Brand-to-generic drug therapeutic substitution effects on patient health is an important health policy issue. State pharmacy drug product selection (DPS) laws allow pharmacists to more easily switch prescriptions from brand-to-generic drugs. This research measures the effects of DPS laws on statin-patient generic-to-branded drug switch-backs, this being a potential indicator of clinical failure from the initial brand-to-generic substitution. Anonymized patient-level data from 2006–2008 were analyzed on statin drug utilization patterns for 397,111 U.S. patients. Logistic regression results on DPS and non-DPS variables show effects on switch-backs in a manner consistent with implications from a principal-agent framework in healthcare. DPS laws should be reviewed to ensure that drugs dispensed by pharmacists are those intended by physicians and in the best health interests of patients.
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