When should you use DAW code 1?

Using DAW code 1 is applicable when the prescribing physician indicates that a specific brand medication is medically necessary for the patient. This typically occurs when the doctor believes that the particular brand medication provides a critical benefit or is essential for the patient's health, potentially due to effectiveness, formulation, or the patient's individual needs.

In this scenario, the DAW code serves to communicate to insurers and pharmacists that the brand name drug cannot be substituted with a generic alternative due to the physician's explicit instructions. This is important for ensuring that the patient receives the intended medication as prescribed, which is vital for their treatment plan.