Consumer harm in veterinary services

Executive summary

It is estimated that more than 16 million UK households own pets and they rely on vets to keep their animals healthy, but there are indications that consumers may be suffering harm when they buy veterinary care. Despite the importance of the market, there has been little research into the consumer experience, but the government's Consumer Protection Study found that around one in nine consumers who had purchased vet services had suffered detriment due to some negative experience in the year 2020-21 and that the sector had the fifth highest median ‘net monetised detriment’ among all sectors at £143 per incident.

Which? has undertaken research to explore this harm. Using an online survey of more than 2,000 pet owners who had used a vet in the past 12 months, we’ve investigated consumer experiences of veterinary services. The survey explored consumer views around pricing, their decision-making processes and their perception of and trust in these services. The survey was designed using insight from interviews with pet owners and complemented by desk research into the market. We also matched information from survey respondents about their regular practice (its name, local area and postcode) with practice data from the websites of large chains and the Royal College of Veterinary Surgeons (RCVS) so that we could explore whether consumers' experiences differed depending on whether they used a practice that is independent or part of a chain.

Our main findings are:

• There is limited price competition between practices, since only a minority (27%) of pet owners compare prices when choosing a practice. In part, this is due to a lack of price transparency on the part of veterinary practices. We found it is rare for vets to display treatment prices on their website.
• Customers often do not know who they are buying from, with many chain customers unable to identify which chain their vet belongs to or even if it is part of a chain at all. This reflects that some chains brand practices individually or as small groups. This can matter because consumers could waste time unwittingly comparing practices belonging to the same group and because we find it is related to consumer trust, it could influence decisions such as which practice to use.
• We found evidence that owners often agreed to treatments before being made aware of the cost. More than a third (36%) of pet owners said that they usually only find out the price of veterinary treatment after the appointment at reception, and 4% only on receiving a bill.
• There are also concerns about over-treatment, with just over a quarter (27%) of our survey sample having at some point doubted whether a treatment recommended by their vet was really necessary. Pet owners find it difficult to assess the quality of advice and treatment given by veterinary practices due to information asymmetries between them and the practitioner. This can be exacerbated by the emotional nature of decisions when accessing these services. 
• Less experienced pet owners, who will likely be less able to assess the quality or need for treatment, are more likely to go ahead with a treatment despite doubting its need. Only 34% of first time pet owners who doubted the necessity of a treatment refused it, compared to 61% of those who had owned more than five pets.
• We found no evidence of widespread overselling of products not directly related to an animal’s treatment, but about one in ten pet owners (9%) reported being upsold such products during consultations.
• There is little shopping around for medications, which can often be bought at lower prices from independent pharmacies. Only 22% of pet owners who had bought prescription medications had done so outside of their vet practice, although it is more common for experienced owners to shop around. Some pet owners told us they are not aware it is possible to shop around for medication, while others claimed their vet was reluctant or even refused to write a prescription to take elsewhere, or that the cost of obtaining them can sometimes be prohibitive, eliminating the savings from buying elsewhere.

Overall, we have found enough evidence of potential consumer harm in veterinary services to believe that the market should be explored in greater detail, and we welcome the Competition and Market Authority’s (CMA) decision to open a review of it. We expect that if the CMA finds evidence of consumer harm it will use its powers appropriately to remedy this. We anticipate that there will, at the very least, need to be action to improve the transparency of prices and to ensure that practices display prices for standard treatments on their websites. Beyond this, it may be necessary for the CMA to issue guidance to practices on their obligations with consumer law and to take steps to address barriers to consumers shopping around for medication. We also hope that the CMA’s review may shed light on issues that we have not been able to cover in this research, such as whether complaints and redress processes work well.

Download the pdf version of the report below:

1. Introduction

Veterinary services is a huge market in the UK, with an estimated spend of £4 billion on vets and other services for pets within a year in 2020-2021. An estimated 57% of UK households, equivalent to 16.2 million, own pets, and 23% of all consumers accessed veterinary services between April 2020 and April 2021.

