State Specific Laws on Drug Product Selection
This information is a summary based on the Drug Product Selection Laws Section of the 2012 Survey of Pharmacy Law done by the National Association of Boards of Pharmacy. This only serves as guide/reference, for patients along with their healthcare provides, to understand and navigate the regulations regarding drug substitution, more commonly referred to by many as Dispense as Written (DAW). Please note that Individual state law is subject to change and may allow other ways to indicate no substitution.

StateGeneric SubstitutionHow to Prevent SubstitutionPatient Consent
Permissive - State law permits the pharmacists to substitute a generic version of the prescribed drug.
Mandatory - State law mandatorily require the pharmacist to substitute a generic version of the prescribed drug.Yes - Includes states where consent is required and those that require the patient to be notified/informed of substitution
AlabamaPrescriber must sign the appropriate on signature line of two-line prescription.Yes
AlaskaPrescriber must handwrite “Brand Necessary”Yes
ArizonaPrescriber must expressly indicate that substitution is not allowedYes
ArkansasPrescriber must handwrite “Brand Necessary”Yes
CaliforniaPrescriber must handwrite or orally state “Do Not Substitute” or similar words or initial the “Do Not Substitute” boxYes
ColoradoPrescriber must handwrite “Dispense as Written” or initial the “Dispense as Written” pre-printed boxYes
ConnecticutPrescriber must handwrite “DAW,” “Dispense as Written,” or “Medically Necessary”Yes
DelawarePrescriber must handwrite “DAW” or “Dispense as Written”Yes
District of ColumbiaPrescriber must expressly indicate that substitution is not allowedYes
FloridaPrescriber must expressly indicate that substitution is not allowedYes
GeorgiaPrescriber must handwrite “Brand Necessary” or “Brand Medically Necessary”Yes
GuamPrescriber/Licensed Practitioner must handwrite "No Substitution" or "No sub"No, Patient may request the brand name to be dispensed, but prescriber must authorize generic
HawaiiPrescriber must handwrite “brand necessary” or “brand medically necessary”Yes
IdahoPrescriber must mark “May not substitute” or check brand only boxYes
IllinoisPrescriber must mark “May not substitute”No, Except for anti-epileptic drugs
IndianaPrescriber must sign the appropriate on signature line of two-line prescription.Yes, patient must be informed/notified
IowaPrescriber must expressly indicate that substitution is not allowedYes
KansasPrescriber must sign the appropriate on signature line of two-line prescription or must expressly indicate that substitution is not allowedYes, patient must be informed/notified
KentuckyPrescriber must handwrite “Brand Medically Necessary” (Medicaid) or expressly indicate that substitution is not allowed or “Do Not Substitute”Yes
LouisianaPrescriber must check box on prescriptionYes
MainePrescriber must expressly indicate that substitution is not allowed or check box on prescriptionYes
MarylandPrescriber must handwrite “Brand Medically Necessary” (Medicaid), or expressly indicate that substitution is not allowedYes
MassachusettsPrescriber must indicate “No Substitution”No
MichiganPrescriber must handwrite “DAW” or “Dispense as Written”No
MinnesotaPrescriber must handwrite “DAW” or “Dispense as Written” Yes
MississippiPrescriber must sign the appropriate on signature line of two-line prescription.Yes
MissouriPrescriber must sign the appropriate on signature line of two-line prescription.Yes
MontanaPrescriber must handwrite “Brand Name Medically Necessary,” or printed if electronically generated.Yes
NebraskaPrescriber must expressly indicate that substitution is not allowedYes
NevadaPrescriber must handwrite “Dispense as Written”No
New HampshirePrescriber must handwrite, orally state, or include on the face of electronically transmitted prescription, “medically necessary”Yes
New JerseyPrescriber must sign the appropriate on signature line of two-line prescription.No
New MexicoPrescriber must handwrite “No Substitution” or “No Sub.”No
New YorkPrescriber must handwrite “Brand Medically Necessary” (Medicaid) or indicate "DAW or “Dispense as Written” in the designated boxYes
North CarolinaPrescriber must sign the appropriate on signature line of two-line prescription or expressly indicate that substitution is not allowedYes, For narrow therapeutic drugs only
North DakotaPrescriber must handwrite “Brand Medically Necessary”Yes
OhioPrescriber must handwrite “DAW” or “Dispense as WrittenYes
Oklahoma--Unlawful for pharmacists to substitute without the authority of prescriber or purchaserUnlawful for pharmacists to substitute without authority of prescriber or purchaser
OregonPrescriber may specify in writing, telephone communication or by electronic transmission that there shall be no substitutionNo
PennsylvaniaPrescriber must handwrite “Brand Necessary” or “Brand Medically Necessary”Yes
Puerto RicoPrescriber must handwrite “Do not interchange”Yes
Rhode IslandPrescriber must handwrite “Brand Necessary” or “Brand Medically Necessary” or patient may request, in writing, that the brand name be dispensedNo
South CarolinaPrescriber must sign the appropriate on signature line of two-line prescription.Yes
South DakotaPrescriber must handwrite “Brand Necessary”Yes
TennesseePrescriber must handwrite “Brand name medically necessary,” “dispense as written,” “medically necessary,” “brand name,” “no generic,” or any abbreviation of this language or circle preprinted “dispense as written”No
TexasPrescriber must handwrite “Brand Necessary” or “brand medically necessary”Yes
UtahPrescriber must expressly indicate that substitution is not allowed or check pre-printed “Do Not Substitute” boxYes
VermontPrescriber must handwrite “brand necessary,” “no substitution,” "dispense as written" or "DAW" plus a statement that the generic equivalent has not been effective or is reasonably certain it will not be effective or is reasonably certain to cause adverse reactionsYes
VirginiaPrescriber must handwrite “Brand Medically Necessary”Yes
WashingtonPrescriber must sign the appropriate on signature line of two-line prescription.No, Patient may request the brand name to be dispensed, but prescriber must authorize generic
West VirginiaPrescriber must expressly indicate that substitution is not allowed or handwrite “Medically Necessary,” "brand necessary," or "brand medically necessary"Yes
WisconsinPrescriber must expressly indicate that substitution is not allowedYes
WyomingPrescriber must expressly indicate that substitution is not allowedNo

References

National Association of Boards of Pharmacy. Survey of Pharmacy Law—2012. Mount Prospect, IL: National Association of Boards of Pharmacy; 2011.

Wockhardt USA (2010), State-Specific Regulations for Writing Dispense as Written (DAW).

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