Business models of the French veterinary offices in rural areas and regulation of veterinary drug delivery.

French veterinarians are authorised to both prescribe and deliver drugs. This situation of conflict of interest is sometimes denounced as a potential source of over-prescription and overuse of veterinary antimicrobials, even if no evidence is available up to now. This leads to regular calls for separating prescription from drug delivery, even if the consequences of such separation are unknown. The present work aims at describing the business model of French veterinary offices and the expected impact of separation on those offices. A dataset of 15 million observations was built with structural and accounting data collected for the period 2015-2017 from French mixed veterinary offices. Results of the baseline scenario indicate that veterinary offices' profit generated from farm animal activities is mainly driven by drug delivery (about 70%), while profit from companion animal activities is mainly driven by medical acts (i.e., consultation and advice, surgery, and laboratory analysis) and sale of accessory products (about 65%). The net margin rate is higher than 25% for all activities, except for material selling. If drug delivery or sales associated with a medical act (same day, same client, and same animal) do not require additional human resources (alternative scenario), the net margin is reduced for medical acts. For both scenarios, a high variability is observed between veterinary offices. This shows that the profit of each activity is highly driven by time spent on the activities. Our results suggest that, in the case of restrictions on drug delivery by veterinarians, their profit may dramatically decrease, especially for farm animal practitioners and those with low medical acts profitability. Further work is needed to account for the high diversity of situations faced by veterinary offices and the sensitivity of their profitability to production costs.

Factors associated with persistence of African animal trypanosomiasis in Lango subregion, northern Uganda.

African animal trypanosomiasis (AAT) continues to inflict heavy losses on livestock production especially cattle in terms of decreased production and productivity in Uganda. AAT is a disease complex caused by tsetse fly-transmitted Trypanosoma brucei brucei, Trypanosoma brucei rhodesiense, Trypanosoma congolense, and Trypanosoma vivax. The disease is most important in cattle but also known to cause serious losses in pigs, camels, goats, and sheep. Several control measures including live bait technology, mass treatment of cattle with trypanocidal drugs, and deployment of tsetse traps have been used in the past 10 years, but the problem still persists in some areas. This necessitated an exploration of the factors associated with continued trypanosome infections in cattle, which are also known reservoirs for the zoonotic trypanosomiasis. A structured questionnaire was administered to 286 animal owners from 20 villages purposively selected from Lira, Kole, and Alebtong districts of Lango subregion to obtain information on the factors associated with persistence of infection. Over 50% of the respondents reported trypanosomiasis as a major challenge to their livestock. Land ownership (P = 0.029), type of livestock kept (P = 0.000), disease control strategy employed (P = 0.000), source of drugs (P = 0.046), and drug preparation (P = 0.017) were associated with persistent AAT infection. We recommend continued farmer sensitization on the threat of AAT and the available prevention and control options. The use of isometamidium chloride for prophylaxis against trypanosomiasis is highly recommended. There is also a need to foster qualified private veterinary drug supply in the region.

Assessing pet owner and veterinarian perceptions of need for veterinary compounding services in a community pharmacy setting

Background: Pets, pet owners (referred to as clients in veterinary medicine and throughout this article), veterinarians, and community pharmacies may all benefit from veterinary compounding services provided in community pharmacies, but the benefits of this service are not well-documented in the literature. Objectives: This study identified perceived benefits and barriers and evaluated the need for veterinary compounding services in community pharmacies; it also evaluated current business practices related to veterinary compounding services. Methods: A cross-sectional survey was administered to three groups: 1) clients who filled a pet prescription at a study pharmacy, 2) clients who had not filled pet prescriptions, and 3) local veterinarians. Eligible participants were 18 or older; clients must have owned a pet in the past five years. The surveys collected demographic information and assessed benefits, barriers, need, and business practices regarding veterinary compounding services. Demographics were evaluated through descriptive statistics. Responses to Likert-scale items were compared between groups using the Mann-Whitney U test. Qualitative responses were assessed for emerging themes. Results: One hundred eighteen clients and 15 veterinarians participated in the study. Seventy-two of 116 clients (62%) and eight of 10 veterinarians (80%) agreed that clients would benefit from veterinary compounds provided in community pharmacies. Only 40% of veterinarians agreed that community pharmacists have the knowledge to compound pet medications, compared to 67% of clients (P=0.010). Similarly, 47% of veterinarians agreed that community pharmacists have the skills to compound pet medications, compared to 72% of clients (P=0.016). Forty-eight of 118 clients (41%) would travel 10 miles or more out of their way for veterinary compounding services at community pharmacies. Conclusions: This study assessed client and veterinarian perceptions of veterinary compounding service benefits, barriers, and need in community pharmacies. Clients identified more opportunities for veterinary compounding services in community pharmacies when compared to veterinarians. Both groups identified a need for veterinary compounding services and agreed community pharmacies providing these services would benefit pets and clients

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