Pharmacy Benefits Glossary
A guide to general pharmacy benefits terminology.
- Dispense As Written: Definition
- What Is a Dispense As Written Exception?
- Why Is Dispense As Written Important?
- Understanding DAW Codes and Their Meaning
- DAW 0
- DAW 1
- DAW 2
- DAW 3
- DAW 4
- DAW 5
- DAW 6
- DAW 7
- DAW 8
- DAW 9
- What Impact Does DAW Have on Patients and Pharmacies?
- DAW Impact on Patients
- DAW Impact on Pharmacies
- What Happens When the Proper DAW Code Is Missing, Invalid, or Incorrect?
Dispense As Written: Definition
The definition of dispense as written (DAW) is an instruction from a prescriber to a pharmacist to provide the exact medication prescribed without substituting or changing the order prescribed. However, DAW is also a set of dispensing codes that tell a pharmacist whether or not a generic can be substituted for a brand-name drug.
Physicians use DAWs to ensure their patients receive the right medication. The greater purpose of DAW codes is to ensure adherence to the physician’s instructions while keeping drug costs as low as possible throughout the system.
What Is a Dispense As Written Exception?
A dispense as written exception is a specific DAW that the pharmacist must fill the prescription with the brand-name drug even if the generic is available.
Why Is Dispense As Written Important?
DAW codes help reduce costs by preventing unnecessary and excessive prescription fills for expensive brand-name medications when a generic equivalent is available.
But, since there are specific conditions where a patient may need a brand-name version, prescribers can specify the conditions with a specific instruction to ensure the patient gets what they need and to allow a path for the medication to be covered by insurance while reimbursing the pharmacist at the correct rate.
Understanding DAW Codes and Their Meaning
DAW instructions are given specific codes for physicians to use when filling a prescription they file electronically. The following are the different DAW codes that detail unique instructions for the pharmacy to follow:
DAW 0
This indicates that there is no DAW code. Therefore, no specific product is indicated, meaning a substitution is allowed.
DAW 1
This code indicates that no substitution is allowed. The prescriber requires the brand-name version of the medication to be filled.
DAW 2
DAW 2 indicates that the patient has requested a specific substitution to be used to dispense the brand-name version instead of the generic, and the physician is allowing the pharmacy to dispense that substitution.
DAW 3
This indicates that the pharmacist is allowed to select a substitution to dispense.
DAW 4
This code indicates that the pharmacist is permitted to make a substitution using the brand-name drug if the generic drug is not in stock.
DAW 5
This code indicates that the pharmacist can fill the brand-name version of the drug as a generic.
DAW 6
DAW 6 is a code that means to override the DAW Code. Whenever the pharmacist needs to override a code, DAW 6 is used to do so.
DAW 7
This code designates that the brand-name version of a drug is required to be dispensed by state law.
DAW 8
This code is entered when the pharmacist is instructed to dispense the brand-name version of the drug if the generic version is unavailable due to no longer being manufactured or distributed or simply being unavailable.
DAW 9
DAW 9 is an all-purpose code to use when none of the other codes are applicable, but some other form of information needs to be indicated.
What Impact Does DAW Have on Patients and Pharmacies?
DAW codes encourage the use of generic drug options whenever they are available and provide prescribers a means of defining the exact conditions when they are acting in their patient’s best interest to specify using the more expensive brand-name drug even when a generic exists. This has a direct impact on patients and pharmacies.
DAW Impact on Patients
Patients may have to pay additional costs when opting for a brand-name drug in place of generics that are available to be filled. Patients must be informed of these cost considerations when weighing the cost implications.
Suppose a patient’s physician instructs the pharmacist only to fill a brand-name drug that is significantly more expensive than an available generic. In that case, the patient may opt to simply not fill the prescription when their insurance plan would require them to pay the added cost. If a patient would prefer to choose the generic version, the DAW code could cause delays in getting the prescription filled.
DAW Impact on Pharmacies
DAW codes can impact whether a pharmacy is properly reimbursed for filling prescriptions if it fills a brand-name drug and the insurer only pays at the generic rate. This can lead to losses for pharmacies and trigger audits that place an added burden on them. Pharmacies may resort to pre-editing system alerts to help determine potential payment errors or issues with dispensing drugs under a code that might not adequately reimburse them.
What Happens When the Proper DAW Code Is Missing, Invalid, or Incorrect?
Multiple potential negative impacts can occur if a DAW code is missing, invalid, or incorrect:
Pharmacies can lose money by getting reimbursed for a brand-name drug at generic costs.
Inaccuracies can disrupt workflow, cost excess time, and lead to claim rejections that require a pharmacy to re-bill these claims.
