Generic and brand-name drugs

For claims with dates of injury prior to April 1, 2000, BWC will reimburse for brand-name drugs when the physician designates DAW or Dispense as Written on the prescription.

For claims with dates of injury on or after April 1, 2000, BWC will not reimburse for brand-name drugs when a generic equivalent is available. If the physician designates DAW or Dispense as Written on the prescription, or the injured worker requests the brand name drug, the injured worker will be responsible for the difference in cost.

In cases when unusual circumstances warrant the use of brand-name drugs in claims with dates of injury on or after April 1, 2000, the prescribing physician must request prior authorization for the brand-name drug from BWC’s pharmacy department in writing before prescribing it. The request should fully explain the reason the brand name drug is medically necessary and the reason(s) another drug that is therapeutically equivalent to the prescribed drug is not being prescribed. BWC will not consider explanations such as “side effects reported by the patient” or “failure of generic” as justification for the use of the brand name drug.

Submit requests for authorization in one of three ways:

1. Email - Pharmacy department
   
   
2. Mail - Pharmacy Department
   Ohio Bureau of Workers’ Compensation
   30 W. Spring St., 21st floor
   Columbus, OH 43215-2256
   
   
3. Fax - 614-621-5220