Supplements, or nutraceuticals, are products that claim physiological benefits, but are not marketed for the medical treatment of disease.
As such, they are not subject to the same safety and efficacy requirements as medicines, and are most frequently used as an adjunct to medical therapy.
These supplements are commonly used early in the course of a disease with a mild presentation (for example, dry skin or poor coat quality), or in the management of chronic disease (such as joint supplements).
A multimodal approach
The rapid growth in activity on online forums discussing non-veterinary interventions in pet health indicates owners are increasingly looking for alternatives to medical therapy.
Vets can be perceived as closed off to alternatives, and too quick to peddle pharmaceuticals, being accused of ulterior profit-driven motives in the Facebook echo chambers.
Having a multimodal approach, including adjunctive therapies and supplements, is important to create the choices modern clients want. If we don’t react to these trends by providing the best complementary options for owners, they will simply go elsewhere – and frequently to non-veterinary sources.
In the US, data shows pet owners are increasingly scouting out pet supplements online.
In Packaged Facts’ February/March 2017 pet owner survey, 31% of dog owners and 24% of cat owners purchased pet supplements via the web, citing that they found it easier to access extra product information and reviews as their primary reasoning for doing so.
The pet supplement market saw a steady 3% to 5% annual increase, until it skyrocketed by 21% in 2020 thanks to heightened consumer interest during COVID-19. However, vet practices were still the single largest channel in 2016, accounting for half of sales.
The veterinary team, therefore, plays a major role in influencing the pet supplement choices of its clients, both in recommending efficacious products and cautioning against suspect ones.
The use of pet supplements is showing a consistent upward trend year on year, following a similar one in human supplement use. In the UK in 2016, 65% of adults were taking supplements, with an increasing percentage taking them consistently and regularly.
With the lack of regulation, this inevitably invites bogus or low-quality products on to the market. It is our duty, as veterinary professionals, to advise our clients to protect their pets (and their wallets) from ineffective or – at worst – harmful products, and to recommend safe, efficacious options.
Choose wisely
Several factors can weigh on us when considering which product to stock, including the personal risk of recommending a product to clients; we want it to be the best option for them.
If products are not directly comparable, inevitably a degree of insecurity could surround this recommendation. We may also have our own scepticism concerning the true cost-benefit to owners and their pet. In addition, we have the business consideration of stocking product we may not be able to sell. So, how do we address these concerns?
The first step is to compare the products. What are the components? For example, the amount of, say, glucosamine in a joint supplement will widely differ, and as this is the component with the greatest evidence base for potential benefits it carries more weight in terms of value than a higher chondroitin level.
The form of the components is also important, as this will affect the bioavailability. It’s no use having high levels of glucosamine if it’s bound as a poorly absorbed salt.
Also, additional components may affect absorption – for example, iron can reduce the bioavailability of zinc.
But even product types with clinical benefits supported by research are subject to little regulatory oversight and can often vary widely in quality. Ensuring the quality of manufacture is important, with the absence of any toxic additives or contaminants (such as heavy metals in fish oils) and robust, tamper-free packaging.
Best choice for owners
To recommend these products to clients we need to be sure we are clear about the potential benefits and likely costs, plus any contraindications, drug interactions or toxicity risks.
Many nutraceuticals are used for chronic disease management, and it does not make sense to stop and start treatment – especially when it takes time for some components to reach biologically active levels, necessitating higher loading doses.
Long-term costs need to be factored into discussions with owners at the outset.
Looking across the pond, the American Pet Products Association found millennials were now the largest group of pet owners, and they desired a partnership approach to veterinary care. They are willing to spend more on their pets, to be compliant, to use treatment preventively and to do so for longer.
They also see veterinary advice as integral to pet ownership, but use this alongside other sources of information (the dreaded Dr Google). They want your advice to make an educated choice, so thinking about your owner demographic and which supplements will appeal to them, and why, is important.
However, while 80% of dog owners and 73% of cat owners sought veterinary advice for worming medications, fewer were likely to ask their vet about pet supplements and vitamins (69% and 68%, respectively). We need to be more involved in the supplements discussion in the consulting room.
Owner perspective
Putting yourself in owners’ shoes, listening to them and their concerns, and understanding their motivation is key to any successful veterinary transaction (monetary or otherwise).
From an owner’s perspective, practical factors – such as the ease of use, palatability, tablet size, bottle design, product feel, aroma and accompanying instructions for use – are important considerations. An extended expiry date is helpful when owners are using the product over many months.
Loyalty cards encourage long-term use and reward compliance on the part of the owner. Additional information and support resources available through manufacturer websites are useful for directing owners to further reading once they have left the consulting room.
Best choice for your practice
Supplements can offer direct revenue to practices, provided owners don’t seek to purchase through non-veterinary or online channels.
A veterinary exclusive product range necessitates an ongoing conversation with the owner, increasing footfall through repeat visits and, therefore, enabling more regular check-ins with clients and their pets.
Vita firmly believes the veterinary team is best placed to have these discussions, which is why all its products are available only through the veterinary channel.
To maximise benefits to the practice, flexibility in both pricing and stocking quantities will help the practice not only be agile to client needs, but also benefit from promotional deals. Direct delivery to the client through a subscription service also reduces ordering, stocking and risk of non-compliance issues.
Transactional human factors
Once all the product considerations are taken into account, what happens if there isn’t much between two nutraceutical product lines? What other factors feed into our decision-making?
The bottom line may be profit margin, but this isn’t the only factor, as saleability of product will affect this. Here’s where the human factors come into play. Are your staff happy with the support the company provides? Have you had the opportunity to trial the product, listen to owner feedback and observe patient response?
Robert Cialdini introduced the six principles of human influence (Figure 1), which can affect our decision-making:
[1] Reciprocity. If you benefit, for example, with free product, you are more likely to stock it.
[2] Consistency. Recommending one brand consistently is a stronger message to owners than having products from multiple different ranges. Brand consistency can also look better on the waiting room shelf, improving marketability.
[3] Social proof. Other people are using and like the products. In this modern era of sharing via social media, people who see recommendations from others similar to themselves (for example, with the same breed of dog) are much more likely to use the same product.
[4] Liking. You simply get on with the person behind the company and share common interests, values and connections.
[5] Authority. Reps know their onions and can speak with authority about the product. This may include an understanding of how clients tick, as well as your practice and its business challenges.
[6] Scarcity. If we think a resource or product is scarce, we are more likely to purchase. For example, a stock or time-limited offer for a reduced price product makes us more likely to browse and buy.
Conclusion
The first step to making the best choice of nutraceuticals for your practice is to create a shortlist of possibilities based on the evidence and financial considerations.
Then imagine you’re the client. How easy and practical is it to use the products, and are they appealing? If all else is equal, it probably comes down to the most important human factor of all in any transaction – trust.
Trust is built not simply through direct relationships with sales reps, but also through looking at the origins of the business. Look for evidence that companies understand and support the profession, and that their values – especially on animal health and welfare, and the owner-pet bond – align with your own. If we can recommend the products in good faith to our clients, we nurture the trust – truly the most valuable asset to our practice.
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