A federal court has denied North Dakota’s request to pause enforcement of a ruling that struck down its 340B drug pricing law while the state appeals, according to a July 27 court order.
The U.S. District Court for the District of North Dakota permanently blocked North Dakota’s 340B law in April, ruling the statute unconstitutional. North Dakota appealed April 29 but waited until July 7 to request a stay, citing three appellate rulings it argued supported a pause, including an 8th U.S. Circuit Court of Appeals decision upholding a similar Missouri law.
AbbVie and the Pharmaceutical Research and Manufacturers of America opposed the stay. PhRMA argued the state’s 2 1/2-month delay in seeking relief undercut its claim of harm.
The court sided with the drugmakers on every factor. It found North Dakota’s law harsher than Missouri’s because it carries criminal penalties, and said the state was regulating drug pricing rather than pharmacy delivery. The court also noted the injunction has been in place for 2 1/2 months, so pausing it now would disrupt the status quo rather than preserve it. AbbVie estimated the law cost the company $10 million in 2025 and would cost another $35 million in 2026 in discounts it otherwise wouldn’t provide. North Dakota submitted no evidence the injunction has harmed residents’ access to care.
The ruling keeps North Dakota’s law blocked amid a growing split among federal courts over state authority to regulate 340B. The 4th U.S. Circuit Court of Appeals sided with drugmakers on West Virginia’s contract pharmacy law, while the 5th U.S. Circuit Court of Appeals upheld Mississippi’s and Louisiana’s 340B protections and the 8th Circuit backed Arkansas‘ and Missouri’s laws.
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