⌧ Pharmacy Policy Manual
Chapter: Purchasing: Inventory
Operations Procedure Manual Chapter
Policy #: 9.5
Title: Generic Alternate Selection Procedure
I. PURPOSE: To establish guidelines that all purchasing staff will follow when
selecting generic alternate items.
II. POLICY: Personnel who routinely purchase medications for the UWHC Pharmacy
Department will follow the following procedures to select generic
alternate items when the wholesaler is unable to supply items via routine
ordering or when a lower cost alternative product is identified.
a. UWHC Pharmacy Department Do Not Substitute List
a. UWHC pharmacy department purchasing staff routinely receives notice of
items which are not available or have a lower cost alternative item available.
b. The pharmacy department purchasing staff may select alternative generic
medications unless the product appears on the UWHC Pharmacy Department
Do Not Substitute List.
c. Generic products must be “A” Rated Products.
i. These are products are therapeutically equivalent according to the FDA
ii. This includes products rated AA, AB, AN, AO, AP, AT, etc.
iii. Therapeutic equivalence ratings may be found in McKesson’s Online
Purchasing System, Orange Book, Approved Bioequivalency Codes,
FDA website, RedBook and Facts and Comparisons Online (eFacts).
d. Pharmacy purchasing staff must obtain approval from a Drug Policy Program
(DPP) pharmacist prior to substituting any of the following:
i. Products where a therapeutic equivalence code cannot be found.
ii. Products which appear on the UWHC Pharmacy Department Do Not
iii. Items will be added to this list by the DPP when issues related to use of
generic equivalents in clinical practice warrant use of brand name
products only on an institutional basis.
V. RELATED POLICIES
a. UWHC Pharmacy Department Policy 9.3 - Product Shortage Notification and
b. UWHC Pharmacy Department Policy 13.24 - Procedure for Establishing
a. AUTHORED BY: Manager, Supply Chain and Purchasing
Approved By: ____________________________
Director of Pharmacy Services
Form A. UWHC Pharmacy Department Do Not Substitute List
Generic Name Brand Name Rationale for Restriction
Cyclosporine Neoral Levels may vary with different products,
no data to support this- Tx Team will
Cytarabine Any Brand which is
Possible increase in neurotoxicity with
brands which contain preservatives.
Digoxin Lanoxin Blood levels inconsistent with generics.
This restriction is for tablets only. May
substitute for liquid and injectable
American Reagent brand Need bisulfite-free epinephrine for ocular
Fish Oil Caps Advanced Nutritional
No equivalent products approved.
Solu-cortef Must have a preservative-free product.
Immune Globulin IV Various Brand Preference based upon physician,
Levothyroxine Synthroid Special Contract Pricing
Methotrexate LPF Must be a preservative free liquid.
TOP CR 1%
Thermazene Brand preference based upon product
performance in Burn Patients.
Warfarin Coumadin Blood levels inconsistent with generics;
Special Contract Pricing