WOONSOCKET, R.I., March 25, 2011 /PRNewswire/ — Approximately
five percent of prescriptions submitted by CVS Caremark Pharmacy
Benefit Management (PBM) members in a 30-day period during 2009
included a “dispense as written” (DAW) designation. This practice
– whereby doctors or patients demand the dispensing of a
specific brand-name drug and not a generic alternative –
costs the health care system up to $7.7 billion annually, according
to a new study by researchers at Harvard University, Brigham and
Women’s Hospital and CVS Caremark. Moreover, these requests reduce
the likelihood that patients actually fill new prescriptions for
essential chronic conditions.
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In a study published this week in the American Journal of
Medicine, the researchers demonstrate that DAW designations for
prescriptions have important implications for medication adherence.
They found that when starting new essential therapy, chronically
ill patients with DAW prescriptions were 50 to 60 percent less
likely to actually fill the more expensive brand name prescriptions
than generics. “Although dispense as written requests would seem to
reflect a conscious decision by patients or their physicians to use
a specific agent, the increased cost sharing that results for the
patient may decrease the likelihood that patients actually fill
their prescriptions,” the researchers said.
“This study shows that dispense as written requests are costing
the health care system billions,” said William H. Shrank, MD, MSHS,
of Brigham and Women’s Hospital and Harvard, and the study’s lead
author. “The further irony is that patients with
prescriptions specifying a certain brand seem less likely to fill
their initial prescriptions, adding to the medication non-adherence
problem.”
“Previous to this study, little was known about the frequency
with which doctors and patients request dispense as written
presc
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