                                 CODE OF VIRGINIA

DISPENSING OF THERAPEUTICALLY EQUIVALENT DRUG PRODUCT PERMITTED (§
54.1-3408.03)

A. A pharmacist may dispense a therapeutically equivalent drug product for a
prescription that is written for a brand-name drug product unless (i) the
prescriber indicates such substitution is not authorized by specifying on the
prescription, &#8220;brand medically necessary&#8221; or (ii) the patient
insists on the dispensing of the brand-name drug product.
			In the case of an oral prescription, the prescriber&#8217;s oral dispensing
instructions regarding substitution shall be followed.

B. Prescribers using prescription blanks printed in compliance with Virginia law
in effect on June 30, 2003, having two check boxes and referencing the Virginia
Voluntary Formulary, may indicate, until July 1, 2006, that substitution is not
authorized by checking the &#8220;Dispense as Written&#8221; box. If the
&#8220;Voluntary Formulary Permitted&#8221; box is checked on such prescription
blanks or if neither box is checked, a pharmacist may dispense a therapeutically
equivalent drug product pursuant to such prescriptions.

C. If the pharmacist dispenses a drug product other than the brand name
prescribed, he shall so inform the purchaser and shall indicate, unless
otherwise directed by the prescriber, on both his permanent record and the
prescription label, the brand name or, in the case of a therapeutically
equivalent drug product, the name of the manufacturer or the distributor.
Whenever a pharmacist dispenses a therapeutically equivalent drug product
pursuant to a prescription written for a brand-name product, the pharmacist
shall label the drug with the name of the therapeutically equivalent drug
product followed by the words &#8220;generic for&#8221; and the brand name of
the drug for which the prescription was written.

D. When a pharmacist dispenses a drug product other than the drug product
prescribed, the dispensed drug product shall be at a lower retail price than
that of the drug product prescribed. Such retail price shall not exceed the
usual and customary retail price charged by the pharmacist for the dispensed
therapeutically equivalent drug product.

E. A therapeutically equivalent drug shall be eligible for dispensing only if
the manufacturer has established adequate provisions for the return of outdated
drugs, through the distributor or otherwise, by pharmacies. Such provisions
shall permit pharmacies to return drugs in both full and partial containers up
to six months after the label expiration date for full credit or replacement.

HISTORY: 2003, c. 639; 2025, c. 270.