Transitioning pharmacy to "standard of care" regulation: Analyzing how pharmacy regulates relative to medicine and nursing.

Abstract

The National Association of Boards of Pharmacy (NABP) recently established a task force to help states develop regulations based on "standards of care" rather than "prescriptive rule-based regulation." The NABP resolution signals a paradigm shift as the pharmacy profession has historically been governed by prescriptive rules at both the federal and state levels. To identify opportunities to make the transition to a "standard of care" regulatory model in pharmacy law as NABP has advanced, this manuscript attempts to quantify the regulatory burden for the medical, nursing, and pharmacy professions in the state of Idaho to facilitate a comparison. The relevant statutes and regulations were gathered, and key measures were extracted, including word count and restrictions (e.g., the use of specific terms like "shall"), the composition and age of each profession's laws, how frequently the respective laws have been amended, and how the composition has changed from 1996 to 2017. When compared to medicine and nursing, pharmacy laws have a larger overall word count, more restrictions, a younger overall age, and have been amended more frequently. In particular, pharmacy has 97.5% more words than nursing and 105.8% more words than medicine with respect to the regulation of professional practice standards. From 1996 to 2017 nursing and pharmacy took two diverging paths to professional practice standard regulation. Nursing decreased the net word count in this area (-3006 words; -28.7%), whereas pharmacy (5208 words; 36.6%) experienced gains. For pharmacy to continue to evolve, replicating the medical and nursing approach to the regulation of professional practice standards will be necessary to fully achieve patient and public health goals.