With such widespread use of these services, the potential for consumer detriment in the sector is large and there is evidence that consumers are experiencing harm. The Department for Business, Energy & Industrial Strategy (BEIS) Consumer Protection Study found around one in nine consumers who had purchased vet services had experienced detriment in the year 2020-21 and that the sector had the fifth highest median ‘net monetised detriment’ among all sectors at £143 per issue.

There are two reasons why having an understanding of the consumer harm in veterinary services market is of increasing interest. First, pet ownership boomed during the Covid pandemic, and rising costs are leaving some households struggling to cover the associated costs, with pet charities reporting an increase in owners looking to give up their pet, often due to the associated cost pressures. There is evidence of rapidly rising prices in veterinary care, with The Association of British Insurers (ABI) reporting that the average cost of a pet insurance claim increased 17.6% between 2015 and 2021 (from £721 to £848). This outstripped inflation, with the increase in the CPI over the same period having been 11.6%.

Second, the sector has experienced rapid consolidation in the past decade, and there are concerns that this could lead to consumer harm. Independent vets accounted for 89% of the industry in 2013, but this fell to approximately 45% by 2021, primarily due to six large corporate groups acquiring independent practices. The Competition and Markets Authority  investigated the acquisitions of several of these groups, including the takeovers of The Vet by CVS and Goddard Veterinary Group by VetPartners, and IVC-Evidensia and Medivet takeovers of various independent veterinary businesses.  In each case it was found that the takeovers raised competition concerns and could lead to reduced choice and increased prices for customers. This could be a particular risk if groups buy up multiple independent vets in the same local area, as they could control a large portion of local markets. Large groups also often operate other services such as pet crematoria, which creates the possibility for cross-selling and self-referral that might reduce competition and limit consumer choice.  

Given the large potential for consumer harm in veterinary services, we conducted a research project to explore the consumer experience of using these services. This report details our findings from our review of the veterinary market and an online survey of more than 2,000 pet owners across the UK.

2. Methodology

Our research had three stages. We started by conducting desk research and a small number of qualitative interviews with pet owners, which we then used to inform the design of an online survey of pet owners. Finally, we matched data from the survey with data collected online to identify whether the respondent uses a chain vet, and if yes which chain they use.

Background research

Desk research was undertaken to review the nature of the market, the key players (i.e. the six corporate groups), and the evidence already available of consumer harm. In addition to that, we conducted eleven qualitative conversations with pet owning colleagues to establish the experience of veterinary services from a customer perspective and identify the most commonly arising issues. This informed the design and focus of our online survey. 

We also conducted a review of pricing information on veterinary websites to inform findings about price comparison in the market. For this, we reviewed the websites of at least five randomly chosen practices from each large chain (except where the chain is covered by a single, overarching website) and a selection of independents or small groups, and documented any pricing information available on their websites. 

Online survey

An online survey of 2,035 pet owners was conducted by Yonder on behalf of Which? from 30th May to 4th June 2023. The survey included a range of behavioural and attitudinal questions about pet owners’ experiences of using veterinary services, exploring their views around pricing, their decision-making processes and their perception of and trust in these services. You can find the survey in full in the pdf version of the report.

Our survey sample

Respondents needed to have visited a vet with their pet/s within the last 12 months to qualify for the survey. Our sample is broadly in line with other surveys with regards to pets owned looking at pet-owning populations, with dogs and then cats being the most commonly owned pets, followed by fish and then small mammals (rabbits, rats, guinea pigs etc.). This is in line with a ‘Pet Census’ carried out by pet insurance company Petplan in 2018 with more than 60,000 pet owners.

A theme in our qualitative background interviews was that there were differences in the attitudes and behaviours of pet owners according to their experience of owning pets.Therefore, we asked the pet owners how many pets they had owned in their adult life, using this as a proxy for experience. Our sample provides a reasonable spread of pet-owning experience with a sizeable group of people owning their first pet and some very experienced owners.  

