The DAW 2 code indicates that substitution was allowed, but the patient specifically requested the brand-name product be dispensed instead of a generic alternative.
Understanding DAW Codes in Prescription Filling
Dispense as Written (DAW) codes are crucial identifiers used in prescription processing to communicate specific instructions regarding the substitution of a brand-name drug with its generic equivalent. These codes inform pharmacists and insurance companies whether a generic substitution is permissible or if the brand-name medication must be dispensed. They play a significant role in managing prescription costs and ensuring patient preferences or prescriber instructions are followed.
The Significance of DAW 2
The DAW 2 code specifically highlights a scenario where a generic option might be available and generally permissible, but the patient's direct request for the brand-name product overrides the potential for generic substitution. This often occurs for various reasons, including:
- Patient Preference: Individuals may have developed a preference for a specific brand due to prior positive experiences, perceived effectiveness, or familiarity.
- Concerns about Generics: Some patients might have unfounded or personal concerns regarding the efficacy, side effects, or quality of generic medications, even though generics are rigorously tested to be bioequivalent to their brand-name counterparts.
- Past Experience: A patient might have previously experienced an adverse reaction or perceived lack of efficacy with a generic formulation of a particular drug.
Common DAW Codes and Their Meanings
Understanding the full spectrum of DAW codes provides a complete picture of the different scenarios that can influence drug dispensing. Here's a breakdown of the common DAW codes:
| Code | Code Value |
|---|---|
| 1 | Substitution Not Allowed by Prescriber |
| 2 | Substitution Allowed - Patient Requested That Brand Product Be Dispensed |
| 3 | Substitution Allowed - Pharmacist Selected Product Dispensed |
| 4 | Substitution Allowed - Generic Drug Not in Stock |
Each code guides the pharmacist on whether to dispense the brand-name drug or a generic, based on the primary reason for that decision. For instance, a DAW 1 code means the prescriber explicitly stated no substitution is allowed, making it a medical necessity or a prescriber's definitive choice. In contrast, DAW 2 signifies that the patient's choice is the determining factor, even when substitution is otherwise allowed.
Practical Implications
When a DAW 2 code is used, it typically means:
- Higher Cost: The patient will often incur a higher out-of-pocket cost, as brand-name medications are generally more expensive than generics, and insurance plans may cover less or require a higher co-pay for brand-name drugs when a generic is available.
- Documentation: Pharmacists must document the patient's request clearly, as this justifies dispensing the more expensive brand-name product when a generic option exists.
- Patient Education: While fulfilling the patient's request, pharmacists often take the opportunity to educate patients about generic equivalents, their safety, and cost benefits, ensuring patients make informed decisions.
In essence, the DAW 2 code is a clear signal that the patient's preference for a specific brand was honored, despite the availability of a therapeutically equivalent and often more affordable generic alternative.
