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  • Drop it into MD Drop it into MD 
    Participant
    Status: Physician
    Posts: 440
    Joined: 09/20/2018

    Do you ever check the box?

    #175790 Reply
    White.Beard.Doc White.Beard.Doc 
    Participant
    Status: Physician
    Posts: 960
    Joined: 02/06/2016

    Huh?

    #175817 Reply
    Liked by jfoxcpacfp
    ENT Doc ENT Doc 
    Participant
    Status: Physician
    Posts: 3567
    Joined: 01/14/2017

    Dispense as Written?

    #175818 Reply
    hatton1 hatton1 
    Participant
    Status: Physician
    Posts: 3123
    Joined: 01/11/2016

    Yes occasionally. Some patients are convinced name brands are better. This thinking has decreased as meds have become so stupidly expensive.. This comment assumes daw is dispense as written. Otherwise huh?

    #175833 Reply
    Avatar Peds 
    Moderator
    Status: Physician
    Posts: 4666
    Joined: 01/08/2016

    Always check substitution allowed…..

    #175834 Reply
    Avatar LizOB 
    Participant
    Status: Physician
    Posts: 322
    Joined: 06/05/2017

    Only if specifically requested by the patient. If they really want it, it’s no skin off my back if they pay more for it

    #175835 Reply
    Liked by Megalops, HikingDO
    The White Coat Investor The White Coat Investor 
    Keymaster
    Status: Physician
    Posts: 4601
    Joined: 05/13/2011

    Only if specifically requested by the patient. If they really want it, it’s no skin off my back if they pay more for it

    Click to expand…

    You mean your nose?

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #175857 Reply
    Liked by jfoxcpacfp
    PhysicianOnFIRE PhysicianOnFIRE 
    Moderator
    Status: Physician
    Posts: 1543
    Joined: 01/08/2016

    I’ve been to DFW a couple times. Enjoyed myself there. Stay clear of the grassy knoll and enjoy the stockyards and that kitschy bar with all the white elephants. I played a lot of shuffleboard there.

    40-something anesthesiologist and personal finance blogger @ https://physicianonfire.com [Part of the WCI Network] Find me on Twitter: @physicianonfire

    FIRE. Financial Independence. Retire Early.

    #175873 Reply
    NaOH NaOH 
    Participant
    Status: Pharmacist, Spouse
    Posts: 120
    Joined: 01/09/2016

    Please don’t. ;_;

    "Don't fear failure - not failure, but low aim, is the crime.
    In great attempts it is glorious even to fail."

    #175922 Reply
    Avatar trebizond 
    Participant
    Status: Resident
    Posts: 132
    Joined: 12/31/2017

    There have been some medications where even specialists feel that there is a real difference between the generic and brandname. I’ve heard Synthroid vs. levothyroxine from numerous patients and endocrinologists. DAW there would be reasonable. Otherwise, should be kept to a minimum.

    #175924 Reply
    Drop it into MD Drop it into MD 
    Participant
    Status: Physician
    Posts: 440
    Joined: 09/20/2018

    Sorry for the confusion.  Yes I am talking about dispense as written.  I personally do not ever see a reason to write for a brand name when a generic is available but I was hoping to get some comments from this crowd.  I agree the biggest issues is synthroid.  I do not believe there is a meaningful difference and even if there is it can be dose corrected so I refuse.  It seems like a silly thing to fight with a patient about but we all draw the line in different places.

    The thread about emotional support animals made me think to ask this because I see quite a lot of overlap of these issues in patients.

    #175931 Reply
    Drop it into MD Drop it into MD 
    Participant
    Status: Physician
    Posts: 440
    Joined: 09/20/2018

    Please don’t. ;_;

    Click to expand…

    Do not worry I won’t.

    Physicians seem to be all over the board with this issue but I have never met a pharmacist who would recommend a brand.

    #175932 Reply
    Avatar GPGP 
    Participant
    Status: Physician
    Posts: 202
    Joined: 05/02/2017

    I have several patients for whom brand a of metformin extended release is fine but brand b/c gives them diarrhea almost as bad as plain metformin. (Lending some credence, insurance company changes have led to the formulary dance, and we had to adjust dosing up and down to maximum tolerated). Have one where glumetza is best, another where it’s formamet)

    A few random other ones come to mind (synthesis, ppi). But I never recommend DAW.

    Probably 20-30 patients in career where brand was truly better or necessary.

    #175938 Reply
    Avatar HikingDO 
    Participant
    Status: Physician
    Posts: 369
    Joined: 03/09/2017

    I guess it’s a fight I don’t care to have, if the patient still wants to spend more money on a name brand pill that’s chemically the same as generic ( after I’ve explained this to them), oh well. I waste my money on dumb things too.

    #175941 Reply

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