Estimates of the proportion of pet owners who have insurance vary widely, but a large number of pet owners do not have pet insurance (over 40% according to 2023 research by Tesco Bank). In our survey, a third (33%) of pet owners had no pet insurance for any of their pets. Though the majority do, this is still a sizable minority. 71% of dog owners surveyed reported having insurance for their dog, as did 58% of cat owners for their cat. Insurance for other types of pets was more rare. Only 12% of those who own a rodent, indoor bird or reptile had insurance for any of those animals. 

Lower-income consumers were less likely to have taken out a pet insurance policy. 52% of pet owners surveyed with a household income up to £14k had a pet insurance policy, compared to 76% of those in the highest income bracket.

Figure 1: Lower income consumers were less likely to have pet insurance

Chain versus independent vet classification

The classification of a vet as part of one of the large corporate groups was established as an important factor by our background research. Consumers may often be unaware of the ownership of their practice, given the different branding approaches of the large groups. Given this, we asked respondents for information about their regular practice (its name, local area and postcode) and matched this to practice data from the large chain and the Royal College of Veterinary Surgeons (RCVS) websites. This allowed us to classify the practices used by respondents as being from one of the large corporate chains or not, even if the consumers themselves were unsure. 

Not all respondents gave us this information, but we were given sufficient data by 1,539 respondents (over three-quarters of the total sample) to match with our practice lists and establish whether the vet was a chain. The data was checked before matching to minimise errors caused by mistyping or incorrect information given by the respondents. This involved checking that postcodes given were valid postcodes, and ensuring that the local area and postcode data matched.

We classified a ‘large chain’ vet as one belonging to one of the following corporate groups, which are the largest operating across the country:

• CVS
• IVC-Evidensia
• VetPartners
• Pets at Home (Vets4Pets and Companion Care)
• Medivet 
• Linnaeus

The rest of the market is made up of independents and some smaller chains, for example the veterinary charity People's Dispensary for Sick Animals (PDSA) runs a group of pet hospitals and there is a London only chain called Goddards. They are included in the ‘independents and small groups’ class.

3. Overview of the market

Vet groups

The veterinary services market has changed rapidly, with independent practices making up 89% of the market in 2013 but less than half by 2021. While some smaller groups operate in local areas, the large majority of chain practices are owned by six large corporate groups that operate across the UK. The six large groups are:

• IVC-Evidensia
• Pets at Home - operates two vet brands Companion Care Vets and Vets4Pets. 
• CVS 
• VetPartners
• Medivet
• Linnaeus

Table 2 contains some information on these six large groups, including the approximate number of practices, the history and ownership of the group, and the way their practices are branded, which is relevant to some of the findings of our research.

Table 2: background on the six large corporate groups

Many of these chains also operate other, related services. Vets4Pets and Companion Care are part of Pets at Home, which is a large chain retailer of a variety of pet products. CVS, IVC-Evidensia and VetPartners all operate their own pet crematoria, with the latter having acquired a chain of crematoria with 14 sites in 2021. Chains also often operate various facilities such as referral centres and out-of-hours clinics. CVS even operates its own online pharmacy selling food, medications and other pet products.

4. Research findings

Lack of price comparison and price transparency

Despite believing vets to be expensive, pet owners usually do not compare prices

Pet owners overwhelmingly view veterinary services as expensive. 73% of pet owners said that vet consultations are expensive or very expensive, whilst 82% said that vet treatments and medications are expensive. With just a quarter (26%) and less than a fifth (17%), respectively, thinking they are reasonably priced.  More experienced pet owners were more likely to consider insurance and treatments and medications expensive than less experienced pet owners.

