How to implement a "standard of care" regulatory model for pharmacists.

National pharmacy associations have increasingly explored regulation according to a "standard of care." In such a model, pharmacists can provide a wide range of clinical services aligned with their education and training. Based on Idaho's experience implementing this model, there are five critical steps states must take to enact a standard of care: 1) Adopt a broad definition of "practice of pharmacy;" 2) Allow elasticity for practice innovation over time; 3) Decide which limited instances still necessitate prescriptive regulation; 4) Eliminate all unnecessary regulations; and 5) Strengthen accountability for deviations from the standard of care. States wishing to adopt a standard of care approach can follow this five-step process to enhance patient care and mitigate the lag that is otherwise constant between laws and practice.

Opportunities for pharmacist prescriptive authority of buprenorphine following passage of the Mainstreaming Addiction Treatment (MAT) Act.

In December 2022, Congress passed the Mainstreaming Addiction Treatment Act, which removed the federal legal barrier to pharmacist buprenorphine prescribing. As a result, each state can now decide whether or not to allow pharmacists to prescribe buprenorphine as an additional access point to reduce fatal opioid overdoses. At least 10 states allow pharmacists to prescribe controlled substances under collaborative practice agreements. Two states (California and Idaho) have also created pathways for independent prescribing of buprenorphine by pharmacists. Additional states should seek to enable pharmacists to prescribe buprenorphine to increase access to a proven beneficial treatment and help reduce fatal opioid overdoses.

Rethinking pharmacy regulation: Core elements of Idaho's transition to a "Standard of Care" approach.

The National Association of Boards of Pharmacy recently established a task force to explore the feasibility of developing regulations based on "standards of care" rather than "prescriptive rule-based regulation." The Board sought to update its professional practice standards by transitioning from prescriptive regulations to a "standard of care" model that harmonizes pharmacists education and training with their legal scope of practice. In doing so, the Board expanded practice authority to include prescription adaptation services and independent prescribing of certain drug classes. As the Board approached how to update its facility standards, it pursued 2 primary goals: (1) Make the regulations practice- and technology-agnostic; and (2) Enable decentralization of pharmacy functions to offsite locations. The Board achieved its goal of reducing overall word count and restrictions in its laws. The Board also created a more permissive professional practice standard rooted in a "standard of care" approach that is more closely aligned with the regulatory model employed by the medical and nursing professions.