Strategies to reduce antimicrobials in livestock and aquaculture, and their impact under field conditions: a structured scoping literature review.

Antimicrobial resistance is a pandemic problem, causing substantial health and economic burdens. Antimicrobials are extensively used in livestock and aquaculture, exacerbating this global threat. Fostering the prudent use of antimicrobials will safeguard animal and human health. A lack of knowledge about alternatives to replace antimicrobials, and their effectiveness under field conditions, hampers changes in farming practices. This work aimed to understand the impact of strategies to reduce antimicrobial usage (AMU) in livestock and aquaculture, under field conditions, using a structured scoping literature review. The Extension for Scoping Reviews of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA-ScR) were followed and the Patient, Intervention, Comparison, Outcome, Time and Setting (PICOTS) framework used. Articles were identified from CAB Abstracts, MEDLINE and Scopus. A total of 7505 unique research articles were identified, 926 of which were eligible for full-text assessment; 203 articles were included in data extraction. Given heterogeneity across articles in the way alternatives to antimicrobials or interventions against their usage were described, there was a need to standardize these by grouping them in categories. There were differences in the impacts of the strategies between and within species; this highlights the absence of a 'one-size-fits-all' solution. Nevertheless, some options seem more promising than others, as their impacts were consistently equivalent or positive when compared with animal performance using antimicrobials. This was particularly the case for bioactive protein and peptides, and feed/water management. The outcomes of this work provide data to inform cost-effectiveness assessments of strategies to reduce AMU.

Dairy farmer's income, working time, and antimicrobial use under different dry cow therapy protocols.

Mastitis is one of the most common diseases of dairy cattle. It has a high impact on farm economy, farmers' working time, and antimicrobial usage (AMU). Selective dry cow therapy (SDCT) is an effective means of reducing AMU without negatively affecting udder health. The objective of our study was to evaluate the impact of SDCT implementation on farmer's income, working time, and AMU, using a bioeconomic model. A stochastic dairy simulation model (DairyHealthSim) based on a weekly model was used to simulate herd dynamics, reproduction, milk production, culling decisions, health outcomes, and the management of health events. A specific module was developed for the simulation of quarter-level intramammary infection (IMI) acquisition and elimination during the lactation and dry-off periods, and 25 different farm settings were defined to represent herds with various udder health situations. We then defined 20 scenarios of SDCT by combining both the use of different thresholds of somatic cell count and milk bacteriology for treatment allocation and the use of internal teat sealant (ITS). All SDCT protocols had a low impact on farmer's income, and we identified some protocols with a positive farm gross margin (up to 15.83 CA$/dried- cow). We also found that adding an ITS to all cows led to greater economic gain. The application of SDCT had a low impact on farmers' working time, except when milk bacteriology was used for decision-making. Antimicrobial treatment to all cows above 200,000 cells/mL at last control, with the use of ITS on all cows, seems a good choice in most dairy farms. These findings could be used to convince farmers to adopt this strategy at dry-off.

Herd-level prevalence of bovine leukemia virus, Salmonella Dublin and Neospora caninum in Alberta, Canada, dairy herds using ELISA on bulk tank milk samples.

