Purchaser choice and a proposed substitution
A District patient presents a brand-name prescription without a qualifying substitution prohibition. The pharmacy has two qualifying equivalent products in stock. Their costs to the purchaser are $9 and $14, while the pharmacy would earn a larger margin on the more expensive product. The purchaser initially asks for the lowest-cost qualifying generic but, before purchase, asks whether the prescribed brand is still an option. A staff member says the pharmacy's profit target determines which generic must be supplied and that the purchaser has no right to refuse. The pharmacist has not yet completed the transaction. Assume the products meet the applicable equivalence criteria and that no separate therapeutic-interchange issue is involved.
1. Which cost measure governs the generic selection under the cited District provision?
Read the worked answer
The relevant comparison is cost to the purchaser among qualifying products in stock, not pharmacy margin.
2. How should the purchaser preference be handled?
Read the worked answer
Explain the proposed substitution before purchase, respect the statutory right to refuse, and assess the purchaser's expressed preference for the originally prescribed product.