External pharmacies and veterinary prescriptions: How to decide what works for your practice

In the AAHA Community, members ask questions and share advice on a variety of topics related to small animal veterinary practice. One of the questions asked recently was about the time and energy expended by practice team members to review and approve prescription requests from external pharmacies.

Some community members cite that this activity takes hours of their team members’ time due to the number of prescription requests. Other community members chimed in that they addressed this concern by no longer accepting requests for external prescriptions or by charging clients to write or approve a prescription.

According to Sarah Magoon, LVT, CVPM, Practice Consultant Manager for AAHA, veterinary teams need to reconcile veterinary clients’ desire to have their pets’ prescriptions filled at the pharmacy of their choice and veterinary practices’ needs to minimize the time, effort, and revenue loss associated with external pharmacy requests.

She said that clients will choose to have medications filled via external pharmacies for a variety of reasons. These include “real or perceived cost savings,” she said, when compared to the same medication dispensed directly from the practice. Sometimes the convenience of home delivery and/or auto-shipping influences a client’s choice to fill a prescription via an external pharmacy. And in some cases, it is out of necessity if the patient has been prescribed a medication or other product that the practice does not carry.

Challenges of working with external pharmacies

According to the Veterinary Hospital Managers Association (VHMA) Insider’s Insights Management Trends reported to members in August 2025, 58% of veterinary practices surveyed said they approve prescription requests from all outside pharmacies. Another 22% said they don’t approve any outside pharmacy prescription requests, and 19% said they only approve requests from specific pharmacies.

The VHMA’s report highlighted multiple pain points identified by veterinary practices that likely play a role in a veterinary practice’s decision to working with outside pharmacy requests. The two most commonly reported pain points were the time involved in the approval process and the missed revenue opportunities associated with clients choosing to have their pets’ prescriptions filled outside of the practice.

Magoon’s experiences working in veterinary practice and working with AAHA member practices mirror many of the findings reported by the VHMA. She said that the challenges that she sees to be associated with reviewing external prescriptions include the time veterinarians and other team members must spend reviewing, approving, and sometimes writing prescriptions. They also have to field requests via multiple sources, including online portals, faxes, and sometimes phone calls, depending on the circumstances.

Magoon also hears concerns about decreased revenue when clients choose to purchase a product from an external pharmacy as opposed to getting if from their veterinary team.

She said that in some cases, filling a medication via an external pharmacy can increase the risk of errors, citing an instance in which a pharmacist not familiar with veterinary prescriptions dispensed a formulation that contained xylitol, a sweetener that is safe for use in human medication but toxic to dogs.

Benefits to working with external pharmacies

Magoon explained that working with external pharmacies can be beneficial to veterinary practices in multiple ways. First of all, it allows for veterinary practices to decrease their expenditure on inventory and overhead costs since they no longer have to carry every medication or product they might prescribe for their patients. They can instead concentrate on commonly used products and prescribe other less commonly used medications, supplements, and diets to be filled elsewhere.

Working with the pharmacy of your clients’ choosing can also help increase goodwill, Magoon said. “Sadly, there is still so much out in the media that veterinarians are just out to profit from pet owners,” she said. Even when external pharmacy prices aren’t lower than the practice’s, some clients will still believe they are getting a better deal with an external pharmacy and appreciate their wishes being accommodated.

Additionally, some online pharmacies have streamlined their prescribing and approval processes to integrate with certain electronic medical record platforms and/or partner with practices in ways that allow for revenue sharing, both of which can reduce the inconvenience associated with external pharmacy interactions.

When practices refuse to work with external pharmacies

Some veterinary practices make the decision not to interact with online pharmacies, meaning they refuse to answer calls, return faxes, or utilize online portals, even when their clients have requested to have their prescriptions filled this way. While this is up to each practice to decide, Magoon said practices cannot refuse to provide clients with a written prescription upon request that clients can fill at the pharmacy of their choosing.

Clients technically can have a written prescription filled through an online pharmacy, but that often requires them to send the original prescription by mail to the pharmacy, which can inconvenience clients due to the effort required and delay in receiving their pet’s medications. This inconvenience can become more distressing to clients who request a refill authorization for their pet’s medication and are asked to come pick up a new written prescription instead.

Magoon had one last word of advice on issuing written prescriptions. “I do not recommend charging for written prescriptions,” she said. Although she acknowledged that team members’ time and expertise are valuable, she said charging for written prescriptions is “a sure-fire way to cause disgruntlement and potentially lose clients.”

Ways to optimize interactions with external pharmacies

Magoon said there are ways that veterinary practices can make their work with external pharmacies more positive and productive.  Whenever possible, she recommends enrolling in online portals or hubs to streamline approvals and reduce the number of different ways in which team members have to manage approval requests.

The VHMA report highlighted a number of other ways veterinary practices have worked to streamline their interactions with external pharmacies, ensure patient safety, and reduce their own liability. These include:

• choosing to only approve prescriptions from pharmacies that are accredited by the National Association of Boards of Pharmacy (NABP)
• requiring clients to sign a waiver acknowledging the risk of obtaining medication from an external pharmacy and releasing the practice from any liability associated with use of the medication
• only approving prescriptions that can be processed electronically

Veterinary practices can also employ what Magoon calls the “if you can’t beat them, join them” approach and set up their own online pharmacy platform. This can easily be done by working with a veterinary distributor to set up an online storefront for the practice. This allows practices to offer some of the benefits offered by other online pharmacies such as access to medications not available in the practice, home delivery, and autoship functionality.

Prescribing advice for all veterinary teams

Regardless of their decision to work with external pharmacies or not, Magoon had some great advice for veterinary teams to help them communicate effectively with clients and ensure pets get the medications, supplements, and diets they need to optimize their health and quality of life.

These are things that most teams are likely already doing, but it never hurts to have a refresher:

• During patient visits, get a thorough history including medications, supplements, and therapeutic diets. Ask the client if they need any refills.
• Share any relevant practice policies regarding required exams or bloodwork for future prescription refills.
• Post signs explaining the practice’s policies for internal and external pharmacy refills at the front desk and in exam rooms, as well as on the practice website.
• Train team members to make treatment plans that include pricing with any available rebates for medications the practice carries.
• If the practice has an online pharmacy storefront or a preferred online pharmacy partner, offer this information proactively for any product that will not be dispensed from the practice.

Photo credit: Pawel Kacperek/iStock via Getty Images Plus

Disclaimer: Trends™ content is meant to inform, educate, and inspire by providing an array of diverse viewpoints. Any content published should not be viewed as an official stance, position, or endorsement by the American Animal Hospital Association (AAHA) or its Board of Directors.