Figure 2: The vast majority of pet owners said that veterinary services are expensive

This perception of high costs varied little according to whether the pet was insured or not, as pet owners without insurance were only slightly more likely to consider vet fees and medications very expensive compared to those with insurance. This is likely because pet owners with insurance still pay outright for many vet related products and services. Our qualitative conversations indicated that insurance is typically taken out as a means to cover large and unexpected expenses, including things like operations or expensive diagnostics like scans, but more routine services are typically not covered as part of insurance, like flea treatment, vaccinations, neutering and so on.  Even where treatment is technically covered by insurance, the pet owners we interviewed reported paying outright for lower cost treatments (like consultation fees or a course of antibiotics), either as a result of their insurance excess cost or because they do not want to push the price of their premiums up by claiming for less expensive treatment. 

However, we did find that customers of one of the six large corporate groups were more likely to consider vet prices expensive, with 78% stating that consultation fees are expensive, compared to 68% of customers of independents or smaller groups. Similarly, large chain customers were more likely to say treatments and medications are expensive (87%) than were independent or small chain customers (81%). That being said, there is a clear perception that vets are expensive regardless of whether they are part of a chain or not, with the majority in both groups saying they are expensive.

Figure 3: Pet owners who use a vet from one of the six large corporate groups were more likely to consider prices expensive

A majority of pet owners also said that prices have increased over the last two years, This was true both for customers of the large chains/groups and for customers of independents or smaller groups, but customers of vets from large chains were more likely to report that prices have increased a lot over the last two years, this being a statistically significant difference. A third (34%) of large chain customers said vet consultation fees have ‘increased a lot’ over the last two years, compared to 26% of customers of independent vets or smaller groups. Meanwhile, 41% of chain customers said that vet treatments and medications had increased a lot in price, compared to 29% of customers not with the large chains. This perception of increasing prices aligns with evidence from the value of insurance claims that veterinary costs have been increasing at a rate outstripping inflation in recent years. These increases may be driven by a number of factors - inflation rates have generally been high, and demand inevitably higher following increased pet ownership driven by the Covid-19 pandemic. The number of practising veterinarians has also decreased in recent years. The CMA has stated that it will look into rapidly rising prices as part of its review of the sector.

Despite pet owners believing veterinary services to be expensive, it is not common for pet owners to shop around for cheaper prices with only 27% telling us they had compared prices when choosing their veterinary practice. Choice of practice is most commonly influenced by location - 70% identified the proximity of their practice to where they live as a reason for choosing it. The next most common reason contributing to choice of practice was that the staff made a good impression (36%), and thirdly that the practice was recommended to them (34%). 

Of those who did not compare prices, the most common reason given was that price was not their biggest priority (41%). Others did not believe there was much variation in price (32%), they lacked choice in their area (24%) or the information was just too difficult to find (12%). Among those who did compare prices, three in ten (29%) said it was difficult to do so. 

Practice websites lack pricing transparency

Difficulty in comparing prices is likely a result of obscure pricing on veterinary websites. We reviewed the websites of practices in the six large corporate groups, as well as a sample of independent practices. Most practices did not have prices for any treatments on their website. However, it is common to advertise prices for a ‘pet plan’ (or similar), which cover some basic services such as vaccinations and basic health checks for a fixed monthly price and are distinct from pet insurance. It is often claimed the pet plans give significant savings, but since the prices of individual services are usually not advertised then it is often impossible to verify this based on the information available on the website. 

Table 3: Review of pricing availability on veterinary websites

Customers often find out the price of treatment at a late stage

The lack of transparency in pricing goes beyond the initial stage of searching for a veterinary practice as we found evidence that owners often agree to treatments before being made aware of the cost. More than a third (36%) of pet owners said that they usually only find out the price of veterinary treatment after the appointment at reception, and a further 4% only on receiving a bill, see Figure 4. A similar proportion (37%) said they usually find out during the consultation. Only 14% said they usually find out at the point of booking an appointment. 

Figure 4: Pet owners often only find out the price of treatment following a consultation

Low awareness of chain ownership

As outlined in the introduction, the veterinary market has shifted from majority independent ten years ago to majority chain owned now. Customers, though, may not always be aware that their vet is part of a chain, as the groups do not always advertise their takeover of independent practices. 

