The Costs of “Dispense as Written” Prescriptions

CVS logo

 

 

Prescription cost

Wouldn’t it make sense that a patient would be likely to fill the order and do it quickly when a doctor writes a prescription and that requires a specific brand-name medication and not a generic substitute? After all, such specificity would make it clear that this was a pretty important prescription to fill.

But research from CVS Caremark and our partners at Harvard University, Brigham and Women’s Hospital shows that’s not the case at all. Instead what we found is when such “dispense-as-written” prescriptions are written patients are actually 50 to 60 percent less likely to fill the brand-name prescription, due to their higher cost compared to generic medications.

In addition to the adherence and fulfillment question, the use of dispense-as-written (DAW) prescriptions cost the overall health care system around $7.7 billion and patients in particular somewhere on the order of $1.7 million. Those costs likely would have been less if non-brand-name generics had been available for patients to choose from. Furthermore, non-adherence to assigned prescriptions costs the U.S. health care system as much as $290 billion annually.

The study is a product of CVS Caremark’s previously announced three-year collaboration with Harvard University and Brigham and Women’s Hospital to research pharmacy claims data in order to better understand patient behavior, particularly around medication adherence. You can read more about the study with Harvard University, Brigham and Women’s Hospital here.