Endemic infectious diseases remain a major challenge for dairy producers worldwide. For effective disease control programs, up-to-date prevalence estimates are of utmost importance. The objective of this study was to estimate the herd-level prevalence of bovine leukemia virus (BLV), Salmonella Dublin, and Neospora caninum in dairy herds in Alberta, Canada using a serial cross-sectional study design. Bulk tank milk samples from all Alberta dairy farms were collected 4 times, in December 2021 (n = 489), April 2022 (n = 487), July 2022 (n = 487), and October 2022 (n = 480), and tested for antibodies against BLV, S. Dublin, and N. caninum using ELISAs. Herd-level apparent prevalence was calculated as positive samples divided by total tested samples at each time point. A mixed effect modified Poisson regression model was employed to assess the association of prevalence with region, herd size, herd type, and type of milking system. Apparent prevalence of BLV was 89.4, 88.7, 86.9 and 86.9% in December, April, July, and October, respectively, whereas for S. Dublin apparent prevalence was 11.2, 6.6, 8.6, and 8.5%, and for N. caninum apparent prevalence was 18.2, 7.4, 7.8, and 15.0%. For BLV, S. Dublin and N. caninum, a total of 91.7, 15.6, and 28.1% of herds, respectively, were positive at least once, whereas 82.5, 3.6, and 3.0% of herds were ELISA-positive at all 4 times. Compared with the north region, central Alberta had a high prevalence (prevalence ratio (PR) = 1.13) of BLV-antibody positive herds, whereas south Alberta had a high prevalence (PR = 2.56) of herds positive for S. Dublin antibodies. Furthermore, central (PR = 0.52) and south regions (PR = 0.46) had low prevalence of N. caninum-positive herds compared with the north. Hutterite colony herds were more frequently BLV-positive (PR = 1.13) but less frequently N. caninum-positive (PR = 0.47). Large herds (>7,200 L/day milk delivered ∼ > 250 cows) were 1.1 times more often BLV-positive, whereas small herds (≤3,600 L/day milk delivered ∼ ≤ 125 cows) were 3.2 times more often N. caninum-positive. For S. Dublin, Hutterite-colony herds were less frequently (PR = 0.07) positive than non-colony herds only in medium and large stratum but not in small stratum. Moreover, larger herds were more frequently (PR = 2.20) S. Dublin-positive than smaller herds only in non-colony stratum but not in colony stratum. Moreover, N. caninum prevalence was 1.6 times higher on farms with conventional milking systems compared with farms with an automated milking system. These results provide up-to-date information of the prevalence of these infections that will inform investigations of within-herd prevalence of these infections and help in devising evidence-based disease control strategies.

Cost of lameness in dairy herds: An integrated bioeconomic modeling approach.

Foot disorders are costly health disorders in dairy farms, and their prevalence is related to several factors such as breed, nutrition, and farmer's management strategy. Very few modeling approaches have considered the dynamics of foot disorders and their interaction with farm management strategies within a holistic farm simulation model. The aim of this study was to estimate the cost of foot disorders in dairy herds by simulating strategies for managing lameness. A dynamic and stochastic simulation model (DairyHealthSim) was used to simulate the herd dynamics, reproduction management, and health events. A specific module was built for lameness and related herd-level management strategies. Foot disorder occurrences were simulated with a base risk for each etiology [digital dermatitis (DD), interdigital dermatitis, interdigital phlegmon, sole ulcer (SU), white line disease (WLD)]. Two state machines were implemented in the model: the first was related to the disease-induced lameness score (from 1 to 5), and the second concerned DD-state transitions. A total of 880 simulations were run to represent the combination of the following 5 scenarios: (1) housing (concrete vs. textured), (2) hygiene (2 different scraping frequencies), (3) the existence of preventive trimming, (4) different thresholds of DD prevalence detected and from which a collective footbath is applied to treat DD, and (5) farmer's ability to detect lameness (detection rate). Housing, hygiene, and trimming scenarios were associated with risk factors applied for each foot disorder etiologies. The footbath and lameness detection scenarios both determined the treatment setup and the policy of herd observance. The economic evaluation outcome was the gross margin per year. A linear regression model was run to estimate the cost per lame cow (lameness score ≥3), per case of DD and per week of a cow's medium lameness duration. The bioeconomic model reproduced a lameness prevalence varying from 26 to 98% depending on the management scenario, demonstrating a high capacity of the model to represent the diversity of the field situations. Digital dermatitis represented half of the total lameness cases, followed by interdigital dermatitis (28%), SU (19%), WLD (13%), and interdigital phlegmon (4%). The housing scenarios dramatically influenced the prevalence of SU and WLD, whereas scraping frequency and threshold for footbath application mainly determined the presence of DD. Interestingly, the results showed that preventive trimming allowed a better reduction in lameness prevalence than spending time on early detection. Scraping frequency was highly associated with DD occurrence, especially with a textured floor. The regression showed that costs were homogeneous (i.e., did not change with lameness prevalence; marginal cost equals average cost). A lame cow and a DD-affected cow cost €307.50 ± 8.40 (SD) and €391.80 ± 10.0 per year on average, respectively. The results also showed a cost of €12.10 ± 0.36 per week-cow lameness. The present estimation is the first to account for interactions between etiologies and for the complex DD dynamics with all the M-stage transitions, bringing a high level of accuracy to the results.

