The Blueprint Shift: Evaluating NAPLEX and MPJE Performance Trends (2013-2025).

OBJECTIVE: To quantify the association between North American Pharmacist Licensure Examination (NAPLEX) and Multistate Pharmacy Jurisprudence Examination (MPJE) blueprint changes and first-time and all attempts failure rates. METHODS: This repeated cross-sectional study analyzed national passing rate data from 2013 to 2025, We grouped graduating classes by the full implementation of blueprint changes. We calculated odds ratios (ORs) to compare failure rates between the reference group (2013-2015) and subsequent blueprint eras. RESULTS: NAPLEX first-time odds of failure increased significantly with the 2016-2020 blueprint (OR=2.47), the 2021-2024 blueprint (OR=4.75), and the 2025 blueprint (OR=2.57) compared to the reference group. NAPLEX all attempts odds of failure also increased with each blueprint change (OR=1.67, 2.02, and 2.81, respectively). MPJE first-time odds of failure rose with the 2016-2023 blueprint (OR=4.26) and the 2024-2025 blueprint (OR=5.55). MPJE all attempts odds of failure increased with each blueprint change (OR=3.07 and 6.13, respectively). CONCLUSION: Each successive exam blueprint change was associated with a significant increase in failure rates for both NAPLEX and MPJE compared to the reference. We urge NABP to increase transparency and collaboration to ensure the licensing exams meet the needs of the profession in addition to increased access to data for more robust analysis.