Equine veterinarians only have a limited number of medications to use that have been fully approved through the FDA for use in horses. This results in a need to use drugs in an off-label manner and/or for veterinarians to utilize compounded medications to manage cases.
The question is often asked: How do equine insurance policies deal with the use of non-FDA-approved medications in the event of an adverse reaction or the death of the patient?
In reaching out to equine insurance companies commonly used by horse owners to cover their horses, there was an unwillingness on the part of many company representatives to discuss their policies. That said, representatives of one insurance company graciously stepped up to the plate to discuss its philosophy of how such a situation is handled; however, they declined to be quoted by name in the preparation of this news story.
The short answer is that a horse owner is not likely to be penalized for an adverse event connected to an off-label or compounded pharmaceutical, provided that several criteria are met:
- The horse owner reports an adverse event to the insurance company in a timely fashion—i.e., as soon as possible following the event.
- It is the esteemed opinion of the veterinarian that use of a specific off-label medication was appropriate to treat and manage a case.
- Experimental or homeopathic medication is excluded from insurance coverage, so adverse events linked to those medications would likewise be excluded.
Because products and availability in the pharmaceutical world continually change, it is difficult for an insurance company to itemize every specific drug that has the potential to cause an adverse reaction or result in a poor outcome. In addition, insurance companies are regulated state by state, which dictates the type of insurance that the company can sell in that state. Wording regarding restrictions might differ among states; such wording and intent must be approved by each state, so dictates can vary among states across the nation.
The important take-home message is that following basic standard-of-care principles not only protects you, but also protects horse owners in the event of an adverse event.