What is implied by DAW code 4?

DAW code 4 indicates that generic substitution is allowed, but the specific generic product is not available in stock at the pharmacy. This scenario typically arises in situations where a pharmacy wishes to comply with the patient’s prescription while also adhering to the guidelines and preferences surrounding pricing and reimbursement. When a pharmacy notes that a generic alternative should be dispensed but that it is currently unavailable, they may choose to fill the prescription with the brand-name drug instead. This is a common practice in pharmacy, aligning with both regulations and practical stock management.

This code serves to communicate the circumstances of the prescription to insurers, ensuring that they understand why a brand-name product was dispensed in lieu of a generic, which would usually be the preferred option for cost-saving measures.