We asked pet owners whether their main vet was part of a chain or independent and checked whether they were correct or not for those who were prepared to give details about their practice. Of over 900 vets that we identified as part of one of the six large corporate groups, only 57% were identified as such by the pet owner using the vet - 11% said they did not know, but a third (32%) thought that their vet was independent. This varied considerably by vet group, see Figure 5. In our survey, 90% of customers of Vets4Pets and Companion Care, both owned by Pets at Home, identified their vet as a chain, compared to just a third (34%) of IVC-Evidensia customers. 

Figure 5: The vast majority of Pets at Home customers could identify their vet as a chain, but only a minority could for IVC-Evidensia and CVS

Even among customers who correctly identified that their practice was part of a chain, many didn’t know which group their vet was part of and again this varied by chain, see Figure 6. The vast majority (80%) of Pets at Home customers could identify their vet as belonging to that chain, as could three quarters (75%) of Medivet customers surveyed.  For the other chains though, only a very small minority of the customers surveyed could identify the chain their vet belongs to. 

Figure 6: With the exception of Pets at Home and Medivet customers, very few could identify the chain their vet belongs to

These differences accord with the different approaches of the groups to branding. Pets at Home vets are branded either as Vets4Pets or Companion Care, and are often contained within Pets at Home stores. Medivet practices are branded as Medivet. This is not the case for the other four groups, who generally keep the branding of the independent practices or small groups they have acquired. VetPatners and Linnaeus tend to have multiple vets branded the same within a local area. This is also true to some extent for CVS and IVC-Evidensia, though they more so have a mix of former independents and small chains. This accords with awareness levels among customers, with a large proportion of customers of each of those chains believing that their vet is either independent or part of a different chain to which it actually is. For example, a customer who uses a “Village Vet'' (Linnnaeus’s brand in London) may recognise that their vet is part of a chain called “Village Vet'', but not necessarily that this is part of Linnaeus.

Consumers’ lack of awareness of the ownership of their practice may not be directly harmful, but it could reduce competition within the market, especially where groups have practices branded differently within the same local area. Customers may think they are shopping around between different vets in their area without realising they are part of the same group. Figure 7 shows three vets within two miles of one another in Birmingham which have different branding but are all owned by IVC-Evidensia.

Figure 7: IVC-Evidensia has multiple practices in the same local area with different branding

This lack of awareness may also bias the choices of pet owners, and corporate groups may benefit from not advertising their takeover of independent or small groups vets. When describing their reasons for choosing a vet, several survey respondents expressed a preference for independent vets, or dissatisfaction with their previous independent vet being bought by a chain.

“[Our vet was] previously owned by independent vets whom we trusted”

“I was VERY satisfied with an independent vet for years. Kind and caring but it closed over COVID and I had to go to a local 'chain' which I found impersonal”

“My current vet is now part of a group and is pretty much money minded”

Overall, customers of independent or smaller group practices were more likely to say they trust that vets always have the best interest of their pet/s at heart (58%) compared to chain customers (52%).  Trust was also lower among chain customers who know their vet is part of a chain compared to chain customers who believe their vet is independent. 48% of the former always trust their vet to have the best interest of their pet at heart, compared to 61% of chain customers who believe their vet to be independent.

A possible implication of this is that if pet owners are not aware of the ownership of vets, they may choose a vet they believe to be independent out of preference, without realising that it is in fact group owned. 

Pet owners have difficulty in assessing the quality of and need for treatment

Many pet owners suspect that their pet has been overtreated

One of the key issues identified by the qualitative conversations in our background research was that many pet owners had examples of situations where a vet had suggested treatments they suspected were unnecessary. 

