'Dispense as written' Rxs may add $7.7 billion to annual US health care costs

Around 5% of prescriptions submitted by USA-based 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 US 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.

In a study published last week in the American Journal of Medicine, the researchers demonstrate that DAW designations for prescriptions have important implications for medication adherence.

Increased cost leads to non-adherence