State Pharmacy Laws Affecting Generic Prescription Drug Substitution: Their Effect on Public Health

Research has shown that patients are more likely to adhere to prescription regimens when they are prescribed more affordable generic products. However, state-level drug product selection laws and regulations control whether pharmacists can substitute brand-name drugs with generic versions of the same products. Drug product selection laws vary across states in whether they are automatic or permissive, whether they require patient consent, and whether there are exceptions (carve-outs) for certain drug classes. This project will evaluate the associations between these laws and state-by-state patterns of generic drug use and public health outcomes. It will estimate the frequency with which pharmacists in states with permissive drug product selection laws exercise their discretion to substitute generic for brand-name drugs, and to identify predictors of this behavior. The project will also conduct a cross-sectional national survey of 2,000 pharmacists, posing questions concerning substitution frequency, source of drug-related information, and demographics, as well as questions on their perceptions of generic drug safety and effectiveness.