We explored the scale of this through our quantitative survey. Just over a quarter (27%) of our survey sample had at some point doubted whether a treatment recommended by their vet was really necessary. These instances vary in nature - some pet owners report costs building up due to multiple smaller services like repeated consultation fees, dental treatment and diagnostic tests. These can often add up to be very expensive and some pet owners suspect that recommendations may be made in the financial interests of the vet rather than being really necessary for the health of the animal. 

“Every time you visit they say that his teeth need cleaning, which means a pre-assessment, and anaesthetic, and treatment, and is stressful, and seems to be a money making exercise” 

“I felt they were recommending unnecessary treatment just to make money”

“I felt rushed into dental work for my cat, as if you hesitate, the vets keep charging again and again for consultation fees. Appalling practice, and I think they all do it.”

In other cases, pet owners were recommended very costly treatments only to find out later that the treatment was not necessary, or to have been recommended something much cheaper upon getting a second opinion from a different vet.

 “One of our dogs had an abnormal growth in the ear and it looked like it was dying off. The vet quoted £1,600 to get rid of it. We did not do it. It fell off and recovered a week later naturally” 

“They said my dog needed an operation to take part of his foot off. I went to another practice and they said it was just a fatty lump and to cut back on his food”

“Vet claimed a cat had a kidney infection and said an operation was required at a cost of £500+ however…the cat had a common female cat problem requiring occasional pills to rectify”

“My dog had had sickness and diarrhoea for a number of days and they decided to keep him in “hospital” for a number of days on a drip and medication. This happened on two separate occasions. The bills ran into thousands of pounds when we realise now that he was just stressed about things that had happened in the preceding days (being in boarding kennels). If they’d just have given him medication and told us to keep him at home and resting, he’d have just recovered.”

It is difficult for pet owners to challenge vets’ recommendations due to asymmetry of information and the emotional nature of the decision

Of the 27% of pet owners who have doubted the necessity of a treatment, just over half (53%) of these went ahead with it anyway as pet owners often decide to ultimately trust their vet’s recommendations. Nearly three in 10 (28%) of those who had gone ahead with treatment they doubted said it was because they did not have enough information to decide if it was necessary or not.  

Figure 8: Pet owners often go ahead with a treatment they doubt the necessity of because they ultimately trust their vet, or lack the information to make a confident decision

The main reason why many consumers with doubts lack the confidence to make their own decision about treatment go ahead with it is because they do not have the ‘expert’ knowledge of the practitioner. 

“I did [doubt the necessity] but I don’t like to question experts”

“I wasn’t confident enough to say no”

“Just advised to start our dog on early pain management and wasn't sure he was at the point he really needed to commence this, but have decided to follow their advice as the expert, and hope that it isn't a financially led suggestion”.

Further adding to the difficulty to decision making is the emotional attachment that owners have for their pets. Though pet owners may suspect that a treatment is unnecessary, the potential detrimental effect on their pet of making an incorrect decision often leads them to err on the safe side, as they would rather pay for treatment than take any risk with their pet’s health.

“Some services they have advised sound quite far stretched and sometimes seem like just a way for them to make money, but because I care so much about my dog I want to make absolutely certain she is okay”.

“I'm worried that if I refuse the treatment from the vet, my pet will get worse. So although I doubt that these treatments are valuable, I still choose to treat”.

More experienced and less experienced pet owners are equally likely to doubt the necessity of a treatment recommended by their vet. Less experienced pet owners, however, were more likely to subsequently go ahead with a treatment despite doubting its need. Only a third of first time pet owners (34%) who doubted the necessity of a treatment refused it, compared to 61% of those who had owned more than five pets. 

Figure 9: less experienced pet owners were more likely to have gone ahead with treatment that they were unsure of the necessity for

The ownership of a vet practice made little difference to whether a pet owner suspected that a recommended treatment was unnecessary. It was reported by 27% of pet owners using a large chain and 24% at an independent or small group. However, the large chain customers were more likely to subsequently refuse that treatment (55% compared to 46%), which may be related to the differences in trust discussed earlier.