Indications for the use of highest priority critically important antimicrobials in the veterinary sector.

BACKGROUND: Among the measures taken to preserve the clinical efficacy of highest priority critically important antimicrobials (HP-CIAs), the WHO has recommended avoiding their use in food-producing animals. Little is known regarding the indications for which different antimicrobial classes are used in animals, even in countries where data on antimicrobial use are available. OBJECTIVES: To outline, in a narrative review, the diseases for which HP-CIAs are used in veterinary medicine, highlighting incongruences with international guidelines and disease conditions where effective alternatives to HP-CIAs are missing. METHODS: Scientific literature, national reports and expert opinion were used to describe the indications for the use of HP-CIAs in the main food-producing (pigs, cattle and poultry) and companion (horses, dogs and cats) animal species. RESULTS: The most common indications for use of HP-CIAs are enteric and respiratory infections in pigs, cattle and poultry, urogenital infections in dogs and cats and respiratory infections in horses. In some instances, no valid and convenient alternatives to colistin and macrolides are available against certain porcine enteric and bovine respiratory pathogens. Effective, legal and convenient alternatives to HP-CIAs are also lacking for managing common infections in cats, for which oral administration is difficult, Rhodococcus equi infections in horses, some enteric and respiratory infections in poultry and MDR infections in all companion animal species. CONCLUSIONS: Future research and stewardship programmes should focus on the disease conditions identified by this review to reduce the use of HP-CIAs in the veterinary sector.

Impact of Low and High Doses of Marbofloxacin on the Selection of Resistant Enterobacteriaceae in the Commensal Gut Flora of Young Cattle: Discussion of Data from 2 Study Populations.

In the context of requested decrease of antimicrobial use in veterinary medicine, our objective was to assess the impact of two doses of marbofloxacin administered on young bulls (YBs) and veal calves (VCs) treated for bovine respiratory disease, on the total population of Enterobacteriaceae in gut flora and on the emergence of resistant Enterobacteriaceae. In two independent experiments, 48 YBs from 6 commercial farms and 33 VCs previously colostrum deprived and exposed to cefquinome were randomly assigned to one of the three groups LOW, HIGH, and Control. In LOW and HIGH groups, animals received a single injection of, respectively, 2 and 10 mg/kg marbofloxacin. Feces were sampled before treatment, and at several times after treatment. Total and resistant Enterobacteriaceae enumerating were performed by plating dilutions of fecal samples on MacConkey agar plates that were supplemented or not with quinolone. In YBs, marbofloxacin treatment was associated with a transient decrease in total Enterobacteriaceae count between day (D)1 and D3 after treatment. Total Enterobacteriaceae count returned to baseline between D5 and D7 in all groups. None of the 48 YBs harbored marbofloxacin-resistant Enterobacteriaceae before treatment. After treatment, 1 out of 20 YBs from the Control group and 1 out of 14 YBs from the HIGH group exhibited marbofloxacin-resistant Enterobacteriaceae. In VCs, the rate of fluoroquinolone-resistant Enterobacteriaceae significantly increased after low and high doses of marbofloxacin treatment. However, the effect was similar for the two doses, which was probably related to the high level of resistant Enterobacteriaceae exhibited before treatment. Our results suggest that a single treatment with 2 or 10 mg/kg marbofloxacin exerts a moderate selective pressure on commensal Enterobacteriaceae in YBs and in VCs. A fivefold decrease of marbofloxacin regimen did not affect the selection of resistances among commensal bacteria.

A New Tool to Assess the Economic Impact of Q Fever on Dairy Cattle Farms.

