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SB 2402

A BILL for an Act to create and enact two new sections to chapter 43-15 and a new subsection to section 43-48-03 of the North Dakota Century Code, relating to the prescriptive authority of pharmacists and therapeutic substitution; to amend and reenact subsection 1 of section 26.1-36.11-01 and section 43-15-01 of the North Dakota Century Code, relating to the scope of practice of pharmacists; to repeal section 43-15-25.3 of the North Dakota Century Code, relating to approved laboratory tests; and to provide an effective date.

69th Legislative Assembly (2025-26)

North Dakota expands pharmacist authority to prescribe medications and substitute therapeutically equivalent drugs, requiring updates to insurance regulations and removal of laboratory test restrictions.

Committee Hearing 01:00
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WeVote Research Nonpartisan
Bill Summary · SB 2402

Legislative bill overview

SB 2402 expands pharmacist authority in North Dakota by granting prescriptive powers and allowing therapeutic substitution (switching patients to equivalent medications). The bill modifies the scope of pharmacy practice under state law and removes restrictions on approved laboratory tests, while updating insurance regulations to align with these expanded responsibilities.

Why is this important

Pharmacists are often the most accessible healthcare providers, and expanding their authority could improve medication access, reduce costs, and address gaps in rural healthcare where physicians are scarce. However, this represents a significant shift in the traditional physician-pharmacist hierarchy and raises questions about oversight, liability, and patient safety protocols.

Potential points of contention

  • Professional scope disputes: Physicians may resist pharmacists having independent prescriptive authority, arguing this encroaches on medical practice and reduces their gatekeeping role in medication selection
  • Patient safety and oversight: Questions about what conditions pharmacists can prescribe for, required physician consultation protocols, and liability frameworks if therapeutic substitutions cause adverse outcomes
  • Insurance and reimbursement: How insurers will reimburse pharmacist-initiated prescriptions and whether this creates confusion about coverage or increases overall healthcare costs versus projected savings

Compiled from official sources — confirm details with the bill’s official record.

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