4.4 A minority of consumers feel subject to overselling

There also may be overselling of products not directly related to an animal’s treatment

It is fairly commonplace, and reasonable, for veterinary practices to display or advertise products other than medications and treatments, like a particular brand of pet food. Vets might also recommend products and services from companies they have partnered with.

We found no evidence of widespread overselling of such products, but about one in ten customers reported being upsold products not directly related to their pets treatment during consultations (9% of pet owners). Some also had products upsold or promoted by the receptionist at the practice (6%).  Instances of the practitioner or the receptionist upselling products was more common in London, at 19% and 12% respectively, of 205 pet owners in London in our survey.

The extent to which this might be harmful will vary. Some pet owners acknowledge it happening but did not feel that the vet was ‘pushy’ with their recommendations. Others, however, experience more persistent selling, and have concerns about the impartiality of vet recommendations.

“Supplements that weren’t needed. I had to say no 4 times. They also tried to sell me prescription food. I refused again…”

“I find it quite irritating and it slightly reduces my confidence in their impartiality.”

A couple of pet owners in our survey highlighted instances where they were upsold cremation options when having pets euthanized, a situation which is highly emotional and when consumers are vulnerable to potential financial and emotional harm from upselling. 

“We had to have a kitten euthanized. The vet was a little heavy handed in upselling various cremation options”.

“I rushed my dying cat to the vet; she was in heart failure and needed to be put to sleep urgently to prevent her suffering.  The vet didn't begin the procedure until he had tried his best to sell me a cremation service from their partner pet crem, including asking me to read a leaflet whilst my dying cat was on the table. Shocking, can't explain the distress this caused. The lack of empathy floored me and that was the last time I went to said vet”.

4.5 Lack of shopping around for medications

Pet owners can shop around for cheaper medication, but encounter significant barriers to doing so

As already explored in the section on pricing, pet owners view veterinary treatment and medication costs as high. Whilst insurance and consultation costs were also considered expensive (at 68% and 73% respectively), they were particularly likely to say that vet treatments and medications were expensive (82%), with only 17% seeing them as reasonably priced. It is possible for pet owners to shop around for medication, but relatively few do. We found that only a minority (22%) of pet owners who had bought prescription medications had done so outside of their vet practice. 

More experienced pet owners are more likely to have shopped around for medications. 31% of the most experienced pet owners (who had at some point purchased medication) had bought from a retailer other than their veterinary practice, nearly twice the proportion among first time pet owners surveyed (16%). In part this will reflect experienced pet owners have had more opportunity to shop around for medications if they have owned multiple pets over a long period of time, but it is notable that even among those who have owned five or more pets in their adult life, still only a minority have shopped around when buying medications.  

This issue has been investigated previously, in 2003, by the Competition Commission, the UK’s then competition regulator. Following complaints by animal owners about the high price of prescription-only medicine, it published a report on the supply of prescription-only veterinary medicines in the UK. This identified issues that could impact the ability of independent pharmacies to compete with veterinary surgeons in the sale of prescription-only medications, including conduct that discouraged pet owners from obtaining medications outside of their veterinary surgery. The Supply of Veterinary Medicinal Products Order came into effect in 2005, and implemented the recommendations made by this report. These included banning vets from charging for writing prescriptions for a period of time to allow independent pharmacists to enter the market for supplying prescription-only medications. However, there remain barriers to consumers using this secondary market.

Some pet owners prefer not to shop around for medication because they trust their vet more, it is more convenient or they need the medication urgently. However, some pet owners are simply not aware it is possible:

“Didn't know I could get elsewhere. [The] vet just handed it to me and included it in the bill”.