To support farmers in their decisions related to Q fever, a dedicated economic assessment tool is developed. The present work describes the calculator, its economic rationale, and the supporting assumptions. The calculator integrates a yearly compartmental model to represent population dynamism and the main interactions between disorders linked to Q fever, especially reproductive disorders (abortion, retained foetal membranes, purulent vaginal discharge and endometritis, extra services, and calving-conception delays). The effects of the nontangible cost of the disease on human health, the welfare of the animals, and the workload of farmers were not integrated into the model. The model shows high-level sensitivity to the prevalence of Q fever in the herd prevaccination and to the costs of abortion and extra days of calving-conception intervals. Breakeven points, i.e., cost values that allow us to achieve positive vaccination benefits, are also reported. For herds with moderate or high prevalence rates of Q fever prevaccination (>30%), a vaccination benefit is observed. The vaccine should be considered a type of insurance in herds with low prevalence rates of Q fever prevaccination (≤20%). The calculator was developed to aid decision-making at the farm level, and no conclusion can be extrapolated as a generic trend based on the present work.

Effectiveness of rural internships for veterinary students to combat veterinary workforce shortages in rural areas.

Veterinarians are a pivotal force in addressing animal health and welfare surveillance, with a critical role in improving public health security and increasing the profits of livestock farmers. Yet, the veterinary profession is adversely affected by personnel shortages, particularly in rural areas. Since the health of people, animals and their shared environment are interconnected in a One Health perspective, a set of policies are required to ensure public health by attraction and retention of veterinarians in rural areas. In France, a tutored internship programme, financially subsiding students and mentors to execute a training period in remote rural areas, was promoted to better integrate and retain veterinary students ending their veterinary training. This paper aims to evaluate how veterinarians' tutored internships influences students' choices for rural practice, using three different statistical methods derived from causal inference theory. Using survey data for the period 2016-2020, we show that: (i) the average effect of the tutored internship on veterinarians' work in food animal sector is not significant; and that (ii) the tutored internship leads veterinarians with a low share of work in the food animal sector to have a rural practise after they graduated between 13 and 20% greater than those who did not participate in the tutored internship.

Risk factors associated with calf mortality in Western Canadian cow-calf operations.

This study examined the influence of management practices and herd demographics on calf mortality proportions in Western Canadian cow-calf operations, utilizing data from the second Western Canadian Cow-calf Survey. The survey was conducted between October 23, 2017, and February 28, 2018. The survey, which was open to all cow-calf producers across Western Canada, provided producer-reported data regarding calf death loss and corresponding herd-level factors. A fractional logit model was employed to identify significant factors associated with calf mortality proportions. The findings revealed that shorter breeding seasons (<63 days), calves born within the same season, and regular pregnancy checks for breeding females were negatively associated with calf mortality proportions. Conversely, regular breeding soundness evaluations for breeding bulls, traditional weaning methods, and vaccinating heifers for scours showed positive associations with increased calf mortality proportions. Herd operations where dams were vaccinated against clostridial and bovine respiratory diseases had lower calf mortality proportions. Notably, operations with experienced primary decision-makers holding off-farm jobs had lower predicted calf mortality proportions compared to those managed by full-time cattle producers. Higher predicted calf mortality proportions were observed in operations employing a backgrounding system. The study's limitations included potential biases due to its cross-sectional nature and reliance on producer-reported data, which might lead to an underestimation of calf mortality proportions. Also, the limited sample size and missing data might have affected the statistical significance of some variables. This study contributed to the research on cow-calf operation by using a fractional logit model to analyze the correlation between risk factors and calf mortality proportions, and by identifying novel herd-level risk factors. It provided a basis for future research aimed at developing empirically-based management strategies to optimize calf health outcomes.

Individual drivers and barriers to adoption of disease control and welfare practices in dairy and beef cattle production: a scoping review.

The implementation of disease control and welfare practices is an essential part of limiting disease exposure in livestock, however successful adoption of these practices seem to be low in both the beef and dairy cattle industries. The main objectives of this scoping review were to characterize literature published exploring beef and dairy cattle producers' perceptions on the implementation of various disease control and welfare practices, identify major themes of drivers and barriers that influence producers' adoption of these practices, and identify current gaps in knowledge. A total of 2,486 articles were obtained from two database literature searches and screened, from which 48 articles published between 2010 and 2021 were deemed eligible and charted. Europe was the most common region for articles (58%). A majority of articles focused solely on dairy producers (52%). A wide range of barriers and drivers which were categorized into 4 and 5 key themes, respectively. The most commonly mentioned driver was animal health, welfare, and safety, while the most common barrier was costs. Potential gaps in literature were identified, including the underrepresentation of beef producer perceptions relative to dairy producers in current literature.

