HB 643 – Reference Pricing for RX Drugs

Primary House Sponsors: Rep. Verla Insko (D-Orange); Rep. Donna White (R-Johnston); Rep. Ricky Hurtado (D-Alamance); Rep. Pricey Harrison (D-Guilford)



This bill:

  • Establishes the steps that shall be taken to determine the referenced rate, defined as the maximum rate established by the Commissioner utilizing the Wholesale Acquisition Costs and other pricing data, for prescription drugs subject to the referenced rate.
  • Prohibits any health benefit plan that is not an ERISA plan offered by an insurer in the State or any ERISA plan that elects for its purchase of prescription drugs to be subject to the above from purchasing referenced drugs to be dispensed or delivered to an insured in the State, whether directly or through a distributor, for a cost higher than the referenced rate.
  • Requires the Commissioner to annually calculate the savings that are expected to be achieved by subjecting prescription drugs to the referenced rate.
  • Requires any State entity, health benefit plan, or participating ERISA plan to utilize the savings derived from using the referenced rate to reduce costs to insureds and to annually submit a report to the Commissioner describing the savings.
  • Provides a maximum fine of $1K for each violation of the above.



Filed – 4/21/2021