The NVPS, heralding in a new era in medicine prescribing for animals.

greysides · 12-01-2022 9:12pm #1

The National Veterinary Prescription System (NVPS)

This has been in the background for a while, as such we have all known it's been coming, but details have been scarce.

Well, details are still scarce, and some decisions are still to be made, but it's virtually upon us.

Here's a summary of it:

Some of the text is taken from: https://www.gov.ie/en/service/d93ee-national-veterinary-prescription-system/

Why?

Antimicrobial resistance challenges
Anthelmintic resistance challenges
The collection of sales and usage data of antimicrobials and subsequent reporting of this data to the European Medicines agency (EMA).
Ensuring increased availability of veterinary medicines across the EU

What Will The NVPS Do?

The NVPS will allow for the digital generation of a prescription and for the availability, online, of non-dispensed prescriptions to all licensed outlets. It will collect prescription-level usage-data electronically. As a result there will be real time recording and reporting of all prescription based medicines being prescribed and dispensed, to the mandated animal species, in Ireland.

How Will I Access It?

For veterinary practitioners and dispensers currently using paper based systems, the NVPS can be used as a stand alone, free to access and use, app. This will be accessible via a smart-phone, tablet or desktop device. The NVPS will also integrate with existing software systems within the veterinary medicinal product (VMP) supply chain; such as those in veterinary practices, licensed merchants and pharmacist organisations. Animal keepers will receive notification of their prescriptions electronically, either by SMS or by email.

How Will I Fill An Electronic Prescription?

The prescribing veterinary practitioner can dispense the prescription to the animal keeper at the time of creating it, or it will be uploaded to a central database for dispensing elsewhere. Prescription details will be emailed or sent via SMS text message to the relevant animal keeper. The keeper can then present the prescription details to a dispenser. Each prescription will have a unique number; and each VMP, if more than one on a script, will have what is called a line item code beside it. The keeper can present the master code, enabling the dispenser to see the full prescription, or the line item code only in which case only that line item (VMP) will be available to the dispenser to view.

**The EU Veterinary Medicines Regulation 2019/6 is the driving force behind this change. It allows very little discretion to national authorities.**

Antimicrobials:

Prescriptions are to be issued by vets where there is a genuine Client-Patient-Practice-Relationship (as defined by their governing body). A farmer can have more than one such relationship.

Under the regulation, antimicrobials are not to be used routinely (eg. Dry Cow treatments), or to compensate for inadequacies of farm hygiene, management or husbandry. So, their use to prevent disease or to give to in-contact animals will be severely limited and subject to justification, of some form.

Antimicrobials are only allowed for prophylaxis', i.e. for administration to an individual animal or restricted number of animals, when the risk of infection is very high and consequences are likely to be severe, in 'exceptional cases.

In this case, treatment will be limited in quantity and duration to cover the risk.

Antimicrobials for metaphylaxis (in-contact animals) may only to be prescribed after diagnosis of infection, when the risk of spread of an infection is high and when no other appropriate alternatives are available.

Any existing prescriptions for specific antimicrobials, like intramammary tubes for cows, will no longer be valid from 2 February 2022. You will need to get a new prescription.

Veterinary prescriptions for antimicrobials will be valid for 5 days from the date of issue. This relates to the dispensing of them, not the use of what's prescribed. You can treat the animals for as long as is specified by the vet on the prescription.

Some anti-microbials will become 'human use only'. My understanding is that these are likely to include fluoroquinolones ("Marbocyl", "Baytril", etc.), cephalosporins ("Excenel", "Ceporex", etc.) and some macrolides ("Micotil", "Draxxin", etc.).

Anti-parasitics:

The term "anti-parasitics" includes lice and fly treatments, as well as anthelmintics.

Veterinary prescriptions will be required for medicated feed and for anti-parasitics. These are becoming POMs, with no advertising online or in printed media for the general public, and not on-display.

The prescription will be valid for twelve months. Anti-parasitic medicines can then be purchased by the farmer from his preferred supplier (Vet, Licenced merchant, Pharmacy) at the appropriate time throughout the period that the prescription is valid.

Horses are treated as food producing animals, i.e. the same as cattle/sheep.

The Current state of play:

The Regulations come into effect on the 28th January 2022, this includes the new requirements regarding the prescribing of antimicrobials, including antibiotics, and medicated feed.

However, the requirement for a veterinary prescription for anti-parasitics is postponed until 1st June 2022, and a prescription will not be required until that date.

Also deferred until the 1st June, is the requirement to use the NVPS. So, vets can continue to use paper-based prescriptions in the current format until then.

The NVPS will be available for voluntary use by vets from the end of January onwards so prescribers and dispensers are familiar with it when its use becomes compulsory.

From the 1st June 2022, the Regulations will come into force completely.

wrangler · 12-01-2022 9:24pm

It looks like the vets will corner the market for sale of all of these medicines, They're unlikely to be charging as much for their prescriptions if they're supplying the products as well.

Based on those guidelines I can't see it making much difference to our use of medicines

Base price · 12-01-2022 9:53pm

@greysides occasionally we would have cases of pneumonia in weaned (off milk calves) that are still housed. The calves would have received a intranasal vaccine (Rispoval RS+Pi3) on arrival as young calves. We would normally get CTC powder from our Vet to treat the batch. Is this course of action still available or would we now need to get swab tests to confirm the diagnosis?

"Antimicrobials are only allowed for prophylaxis', i.e. for administration to an individual animal or restricted number of animals, when the risk of infection is very high and consequences are likely to be severe, in 'exceptional cases.

In this case, treatment will be limited in quantity and duration to cover the risk.

Antimicrobials for metaphylaxis (in-contact animals) may only to be prescribed after diagnosis of infection, when the risk of spread of an infection is high and when no other appropriate alternatives are available.

greysides · 12-01-2022 10:33pm

CTC powder has been dubious for a while. I think there's going to be a bit of feeling around going to be done for a while until the exact lines become clear.

Off-the-cuff, I'd say the best course of action would be to check for IBR virus. It's rife in dairy herds and affects all ages. It may be that you need a fuller spectrum of vaccine cover. Vaccines seem to be the stock answer for pneumonia problems. Mycoplasma are another thing to check.

Individual treatment remains feasible, of course. The trouble there is, AFAIK, most of the newer antibiotics for pneumonia are likely to restricted in use. Only being able to be used where it is proven nothing else works or totally unavailable. Nuflor is about the only one of the newer crop likely to be unaffected.

This change has been on the table for a while. I'm assuming it's coming in now but it's one of the details I'm unsure of.

greysides · 12-01-2022 10:45pm