INNOVATIONS in pharmacy

What should be the role of a board of pharmacy? Lessons from Idaho

Alex J. Adams

DOI: https://doi.org/10.24926/iip.v17i1.6913

Keywords: pharmacy regulation, pharmacy board, standard of care, pharmacist prescriptive authority, scope of practice

Abstract

The role of state boards of pharmacy is undergoing critical reevaluation amidst widespread reforms in healthcare oversight. This paper explores the evolution of pharmacy governance through the lens of Idaho, a state that has emerged as a national leader in regulatory innovation. In 2025, Idaho enacted legislation that essentially eliminated the quasi-legislative function of its Board of Pharmacy, restoring all policymaking authority to the state legislature and adopting a flexible, statutory-based model grounded in the "standard-of-care" framework. This restructuring reflects broader national trends influenced by legal challenges to antitrust immunity and efforts to reduce regulatory burdens. The paper examines the implications of Idaho’s approach, contrasting traditional quasi-legislative and quasi-judicial roles of pharmacy boards with emerging alternatives such as centralized adjudication systems and consolidated health professional oversight bodies. It argues that the Idaho model may serve as a blueprint for other states seeking to modernize pharmacy regulation, raising fundamental questions about the future necessity and structure of state pharmacy boards in an increasingly adaptive healthcare system.