ND SB2190

Allows pharmacies to substitute FDA-approved interchangeable biosimilar products for prescribed biological products without prescriber authorization

Requires prescribers to write "brand medically necessary" by hand, orally indicate dispensing as communicated, or take specific overt action on electronic prescriptions to prevent substitution

Mandates pharmacists inform patients of potential biosimilar substitution and obtain consent before dispensing, with right to refuse

Requires pharmacist notification to prescriber within 24 hours of substitution via oral, written, or electronic transmission

Requires pharmacy and prescriber to retain substitution records for minimum of five years and establishes that the Board of Pharmacy maintain a public list of FDA-approved interchangeable biosimilar products