The cascade and veterinary specials explained
- Dhruv Jones
- Sep 18, 2024
- 5 min read
In veterinary medicine, the treatment options available for animals are not always as straightforward as those in human healthcare. Sometimes, the exact medication needed for an animal isn't readily available or approved for a particular species. This is where the 'cascade' comes into play – a crucial framework that allows vets to prescribe medications that aren’t specifically authorised for certain animals, ensuring they get the care they need.
In this blog, we'll break down what the cascade is, how it works, and delve into the role of 'specials' in this process.
What is the veterinary cascade?
The cascade is a risk-based decision framework that helps vets prescribe medicines when no suitable authorised veterinary medicine is available for a specific condition. This framework is a legal requirement and is essential for safeguarding animal welfare, especially in situations where timely and appropriate treatment is critical.
“Animals need medicines to help prevent disease and to help treat them if they do fall ill. All species deserve the benefit of medicinal products which have been specifically developed and authorised for their treatment.
The cascade ensures this happens wherever possible, but also gives flexibility for veterinary surgeons to use their clinical judgement to prescribe a medicine where no suitable veterinary authorised medicine exists.”
How does the cascade work in Great Britain?
According to the Gov.uk website, the steps, in descending order of suitability, are:
Veterinary medicine with a Marketing Authorisation valid in NI for indicated species and condition, in accordance with a Special Import Certificate granted by the VMD.
If there is no veterinary medicine as described in step 1, or it is not available in Great Britain, then: a veterinary medicine with a Marketing Authorisation valid in GB, NI or UK wide for a different species or condition. For products not authorised in GB or UK wide a Special Import Certificate from the VMD is required.
If there is no veterinary medicine as described in step 1, or it is not available in Great Britain, then: a human medicine with a Marketing Authorisation valid in GB, NI or UK wide OR an authorised veterinary medicine from outside of the UK. For products not authorised in GB or UK wide a Special Import Certificate from the VMD is required; in the case of a food-producing animal the medicine must be authorised for a food-producing species.
If there is no veterinary medicine as described in step 1, or it is not available in Great Britain, then: An extemporaneous preparation prepared by a vet, pharmacist or person holding an appropriate Manufacturer’s Authorisation.
Exemption: In exceptional circumstances, a human medicine may be imported from outside of the UK. For products not authorised in GB or UK wide a Special Import Certificate from the VMD is required.
How does the cascade work in Northern Ireland?
The NI cascade is split into 3 options depending on the animal species being treated. For non-food producing animals, these steps are as follows:
Veterinary medicine with a Marketing Authorisation valid in NI (under an NI or UK-wide authorisation) or authorised in the EU for the same species, for a different indication, or for a different species for the same or another indication. For products not authorised in NI (under an NI or a UK-wide licence), a Special Import Certificate from the VMD is required. Separate arrangements apply for GB authorised products, see Step 4.
If there is no authorised veterinary medicine as described in step 1, or those authorised are not available in Northern Ireland, then: A human medicine with a Marketing Authorisation valid in NI (under an NI or UK-wide authorisation) or the EU. For products not authorised in NI (either through an NI or UK-wide authorisation) a Special Import Certificate from the VMD is required.
If there is no authorised veterinary medicine as described in step 1 or 2 or those authorised are not available in Northern Ireland, then: Extemporaneous preparation prepared by a vet, pharmacist or person holding an appropriate Manufacturer’s Authorisation, in accordance with the terms of a veterinary prescription.
If there is no authorised veterinary medicine as described in step 1, 2 or 3, or it is not available in Northern Ireland, then: A non-immunological veterinary medicine authorised for the same animal species and indication in GB or outside the EU may be used/imported. For products not authorised in NI (under an NI or a UK-wide authorisation), a Special Import Certificate from the VMD is required. Products that are authorised veterinary medicines in Great Britain may be imported under the Veterinary Medicines Internal Market Scheme without the need for an additional import certificate.
For food producing animal species, please refer to the Gov website.
Source: Gov.uk
“The Cascade ensures animal health and welfare needs are met.
The veterinary medicines industry is worth approximately 2.5% of the human medicines industry. As a result, it is not economically possible for veterinary medicines companies to develop authorized medicines for each and every condition for a wide variety of species. This is particularly the case for so-called ‘minor use, minor species’ medicines.
Companies simply cannot obtain a return on investment and the financial incentives to develop products for all conditions are not there. This is why the prescribing cascade exists, to ensure that vets can preserve animal health and welfare where authorised veterinary medicines are not available”
What are veterinary specials?
Specials are a unique category within the veterinary cascade. These medicines are specifically manufactured or procured to address the clinical needs of an individual patient when no suitable licensed product exists. Veterinary specials are critical when dealing with rare conditions, off-label uses, or when a patient has specific needs that cannot be met by standard medications.
How Raman Pharma and Ascot Laboratories make tailored medications easy for vets
The cascade and specials are vital tools that allow vets to provide effective, personalised treatment in complex situations. At Raman Pharma, we are proud to partner with Ascot Laboratories, a leading manufacturer of specials, to provide veterinarians with high-quality, bespoke medications to ensure animals get the care they need when standard options aren’t available. Ascot Laboratories specialises in producing tailored medications, ensuring they meet the exact specifications required by the veterinary surgeon for individual cases.
This partnership showcases how committed we are to supporting vets to provide the best possible care for their patients, even in the most challenging circumstances. Together, we’re ensuring that sourcing and delivering these innovative medications is an easy and efficient process, always putting animal welfare first.
For more information on our partnership with Ascot Laboratories and how we can support your veterinary practice, read more here.
If you have a requirement you’d like to speak to our team about, call us on 01252 260 460 or email sales@ramanpharma.com.
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