“I did not know you could buy prescription drugs for dogs online”

Even among pet owners who are aware that they can shop around for prescriptions, there are other blockers to them doing so. Some claimed their vet was reluctant or even refused to write a prescription to take elsewhere:

“Vets are reluctant to give prescriptions to pick up at pharmacies”

“My vet won't give me an online prescription to use elsewhere”

And where prescriptions could be obtained, the cost of obtaining them can sometimes be prohibitive, eliminating the saving from buying elsewhere:

“I have to pay for the prescription from the vets to buy elsewhere”

“Cost of the prescription from the local vet makes online more expensive”

There is little information available online from veterinary practices about the cost for writing a prescription, but reported prices vary significantly, with one online pharmacy estimating that vets charge around £25-27. Depending on the length of prescription written and the cost of the medication, a prescription cost of this much could wipe out even large savings on the price of the actual medication. 

5. Conclusions

Our research indicates that there are potential issues at every point we explored in the consumer journey in the veterinary services market. 

To begin with, a lack of shopping around by consumers means that there is likely to be an absence of competitive pressure exerted on practices. Our survey indicates that there are various reasons why pet owners don’t compare prices before choosing a practice, but the absence of easily comparable price information must be disempowering for consumers. Prices for veterinary treatments will vary according to factors such as the type or breed of animal and the severity of the illness or injury and this presents challenges to providing upfront price information on a website or to give exact costs when an appointment is booked. However, similar challenges exist elsewhere and the CMA has been able to make recommendations to address a lack of pricing transparency in other markets such as funerals and legal services. 

Efforts to shop around will also be frustrated when ownership of practices is not made clear. Time spent comparing surgeries that belong to the same chain is likely to be wasted. While for some customers, ownership may be a factor in their choice of practice as it can affect their trust in their vet. However, our evidence shows that many chain customers are unable to identify which chain their vet belongs to, or even if it is part of a chain at all. A much clearer declaration of ownership would address this.

The research also raises issues about the experience of consumers once a veterinary practice has been chosen. We found striking evidence that many owners say they usually only discover the price of treatment after their appointment. We also found it is relatively common for owners to feel they have been recommended an unnecessary treatment, but that it is difficult for pet owners to assess the quality of advice and treatment given by veterinary practices due to information asymmetries between them and the practitioner. This can be further exacerbated by the emotional nature of decisions about the wellbeing of a beloved family pet. To some extent such issues echo previous work by the CMA on self-funded IVF treatments, where it was found that cost information was not always clear to patients, and patients must make emotionally-loaded decisions on the basis of limited information about the efficacy of treatments. In that case the CMA published guidance for fertility clinics to help them comply with their obligations under consumer law.

Finally, we found that there is little shopping around for medications, despite the potential for these to be bought at lower prices from independent pharmacies separate to veterinary practices. Whilst legitimate concerns like trust, convenience and urgency make up part of the reason why few pet owners shop around for medications, the existence of barriers like awareness, reluctance from the vet and high prescription charges raises the question of whether conduct by practitioners in the veterinary market is preventing pet owners from shopping around effectively. Since the ban on charges for prescriptions ended in 2008, there appears to be little guidance about what constitutes a fair price for writing prescriptions. The RCVS states in their Professional Code of Conduct that vets may charge a ‘reasonable’ price for writing prescriptions, but there is no guidance as to what a ‘reasonable’ price is. The Supply of Veterinary Medicinal Products Order was aimed at allowing independent pharmacists to enter the market and compete with veterinary practices in the sale of Prescription only Veterinary Medicines, and the lack of shopping around among pet owners could indicate that it has not been entirely effective in doing so. 

Overall, we have found enough evidence of potential consumer harm in veterinary services to believe that the market should be explored in greater detail, and we welcome the CMA’s decision to open a review of it. We expect that if the CMA finds evidence of consumer harm it will use its powers appropriately to remedy this. We anticipate that there will, at the very least, need to be action to improve the transparency of prices and to ensure that practices display prices for standard treatments on their websites. Beyond this, it may be necessary for the CMA to issue guidance to practices on their obligations with consumer law and to take steps to address barriers to consumers shopping around for medication. We also hope that the CMA’s review may shed light on issues that we have not been able to cover in this research, such as whether complaints and redress processes work well.

Contact us at consumerinsight@which.co.uk for more information.