ND SB2031

Establishes a prescription drug reference rate pilot program administered by the insurance commissioner to study controlling excessive prescription drug prices in North Dakota.

Requires the Public Employees Retirement System to identify the 25 most costly prescription drugs annually and transmit the list to the commissioner by October, who then publishes referenced rates by December based on costs from Canadian and provincial drug pricing sources.

Makes it a class A misdemeanor for state entities, health plans, or licensed pharmacies to purchase or sell referenced drugs above the established rate, with any savings from the program required to be used to reduce consumer costs.

Prohibits drug manufacturers and distributors from withdrawing referenced drugs from the state market to avoid the program or refusing to negotiate prices within the referenced rate, with penalties of $500,000 per drug or the annual savings amount, whichever is greater.

Requires annual reporting to the insurance commissioner and legislative management during 2023-24 and 2025-26 interims, with the entire program expiring July 31, 2027.