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French study finds no evidence of prescribing bias of vets
Photo: NSW State Emergency Service
Support measures for farmers impacted by flood damage
AGRIBUSINESS banking specialist Rabobank has an- nounced it will offer a range of support meas- ures to farming clients adversely impacted by floods and torrential rainfall in NSW and Queensland.
land, there are concerns about damage, particu- larly in the mid-north coast region of NSW,” Mr van Doremaele said.
• Waiver of fees on loan increases neces- sary for rebuilding op- erations
Rabobank group exec- utive country banking Australia Marcel van Doremaele said early indications were that damage from the recent extreme rainfall event affecting the eastern states had primarily been in coastal regions of NSW, particularly the mid-north coast, with reports of live- stock losses, flooded paddocks, access issues and damage to fodder crops and fencing.
Mr van Doremaele said the bank would work directly with cli- ents whose farms or ag- ribusinesses had been impacted to provide support through im- mediate difficulties and offer a range of assis- tance measures in ap- plicable circumstances.
Any farming clients who had been impacted by the floods and had not yet spoken to the bank, should contact their local branch or phone Rabobank on 1800 025 484.
“As well as the devas- tating impact this rain- fall event has had on a number of communi- ties in northern NSW and southern Queens-
These included:
“While we hope good rainfall totals will be largely welcomed by producers in a number of those areas, there is the concern that exces- sive volumes could be damaging,” he said.
“We are keeping a close watch on the situation and are con- tinuing to make contact with clients in impacted areas to offer support and gauge the extent of any damage they have sustained.”
• Waiver of fees for equipment finance con- tract variations.
• Deferral of sched- uled loan payments
• Waiver of break costs on early redemp- tion of farm manage- ment deposits
For more information, visit rabobank.com.au
Mr van Doremaele noted more heavy rain- fall was forecast for northwest and western NSW, with heavy falls also experienced in southeastQueensland.
A FRENCH study of vet- erinary prescribing prac- tices, contracts and med- icine purchases failed to find evidence that joint prescription and delivery introduces any potential prescription bias linked to conflicts of interest.
amine whether the pre- scription behaviour of vets can be biased by joint prescription and sale.
with a 53 percent decrease in the price of those medi- cines.
by $A0.048 cents per an- imal for each additional $A1,550.54 of planned sales – hardly enough to seriously sway prescribing practice.
In France, as in Aus- tralia, vets can both pre- scribe and sell veterinary medicines, but there is substantial pressure on French vets to observe good antimicrobial stew- ardship due to the targets on reduced use set by the European Union.
It is of interest because in France more than 80 percent of medicine de- livery is performed by veterinarians despite vari- ations in livestock sys- tems and species.
Because of the price decrease, more cipro- floxacin was used and the proportion of urinary e coli resistant to cipro- floxacin increased by 200 percent in the following four years.
It looks as though French cattle vets are prescribing on the basis of selecting the best drug for the pur- pose rather than any profit motive.
This statistically com- plex study analysed a data set of nearly 500 pur- chasing contracts between 35 vet practices, 23 phar- maceutical companies and involved 125 medicines during the 2008-2014 pe- riod.
The price per unit after rebate of each drug and contract was calculated.
Its purpose was to ex-
There, in about 2011, an increase in the number – from3to10–ofmedi- cines containing cipro- floxacin was associated
Where rebates occurred, the decrease in price per unit after rebate was $A0.095 per 100kg body weight for anticoccidi- osis treatments, $A0.045 per 100kg body weight for anti-inflammatories, $A0.019 per 100kg body weight, $A0.13 per animal for antiparasitics, and $A0.048 per animal for intramammary antimicro- bials.
Substantial pressure is on French vets to observe good antimicrobial stewardship due to the targets on reduced use set by the European Union.
On an animal basis, the antimicrobial price paid by the clinics decreased
Disclosure: In an earlier life, the author was a con- sulting vet who prescribed medicines to his clients’ herds.
Behind the study is the idea that vets – following undue pressure by their customers or the pharma- ceutical industry – will prescribe more antimicro- bials than necessary and that this in turn will lead to increased antimicrobial resistance.
The analysis focussed largely on the rebates vets received relative to the amount of medicine sold when compared to their contract.
The findings are con- sistent with a recent French project involving multiple stakeholders, which resulted in the re- duced total consumption of antimicrobials in live- stock by up to 37 percent from 2012 to 2017.
This has been found to be true in human medi- cine in Denmark.
Several models of usage and price were compared, but the yearly income for the vet practices was not associated with rebates in any model.
In the case of vets in the European countries where prescription and delivery are decoupled – that is vets can prescribe but not sell antimicrobial drugs – no systematic changes in the pattern of antimicro- bial use have been ob- served.
For antimicrobial drugs, the rebate price was not related to increasing sales on a per kilogram body- weight basis.
Vets apparently are not the rogues the European regulators thought they might be.
Probably because sev- eral factors influence the end user.
Among them cost, ease of use, delivery, regula- tion, risk management and timing.
Ross Cutler
www.porknews.com.au
Australian Pork Newspaper, April 2021 – Page 9