What is it?
The cascade is a long standing legal flexibility providing a rational balance between the legislative requirement for veterinary surgeons to prescribe and use authorised veterinary medicines where they are available., and the need for professional freedom to prescribe other products where they are not. It is intended to increase the range of medicines available for veterinary use.
Why is it important to use authorised medicines?
Animal species have many physiological differences from humans and each other, The authorisation system requires a product to have proven quality and effectiveness and, most importantly, safety for the animal, the user and the environment.
In addition, animal medicines containing the same active ingredient as human medicines may be formulated differently. Human generic medicines that are similar to the authorised veterinary medicines may not be used unless there is no suitable veterinary medicines available.
The cascade provides a legal mechanism allowing veterinary surgeons to use their clinical judgement to prescribe a suitable medicine where no authorised medicine exists. Use and prescription by vets of human generic medicines where a suitable veterinary product is available is a criminal offence and contrary to the RCVS Guide to professional Conduct.
What do vets need to do to comply with the cascade?
If there is no medicine authosrised in the UK for a specific condition, the veterinary surgeon may, in order to mitigate unacceptable suffering, treat the animal(s) in accordance with the following sequence:
1) A veterinary medicine authorised in the UK for use in another animal species or for a different condition in the same species; or, if there is no such product either:
2) a) A medicine authorised in the UK fro human use, or
b) in accordance with an import certificate from the VMD
3) A medicine prepared extemporaneously by a vet or pharmacist
A medicine prescribed in accordance with the cascade may be administered by the prescribing vet or by a person acting under their direction. Responsibility for the prescription and use of the medicine remains with the prescribing veterinary surgeon.
For further information please see the VMD's Veterinary Medicine Guide Note 15 "Controls on the Administration of Veterinary medicines" available from www.vmd.gov.uk.
