State Laws or Statutes Governing Generic Substitution by Pharmacists : Epilepsy.com/Professionals

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State Laws or Statutes Governing Generic Substitution by Pharmacists

Each state has rules concerning generic substitutions. The chart presented here indicates which states allow for generic substitution by pharmacists. However generic substitution is not permitted when "Brand Only" or similar wording is indicated by the prescriber. The chart also notes which states mandate generic substitution under those circumstances. It indicates which states allow dispensing of a brand name medication if that is requested by a patient.

Also listed are states which mandate dispensing the brand name medication if that is what is indicated by the prescriber. Each state's specific wording requirements for prescriptions are given in the far right column. For the two states where a specific exception is made for anticonvulsant medications (Hawaii) or narrow therapeutic range medications (North Carolina), which includes antiepileptic drugs, that indication is given in bold type. Any questions should be referred to your pharmacist.

The information presented in this chart is for reference only. Prescribers, please consult the appropriate authorities in your state for specific requirements and wording to be sure that medications are dispensed as you have determined appropriate for your patient. Any questions should be directed to those authorities.

State Laws or Statutes Governing Generic Substitution by Pharmacists
State	Allows for Generic Substitution by Pharmacists if "Brand Only" Not Indicated by Physician	Mandates Generic Substitution by Pharmacists if "Brand Only" Not Indicated by Physician	Allows for Brand if Requested by Patient	Mandates Brand Only if Indicated by Physician	To Ensure Brand Name Only, Physician Must Indicate the Following on the Written Prescription OR Communicate Orally
Alabama	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written".
Alaska	√		√	√	In the physician's handwriting, the words "Brand Medically Necessary" must appear on the prescription.
Arizona	√		√	√	Clearly display on the prescription "DAW" or other wording indicative of Substitution not Permitted.
Arkansas	√		√	√	In the physician's handwriting, indicate that the product ordered should not be substituted.
California	√		√	√	In the physician's handwriting, the words "Do not substitute" must appear on the prescription.
Colorado	√		√	√	In the physician's handwriting, the words "Dispense as Written" must appear on the prescription.
Connecticut	√		√	√	In the physician's handwriting, indicate that the product ordered should not be substituted.
Delaware	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written".
Florida		√	√	√	In the physician's handwriting, the words "Medically Necessary" must appear on the prescription.
Georgia	√		√	√	In the physician's handwriting, the words "Brand Necessary" must appear on the prescription.
Hawaii		√	√	√	In the physician's handwriting, the words "Brand Medically Necessary" must appear on the prescription. Mandates Brand Only for Anticonvulsant Medications.
Idaho	√		√	√	Physician must indicate "Brand Only" by checking the "Brand Only" box on the prescription.
Illinois	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written".
Indiana	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written".
Iowa	√		√	√	Physician shall communicate to Pharmacist that product should not be substituted.
Kansas	√		√	√	In the physician's handwriting, the words "Dispense as Written" must appear on the prescription.
Kentucky		√	√	√	In the physician's handwriting, the words "Do not substitute" must appear on the prescription.
Louisiana	√		√	√	Physician must indicate "Brand Only" by checking the "Dispense as Written or DAW" box on the prescription.
Maine		√		√	In the physician's handwriting, the words "Dispense as Written", "DAW", "Brand", or "Brand Neccessary" must appear on the prescription.
Maryland	√		√	√	Physician shall communicate to Pharmacist that product should not be substituted.
Massachusetts		√		√	In the physician's handwriting, the words "No substitution" must appear on the prescription.
Michigan	√		√	√	In the physician's handwriting, the words "Dispense as Written" or "DAW" must appear on the prescription.
Minnesota		√	√	√	In the physician's handwriting, the words "Dispense as Written" or "DAW" must appear on the prescription.
Mississippi	√		√	√	Physician shall communicate to Pharmacist that product should not be substituted.
Missouri	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written".
Montana	√		√	√	In the physician's handwriting, the words "Brand Medically Necessary" must appear on the prescription.
Nebraska	√		√	√	In the physician's handwriting, the words "Dispense as Written", "DAW" or similar statements must appear on the prescription.
Nevada		√	√	√	In the physician's handwriting, the words "Dispense as Written" must appear on the prescription.
New Hampshire	√		√	√	Physician must specify that the Brand is Medically Necessary.
New Jersey		√	√	√	Physician must initial next to the option "Do not Substitute" on the prescription.
New Mexico	√		√	√	In the physician's handwriting, the words "No substitution" or "No sub" must appear on the prescription.
New York		√		√	In the physician's handwriting, "DAW" must appear on the prescription.
North Carolina	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written". Narrow Therapeutic Range Drugs must be dispensed as originally prescribed.
North Dakota	√		√	√	In the physician's handwriting, the words "Brand Necessary" must appear on the prescription.
Ohio	√		√	√	In the physician's handwriting, the words "Dispense as Written" or "DAW" must appear on the prescription.
Oklahoma	√		√	√	Physician shall communicate to Pharmacist that product should not be substituted.
Oregon	√		√	√	In the physician's handwriting, the words "No substitution" or "N.S" must appear on the prescription.
Pennsylvania	√		√	√	Physician shall communicate to Pharmacist that product should not be substituted.
Rhode Island		√	√	√	In the physician's handwriting, the words "Dispense as Brand Name Necessary" must appear on the prescription.
South Carolina	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written".
South Dakota	√		√	√	In the physician's handwriting, the words "Brand Necessary" must appear on the prescription.
Tennessee		√	√	√	In the physician's handwriting, the words "Dispense as Written", "DAW", or other language of intent must appear on the prescription.
Texas	√		√	√	In the physician's handwriting, the words "Brand Necessary" or "Brand Medically Necessary" must appear on the prescription.
Utah	√		√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written" OR in the physician's handwriting, the words "Dispense as Written" must appear on the prescription.
Vermont		√	√	√	In the physician's handwriting, the words "Brand Necessary" or "No substitution" must appear on the prescription.
Virginia	√		√	√	In the physician's handwriting, the words "Brand Necessary" must appear on the prescription.
Washington		√	√	√	Sign the prescription signature line labeled "May not Substitute" or "Dispense as Written".
West Virginia		√	√	√	In the physician's handwriting, the words "Brand Medically Necessary" must appear on the prescription.
Wisconsin	√		√	√	In the physician's handwriting, the words "No substitutions" or "N.S" must appear on the prescription.
Wyoming	√		√	√	In the physician's handwriting, the words "Brand Medically Necessary" must appear on the prescription.

Submitted on: 04/25/07
Reviewed by: Steven C. Schachter, MD