Wormers to become prescription-only after misuse led to high levels of resistance

Farmers and merchants fear consequences of prescription-only change for these commonly used treatments 
Wormers to become prescription-only after misuse led to high levels of resistance

Department of Agriculture sources have said  wormer products for livestock are no longer effective on farms, because they have been overused and misused.

Agriculture Minister Charlie McConalogue has pledged to ensure that costs do not increase for farmers due to anti-parasitic treatments becoming prescription-only medicines in January, 2022.

Misuse of the products has led to them becoming ineffective, due to resistance developing in parasites which affect livestock.

Mr McConalogue said he is aware of concerns among farmers that the change to prescription-only could lead to an increase in costs or other challenges in farming.

The products concerned are primarily worm treatments, fluke treatments, sheep dips, pour-on medicines, and horse wormers, that are currently available without prescription from all co-ops, licensed merchants, and pharmacies.

“While we have to comply with our obligations under EU regulations, I want to ensure that we meet those obligations in a practical manner which takes into account the situation facing farmers, to ensure that costs do not increase,” said Minister McConalogue. “It is also important to recognise the role played by licensed merchants in this process and the significant business they have in this regard.

“We are obliged to work to ensure that resistance to antiparasitics does not build up.” Department of Agriculture sources have said the level of resistance to some anti-parasitics is “frightening.” As a result, Ireland can no longer avail of a derogation that depended on no evidence of resistance to antiparasitic medicines, nor of environmental damage relating to them, allowing these products be made available without prescription and dispensed in Ireland by persons other than vets.

However, Ireland’s Health Products Regulatory Authority has identified environmental safety risks for anti-parasitics, and conclusive evidence of widespread anthelmintic resistance.

As a result, Ireland can no longer avail of an existing exemption from EU regulations on what products require a prescription. “Ireland has no national discretion on this issue,” said Mr McConalogue.

Department of Agriculture sources have said resistance is so high that products are no longer effective on farms, because they have been overused and misused.

“Our focus is to make these products prescription-only medicines to encourage better and more responsible use,” said a Department veterinary official. “The reason we have the increased resistance is because of the way we have been using these medicines.

“There are certain practices that need to be followed to use these medicines responsibly and to get the best possible outcome.

“There are practices such as refugia, where not all the animals in the herd are treated at the one time, so a naive population of the parasite is maintained on the farm. Grazing management is key. One does not dose and move to a clean pasture. These parasites only affect the younger animals, so it is all about the grazing system. There is also the quarantine element when buying in animals.“

“If best practice is not followed, resistance continues to develop over time, as we have seen with antimicrobials. The more treatment is used, the more whatever is being treated develops mechanisms to become resistant.

If anti-parasitics become prescription-only, many merchants who depend on profits from their sale warn they will be forced to close.

They say competition in the market would be reduced by veterinary practices both prescribing and selling the treatments.

They have suggested that separating prescribing and dispensing as in human medicine would remove commercial conflicts of interest and free up vets to concentrate on clinical work.

Department of Agriculture sources have confirmed that because it becomes prescription only, the vet does not have to administer the medicine or go onto the farm every time a farmer needs it.

“A prescription is issued as a one-off and the farmer is then free to go wherever he or she so chooses to get that medicine.

“A person, therefore, gets the prescription on day one and can go to his or her licensed merchant whenever he or she needs that product.

“The person is not duty-bound to buy it all from the vet at that time. The Department has never been of the view the vet must administer this treatment.”

Pharmacists say it is ironic that they are deemed competent to supply and advise on the use of anthelmintics and ectoparasiticides for human use without the requirement of prescription, but a veterinary prescription will be required in 2022 to supply and advise on the veterinary equivalent.

They have warned that the unlicensed cross-border trade in veterinary medicines will go from a trickle to a torrent in January 2022 due to wormers becoming prescription only, and it will only take one report of thousands of litres of unregulated product pouring across the Border from the UK into Ireland to wreck the reputation for quality of Ireland’s meat and poultry exports.

Ireland and the UK are the only countries in Europe that still provide antiparasitics without prescription.

Every other country in the EU already requires a veterinary prescription.

A Department of Agriculture spokesperson said, “The core objective is to protect the efficacy of these products because they underpin the sustainability of our livestock sector.

“If antiparasitics do not work, this is a significant problem for us. We need to retain a substantive role for all people who currently supply antiparasitics.”

Mr McConalogue said his Department will undertake an impact assessment, once details are known such as the length of validity of a prescription for antiparasitics, and development of a secure electronic prescribing system.

Assessment findings of the impact the prescription regulation will have on different stakeholders will be published.

An antiparasitic resistance stakeholder group will address the concerns stakeholders have around changes in the sale of antiparasitics.

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