Ensuring the safety and quality of the nations’ drug supply is a collaborative effort between state and federal governments. Historically the regulation of pharmacies and pharmaceutical practice has been under state authority, but emerging market practices and lack of quality standardization justify changes to the traditional regulatory system. Cost and pharmaceutical supply shortages have given rise to consumers seeking alternative sources, via Internet pharmacies or through foreign sources, for prescription needs. Drug shortages have left widely used medications in critically short supply and impacted the ability of health care providers to offer certain treatments. Privacy requirements have required states to develop interoperability standards to inform and facilitate the exchange of prescription drug information across state lines.