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November 19, 1973

Antisubstitution Laws

JAMA. 1973;226(8):1012. doi:10.1001/jama.1973.03230080148040

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To the Editor.—  The "Joint Statement on Antisubstitution Laws and Regulations" (225:142, 1973) and the EDITORIAL (225:164, 1973) affirm support for continued prohibition of unauthorized substitution of drug products. They do not address themselves, however, to the question of how to encourage and facilitate authorized substitution when that would be in the patient's best interest.I suggest that physicians be encouraged to have printed on their prescription blanks one of the following statements or some variation thereof:

  • Generic substitution may be made. Generic substitution may/may not be made.

  • Generic substitution may be made unless this box is checked.

The latter two statements require the physician to take specific action if he does not want substitution and therefore should encourage him to do the necessary study to decide in advance which prescription he writes may reasonably be substituted for and which may not.