How is generic substitution treated in Guam?

In Guam, the treatment of generic substitution is permissive, meaning pharmacists have the discretion to substitute a brand-name drug with a generic equivalent. This approach allows pharmacists to use their professional judgment in determining when it is appropriate to substitute, taking into account factors such as the patient's specific prescription needs, the availability of generics, and the potential cost savings for the patient.

This flexibility can help increase access to medication by potentially lowering costs while still ensuring that patients receive appropriate treatment. In contrast, mandatory substitution would require pharmacists to substitute without considering individual circumstances, and prohibiting it entirely would limit access to potentially more affordable medications. Allowing substitution only for controlled substances would create inconsistencies in practice, as many non-controlled medications also have effective generic counterparts that provide therapeutic equivalence.