Generics/Brand Named Drugs

[panadacoke]

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Hi all, I've been volunteering in a community pharmacy for awhile but I never see the pharmacist ask the patients whether they want brand named drugs/ generics. So I asked the pharmacist and she told me that she gave out generics most of the time because it would be cheaper. My question is, can pharmacists give out generics without asking the patients? Thanks.

 

[npage148]

In new york state, the script must have the DAW box filled out at the bottom of the script to be dispensed brand. If it is a phone in, the person phoning it in must specify if they want the brand name, if they dont say anything it is dispensed generic. On a off note, we will keep a partient on the brand if its a narrow TI drug (synthroid, dilantin, tegretol...) regardless of what they write for.

 

[dgroulx]

Hi all, I've been volunteering in a community pharmacy for awhile but I never see the pharmacist ask the patients whether they want brand named drugs/ generics. So I asked the pharmacist and she told me that she gave out generics most of the time because it would be cheaper. My question is, can pharmacists give out generics without asking the patients? Thanks.

It's up to the individual state. In Florida, we can substitute generics unless the physician writes "Medically Necessary" in his own handwriting on the script. We also have a few negative formulary drugs that we cannot change. I always ask the patient, because we have a few people who refuse anything except brand.

 

[fairyofsong]

It's up to the individual state. In Florida, we can substitute generics unless the physician writes "Medically Necessary" in his own handwriting on the script. We also have a few negative formulary drugs that we cannot change. I always ask the patient, because we have a few people who refuse anything except brand.

Same in Georgia. Unless the doctor specifies "brand name only" the patient's insurance/or/medicaid will only pay for generic. If the patient wants brand and the doctor didn't write it as necessary--then the patient can always pay for the medication out of pocket (not on insurance) which is much more $$! 🙂

 

[ultracet]

and signing DAW isn't enough
they have to write "brand medically necessary"
we had some that just wrote DAW when we requested the other and they had to send us a 3rd prescription....

 

[bananaface]

WA is fun! We may substitute unless the prescriber says DAW... except when the Rx is from out of state. Then we follow the rules of the state that it was written in.

 

[ultracet]

WA is fun! We may substitute unless the prescriber says DAW... except when the Rx is from out of state. Then we follow the rules of the state that it was written in.

we substitute unless brand medically necessary is written on the rx for medicaid patients

or if the patient throws a fit and is willing to pay the difference.... this typically only happens with those who have insurance

i also love the people who complain that their insurance company "doesn't cover" their meds ($20 copay)

 

[bananaface]

We have a state sponsored coinsurance plan here. For non-formulary items, they pay half. Surprisingly, alot of people cough it up. They are starting to realize that when they choose a lower monthly premium, they get fewer prescription and medical benefits. Well, some of them anyway.

 

[SomeGuy]

WA is fun! We may substitute unless the prescriber says DAW... except when the Rx is from out of state. Then we follow the rules of the state that it was written in.

Your state enforces the laws of other states where the law differs? Isn't that against the constitution or something?

 

[bananaface]

Your state enforces the laws of other states where the law differs? Isn't that against the constitution or something?

Pharmacists are expected to follow the rules the prescriber was working under when the prescription was written. How would that be unconstitutional?

 

[sdn1977]

I've been a CA pharmacist for 26 years - I don't know the laws of the other states and wouldn't know how to find them! In CA we are obligated to dispense generic unless MD specifies - that can be done in lots of ways. There is always a process for having insurance pay for brand name -called prior authorization and is usually initiated by MD after we or pt tells them. It is only approved when there is sufficient medical justification for brand name use. Now...the patient can always request the brand name themselves - then there is no obligation for insurance coverage.