ND HB1469

Prohibits pharmacy benefits managers and health plans from requiring step therapy protocols for FDA-approved prescription drugs used to treat metastatic cancer when prescribed by a health care provider.

Applies the prohibition only when the recommended drug is consistent with FDA-approved indications or supported by peer-reviewed medical literature.

Defines "metastatic cancer" as cancer that has spread from the primary site to lymph nodes, nearby tissues, or other parts of the body.

Does not require coverage of nonformulary prescription drugs, preserving health plans' ability to maintain formulary restrictions.

Passed with overwhelming bipartisan support: 91-0 in the House and 47-0 in the Senate.