ND SB2170

Creates Chapter 19-03.7 of North Dakota Century Code to establish maximum "referenced rates" for the most costly prescription drugs based on net price and utilization data.

Prohibits state entities, health plans, and participating ERISA plans from purchasing referenced drugs above the established rate; retail pharmacies also prohibited from selling referenced drugs above the rate to individuals covered by these plans.

Requires the Insurance Commissioner to establish referenced rates annually by October 1st by comparing wholesale acquisition costs to drug prices from Ontario, Quebec, British Columbia, Alberta, and Canada's patented medicine prices review board.

Mandates that savings from lower drug costs be used by health plans to reduce member costs and deposited into a referenced drug fund by state entities for public employees retirement system administration and state health plan premium reductions.

Establishes penalties of $1,000 per violation (each transaction counted separately) for purchasing above the rate; penalizes manufacturers $500,000 or annual savings (whichever is greater) for withdrawing drugs from the market or refusing to negotiate in good faith.