The Marginal Abatement Cost of Antimicrobials for Dairy Cow Mastitis: A Bioeconomic Optimization Perspective.

Maintaining udder health is the primary indication for antimicrobial use (AMU) in dairy production, and modulating this application is a key factor in decreasing AMU. Defining the optimal AMU and the associated practical rules is challenging since AMU interacts with many parameters. To define the trade-offs between decreased AMU, labor and economic performance, the bioeconomic stochastic simulation model DairyHealthSim (DHS)© was applied to dairy cow mastitis management and coupled to a mean variance optimization model and marginal abatement cost curve (MACC) analysis. The scenarios included three antimicrobial (AM) treatment strategies at dry-off, five types of general barn hygiene practices, five milking practices focused on parlor hygiene levels and three milk withdrawal strategies. The first part of economic results showed similar economic performances for the blanked dry-off strategy and selective strategy but demonstrated the trade-off between AMU reduction and farmers' workload. The second part of the results demonstrated the optimal value of the animal level of exposure to AM (ALEA). The MACC analysis showed that reducing ALEA below 1.5 was associated with a EUR 10,000 loss per unit of ALEA on average for the farmer. The results call for more integrative farm decision processes and bioeconomic reasoning to prompt efficient public interventions.

Spatial evaluation of animal health care accessibility and veterinary shortage in France.

The decrease in the supply of veterinary healthcare in France adversely affects health of food-producing animals. In a One Health perspective, the health of people, animals and their shared environment are interconnected, and adequate supply of veterinary healthcare is required to ensure public health. Prevention of outbreaks and zoonotic diseases that may impact public health mobilizes a set of public policies, including strengthening veterinary workforce. These policies should be informed by quantification of animal health care accessibility, yet this has not been well characterized. The objective was to quantify the accessibility to veterinary healthcare for cattle, swine, and poultry sectors in France. A Two-Step Floating Catchment Area (2SFCA) approach was used to measure the level of accessibility to veterinary clinics. In the cattle sector, the 2SFCA score indicated relatively high accessibility in the north and south of France, but insufficient accessibility elsewhere. In the swine sector, there was high accessibility in the north east and in north of France, medium accessibility in the south west, and insufficient accessibility elsewhere. Finally, in the poultry sector, all regions had insufficient accessibility. Sensitivity analysis examining the effects of a change in spatial accessibility according to various travel time showed that the optimal threshold to compute 2SFCA score in cattle, swine and poultry sectors were respectively, 45, 60 and 60 min. According to a definition of "underserved area" derived from an official decree and the optimal thresholds to compute 2SFCA, the cattle, swine and poultry sector have on average 75.3, 89.9 and 98.3% underserved area, respectively. We provided evidence that the supply of animal health care was not sufficient and we proposed recommendations on how to assess animal health care accessibility, enabling modelling and visualization of the effects of potential public policies aimed at reducing veterinary shortages.

The gender wage gap in the French veterinary labor market.

Among the most important recent changes in the veterinary profession is the increasing percentage of women. Understanding trends driving the veterinary labor market is important to enable leaders in the veterinary profession and policy makers to plot strategic actions that will improve the profession. The objective of this paper was to estimate the gender pay gap in the veterinary labor market. We analyzed data from an anonymous online survey conducted in France in 2021 by the veterinary practitioner union. We assessed the gender gap pay using two regression approaches, ordinary least squares method and Blinder-Oaxaca decomposition, while controlling for all other variables (ceteris paribus). We provided evidence that male veterinarians earned wages approximately 9.3% higher (controlling for all other variables). This difference represented the "unexplained variance" that may be due to gender discrimination or unobserved characteristics.

Economic evaluation of antimicrobial use practices in animal agriculture: a case of poultry farming.

