.
• Manufacturers’ guarantees may be void for singles.
• If doctors recommend year-round protection, a single dose contradicts their standard of care.
• Simply put, single doses are bad medicine and bad for business!

How do you help get rid of single doses?
Encourage clinics to reward clients with greater savings on 12 packs. At a southern California practice, the cost per dose on a 12 pack is 30 percent less than a single tablet. Clients pay $16.25 for a single dose compared to $12.50 per dose in a 12 pack. That’s a savings of $45 for a year’s supply. Another bonus: If clients buy a year’s supply, they likely won’t look online for better prices.

Suggest internal promotions to boost sales of packs. Receptionists can place a sign on the counter that says “Ask me how to save 30 percent on your pet’s preventatives today!” They also could put stickers on reminder cards that say “Save 30 percent when you buy a year’s supply of parasite preventatives for your pet.” The hospital manager could send e-mail reminders to promote savings such as “Got fleas? We can get rid of them now. Save 30 percent when you buy a year’s supply for constant protection of your best friend.”

Practice teams can turn their lost-and-found bulletin board into an educational center. Move lost pet notices into a notebook that’s placed on a bench in the reception area, and then use the bulletin board for product promotion. Post a question such as “Did you know that year-round parasite protection is just 42 cents a day?” Make comparisons to items clients frequently purchase. For example, a headline would say, “The cost of year-round prevention is…42 cents a day, less than a postage stamp…$2.94 a week, less than a latte at Starbucks…$13.02 a month, less than a Papa John’s pizza.

Recommend that practices only stock packs of preventatives. At VCA and Banfield hospitals nationwide, six packs are the smallest quantities available. Follow their lead and stock six and 12 packs of heartworm preventatives. For topical flea products, carry three, six, and 12 packs. Set prices so 12 packs are the lowest cost per dose, followed by six packs, and then three doses. Remember, hospitals don’t sell single doses of NSAIDs or antibiotics because pets need more than one dose to resolve the problem. The same is true for preventatives.

Have teams promote the “buy six, get one free” bonus. This lowers the price even more for topicals such as Frontline Plus. When checking out clients, they could ask, “Would you like to get a free dose of Frontline Plus valued at $20 when you buy a six pack?”

When hospitals stop selling single doses, they promote year-round protection for pets, protect practice profits, and provide patients with better medicine. Practice owners and managers should take the risk for the health of their patients and practice. Help your customers stop selling single doses.

Sidebar:
How to measure compliance
Measuring your customer’s compliance for preventatives will help them understand where they are today and allow them to make positive changes to improve compliance. Practice owners and managers should share results of the compliance audit with their entire team. Then brainstorm ways to educate clients so more pets experience optimal wellness. Practice owners and managers should reassess their compliance quarterly and post results so their staff can determine the most effective strategies – and see results!

Recommend that managers gather the following data from their veterinary software reports. Managers may need to call their software provider to identify which reports or queries they need to run to get accurate data.
1. Active patients

• Number of active dogs age 1 and older that have had a veterinary visit within the last 12 months (excludes puppies that would not have yet had a heartworm test and year’s supply of preventatives) = ________
• Number of active cats age 1 and older that have had a veterinary visit within the last 12 months (excludes kittens that would not have yet had a year’s supply of preventatives) = ________
• Total number of active dogs and cats = ________

2. Heartworm testing

• Number of heartworm tests performed in the last 12 months = ________
• Heartworm testing fee = $________

3. Heartworm preventatives sold
List all brands by sizes sold within the last 12 months. Multiply by six for six packs and by 12 for 12 packs to get the number of doses. List all brands you carry that protect pets from heartworms and intestinal parasites.