In the case of a patient with insurance and no check in the DAW box, what is the pharmacist required to do?

In this scenario, if a patient has insurance and there is no indication in the dispense as written (DAW) box, the pharmacist is required to dispense the generic version if the cost is less. This is based on the principle that generic medications are typically a more cost-effective option for both the patient and the insurance provider.

Pharmacists have the responsibility to ensure that patients receive safe, effective, and affordable medications. When there is no directive to dispense a specific brand, they can substitute a generic equivalent that is therapeutically equivalent to the branded product. This practice helps to reduce overall healthcare costs and minimizes out-of-pocket expenses for patients who are covered by insurance.

The other choices do not align with the regulations and standard practices expected of pharmacists in this context. Contacting the prescriber or asking for the patient's preference is generally unnecessary unless there is a specific indication of the patient's desire for a brand or the need for a unique situation where the brand is medically necessary.