The reaction by insurers is mixed. Some fill the prescriptions and move on while others have policies in place that require preauthorization for DAW medications. At some health plans the enrollee must pay the difference in the cost between an equivalent generic and the requested brand name drug.
With 3.6 billion prescriptions filled in the U.S. each year, researchers estimate that DAW instructions could increase prescription costs by $1.2 billion annually and cost our healthcare system $7.7 billion.
That's a big chunk of the national healthcare bill, but even more worrisome is the idea that some patients aren't even filling DAW prescriptions. Researchers have found that patients who asked their physicians to write brand-only prescription were less likely to fill the prescription when they discovered that a generic version couldn't be substituted.
As you might expect, most of dispense-as-written prescriptions are written by physicians who are older, as are the DAW patients. While it is important for physicians to be able to prescribe the drugs their need, it is possible that generic drug education for both physicians and patients might help reduce the need for DAW. With all of the pharmacy statistics collected by pharmacy benefits managers and health plans, this could be a slam dunk.
'Dispense as written' is not nearly as captivating a term as a 'flab tax.' You are probably not going to hear about it on the nightly news, but with its potential economic wallop, it deserves some attention.