8 articles · Updated · The Wall Street Journal · May 7
Judge Daniel Traynor said the state measure, challenged by drugmakers including AbbVie, was pre-empted by federal law; AbbVie estimated it would cost $35m this year.
The law barred manufacturers from limiting discounted sales to contract pharmacies, a practice companies say fuels transfers from drugmakers to hospitals and pharmacy partners without lowering patients' medicine costs.
Traynor's opinion said 340B purchases rose to $81bn in 2024 from $6.9bn in 2012, amid wider litigation and similar state efforts such as Arkansas's.
As federal courts clash over a multi-billion dollar drug program, what does the legal battle mean for patient drug costs?
Will replacing upfront drug discounts with a rebate system fix the program or dismantle a lifeline for community hospitals?
Why does a drug discount program for the poor generate billions for hospitals while patient costs continue to rise?
North Dakota’s HB 1473 Struck Down for Undermining Federal 340B Program and Burdening Interstate Commerce
Overview
On May 6, 2026, U.S. District Judge Daniel Traynor blocked North Dakota's HB 1473, a 2025 law requiring drug manufacturers to provide 340B discounts to contract pharmacies serving rural and low-income communities. The court ruled the law unconstitutional because it conflicted with federal 340B program rules (Supremacy Clause) and burdened interstate drug distribution (Commerce Clause). A key issue was the law's ban on requiring claims data, which hindered manufacturers' ability to prevent fraud. This ruling, opposing a 2024 Eighth Circuit decision upholding a similar Arkansas law, deepens a circuit split and increases the likelihood of Supreme Court intervention to resolve the conflict.