Frequent drug backorders, shifting priorities, and rising costs make anesthetic protocol selection increasingly complex. Comparing options in terms of cost and clinical value is essential to ensure safe, ethical, and effective patient care while supporting access to surgery at a population level. This session explores practical tools for balancing financial realities with veterinary responsibility. We will review a practical framework to compare anesthetic options when doses, drug prices, and multimodal “cocktail” mixes all vary. We’ll normalize protocols to cost-per-pound basis for both protocol comparison and budget assessment using common HQHVSN and shelter developed protocols.