Background: The growing evidence of the contribution of antimicrobial use (AMU) in animal agriculture to the public health threat of antimicrobial resistance has highlighted to policymakers the importance of the need for prudent AMU in animal production. Livestock farming is an economic process, where farmers are using inputs such as antimicrobials to minimize their losses. Objectives: Using a large and unique dataset combining time-series data on economic performance and health records in conventional broiler production in France, we identify how improved healthcare management and disease prevention impact economic performance, AMU reduction and health outcomes. Methods: We analyse the main characteristics of the economic performance of farms measured by the profit per m2, by performing advanced regression models investigating the relative importance of medication and veterinary procedures. Results: In our study, 50% of the treatments (expressed as number of new treatments) are attributable to only 30% of all flocks. There is an inverted U-shaped relationship between AMU and economic performance. This finding implies that the marginal profit of antimicrobials is decreasing, meaning that using antimicrobials is only profitable up to a certain threshold. Results also show that the profit increases as the number of preventive treatments increase. Conclusions: Our findings suggest that policies encouraging farmers to work upstream from the occurrence of disease have the potential to perform better than regulations, as they would maintain a profitable activity while diminishing AMU. Encouraging adequate infection control practices by subsidizing or providing other incentives would benefit farmers and society.

Multi-Criteria Decision Analysis for Assessing Social Acceptance of Strategies to Reduce Antimicrobial Use in the French Dairy Industry.

To respond to the antimicrobial resistance (AMR) threat, public health entities implement policies aiming to reduce antimicrobial use (AMU) in livestock systems, in which policy success and sustainability might be subject to the social acceptability of the novel regulatory environment. Therefore, consistent methods that gather and synthesize preferences of stakeholder groups are needed during the policy design. The objective of this study was to present a methodology for evaluating the acceptability of potential strategies to reduce AMU using multi-criteria decision analysis (MCDA) using French dairy industry as a model. Preference-ranking organization methods for enrichment evaluations were applied to rank stakeholders' acceptance of four different potential AMU reduction strategies: 1. Baseline AMU regulations in France; 2. Total interdiction of AMU; 3. Interdiction of prophylaxis and metaphylaxis AMU; and 4. Subsidies to reduce AMU by 25%. A total of 15 stakeholders (consumers, n = 10; farmers, n = 2; public health representatives, n = 3) representing the French dairy sector and public health administration participated in the acceptance weighting of the strategies in relation with their impact on environmental, economic, social, and political criteria. We established a MCDA methodology and result-interpretation approach that can assist in prioritizing alternatives to cope with AMR in the French dairy industry or in other livestock systems. Our MCDA framework showed that consumers and public health representatives preferred alternatives that consider the restriction of AMU, whereas farmers preferred to maintain baseline policy.

Impact of Peste des petits ruminants for sub-Saharan African farmers: A bioeconomic household production model.

Peste des petits ruminants (PPR), a contagious viral disease affecting small ruminants, has been targeted by the global community for eradication within the next 10 years. However, eradication will require substantial money, human resources, coordination among actors, and individual commitments. The objective was to estimate the cost of PPR at a household level, thereby providing information on the potential economic benefits of PPR eradication and the incentives for small ruminant keepers to actively participate in the PPR Global Eradication Programme. This study focused on four sub-Saharan countries: Ethiopia, Malawi, Mali and Rwanda. Publicly available household level data assembled by FAO were used. A bioeconomic model was built to estimate impacts of PPR for a standardized theoretical area, where each household raised an average small ruminant herd or flock. Model outputs were used to estimate, at a household level, income loss due to a PPR outbreak. We constructed various income scenarios to account for the variability of small ruminant income as a proportion of total household annual income. Household income losses ranged from 2% to 40% of total annual income; percentages varied depending on the income scenario and on the gross annual economic impact of PPR on small ruminant production, which ranged from 20% to 80%, based on results of the bioeconomic model. As expected, the more small ruminant production contributed to household income the greater the impact. Estimates provided herein warn decision makers that, given the heterogeneous impact of PPR on household income, the willingness of small ruminant decision makers to participate in the PPR Global Eradication Programme may vary widely and tailored approaches should be devised and implemented.

Correction: Consumer perceptions of antimicrobial use in animal husbandry: A scoping review.

[This corrects the article DOI: 10.1371/journal.pone.0261010.].

The Association Between French Veterinary Practice Characteristics and Their Revenues and Veterinarian's Time Use.

