The cascade system provides the veterinarian the opportunity to depart from the strict use of registered medicinal products in Belgium. So, it is possible to use a medicinal product for animals of another species or animals of the same species but for another disease. On the other hand, the veterinarian may also prescribe a medicinal product for veterinary use which is authorised in another member state of the European Union, a medicinal product for human use and even a magistral preparation.
- Medicinal products for veterinary use with authorisation in another Member State of the European Union
To administer such medicinal product, the veterinarian must order it from an authorised wholesaler-distributor, or from a pharmacist.
- Medicinal products for Human Use
To administer such medicinal product, the veterinarian must order it from a pharmacist.
- Magistral preparations
To administer these preparations, the veterinarian makes a prescription that must be given to a pharmacist by the person responsible for the animal. Such preparations can not be in the veterinary depot.
This cascade system is related to the following conditions:
1. There is no alternative treatment available in Belgium for the target species or for the involved disease.
2. It is an essential treatment to avoid unacceptable suffering.
3. This is an exceptional situation.
The veterinarian is fully and personally responsible for the implementation of the cascade system. The use of the medicinal product is solely under his responsibility.
Emphasis must be placed on the fact that the cascade system can be applied only in exceptional circumstances.
The wholesaler-distributor and the pharmacist must submit to the FAMHP an overview of provided quantities of medicinal products on a quarterly basis (Article 228). The FAMHP follows trough and acts against possible abuses.
In the interest of the well-being of the animal, the veterinarian can only apply the cascade system under strict conditions. Economic reasons can not play a role!
The Provincial Medical Commission and inspection services of the FAMHP and of the AFSCA will evaluate the quarterly reports and ask a justification in case of suspected abuse of a veterinarian who uses the cascade system.
In addition, the Association of Veterinarians may request a justification from the veterinarian who is abusing his freedom of treatment (art. 14 Law of 28 August 1991 (French version) on the practice of veterinary medicine).
Questions & Answers (French version) (december 2013) about the cascade system
Federal Agency for Medicines and Health Products
Eurostation - Block II - 8th Floor
Place Victor Horta 40 box 40