The provision of healthcare by veterinarians consists of a blend of activities ensuring welfare for animals. It also contributes in the control of infectious diseases and food safety. In general practices, most of the activities generate incomes for veterinarians, notably acts (consultations, surgery, etc.) and sales (drugs, pet food, etc.). Increased size of veterinary practices and the arrival of corporate companies modify the veterinary landscape in many countries. In a context of rapid growth of the companion animal health market, the question of the profitability of veterinary activities is relevant. Indeed, beyond a certain threshold, veterinarians may be tempted to leave behind food-producing animals' acts and focus on companion animals' acts, which are generally recognized to be more profitable and more attractive for new generations of veterinarians. A survey was conducted in French veterinary mixed practices, and a regression analysis was used to quantify the relationships between the turnover and the characteristics of veterinary practices, the time to perform veterinary acts, and the characteristics of veterinarians. We found that the characteristics of veterinary practices are positively associated with the turnover and the price of acts, and that there was an association between the status of veterinarians (associate, collaborator, or employee) and the time required to perform companion animals' and food-producing animals' acts. The present study is the first study showing the association between the characteristics of veterinary practices and the turnover, by investigating the price of veterinary acts and the time required.

Analysis of the demand for pet insurance among uninsured pet owners in the United States.

BACKGROUND: Although cost is often a barrier to providing optimal veterinary care, only a minority of pet owners use insurance to help cover veterinary costs. We sought to estimate consumer demand and preferences for pet insurance and how educating owners on treatment costs and disease risk affects pet insurance uptake. METHODS: We surveyed 306 dog owners across the United States without pet insurance, including a choice experiment, used ordinary least squares regression to estimate the demand for pet insurance, and conjoint analysis to estimate the pet insurance feature preferences. RESULTS: Pet insurance uptake increased by 12.3% after veterinary treatment cost and canine cancer risk information was presented to participants. We found that, on average, pet owners were willing to pay $24 more per month for a preventive care service in pet insurance. Forty-four percent of participants were willing to spend up to $1000 to prolong their pet's life a year, while 46% of the sample were willing to spend $3000 or more. CONCLUSIONS: Our results suggest that providing pet owners' information about the costs and likelihood of disease can increase their willingness to pay for pet insurance. Coverage of preventive care was the most valuable feature in pet insurance among those presented to dog owners.

Could Contracts between Pharmaceutical Firms and French Veterinarians Bias Prescription Behaviour: A Principal-Agency Theory Approach in the Context of Oligopolies.

In France, veterinarians can both prescribe and deliver veterinary medicines, which is a questionable situation from the perspective of antimicrobial use (AMU) reduction to avoid antimicrobial resistance (AMR). This situation places veterinarians in direct commercial relationships with the pharmaceutical industry as purchase contracts are signed between veterinarians and pharmaceutical companies. The aim of the present work is to analyse the relationships between veterinarians and pharmaceutical firms in the oligopoly market context of French veterinary medicine to determine whether the prescription behaviour of practitioners can be biased by joint prescription and delivery. Therefore, we develop an analysis based on principal-agent theory. Contracts between pharmaceutical companies and veterinarians during the 2008-2014 period were analysed based on 382 contracts related to 47 drugs belonging to eight main pharmaceutical firms (2320 observations). The price per unit after rebate of each drug and contract was calculated. The descriptive analysis demonstrated high disparity among the contracts across pharmaceutical firms with regard to the provisions of the contracts and how they are presented. Then, linear regression was used to explain the price per unit after rebate based on the explanatory variables, which included the yearly purchase objective, year, type of drug and type of rebate. The decrease in price per unit after rebate for each extra €1000 purchase objective per drug category was established to be €0.061 per 100 kg body weight for anticoccidiosis treatments, €0.029 per 100 kg body weight for anti-inflammatories, €0.0125 per 100 kg body weight and €0.0845 per animal for antiparasitics, and €0.031 per animal for intramammary antimicrobials. Applying agency theory reveals that veterinarians can be considered agents in the case of monopolistic situations involving pharmaceutical firms; otherwise, veterinarians are considered principals (oligopolistic situations in which at least several medicines have similar indications). The present study does not provide evidence suggesting that joint prescription and delivery may introduce any potential prescription bias linked to conflicts of interest under the market conditions during the 2008-2014 period.