PharmD · North Dakota
Collaborative Practice Agreement for Pharmacists in North Dakota
Not unconditionally. North Dakota calls it a Collaborative Practice Agreement.
Uniquely tiered: § 43-15-31.6 grants pharmacists real independent prescribing for an enumerated list of conditions/devices with no physician agreement, while broader drug-therapy initiation/modification outside that list requires the written collaborative agreement under § 43-15-31.4 — see agreementRequiredNote.
Independent practice requires: prescribing only from the specific statutory list of conditions/devices under N.D. Cent. Code § 43-15-31.6 (lice, cold sores, motion sickness, hypoglycemia, influenza/strep/COVID-19 after a positive point-of-care test, PEP, travel medicine after CE, emergency epinephrine/diphenhydramine, Lyme prophylaxis, certain devices) — this tier needs no physician agreement at all.
What the collaboration must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
collaborative-agreement tier (drug therapy initiation/modification beyond the independent list): Separate prescribing terms required · no controlled-substance authority
Requires shared access to the patient's medical record and immediate notification of the collaborating physician/APRN whenever the pharmacist initiates or modifies drug therapy (§ 43-15-31.4(5)). No controlled-substance authority found under this tier.
independent statutory list (§ 43-15-31.6): Covered by the practice agreement · no controlled-substance authority
Limited to the enumerated conditions/devices in § 43-15-31.6; requires a bona fide patient-pharmacist relationship, a maintained assessment protocol, and notifying the patient's PCP within 3 business days. Therapeutic substitution (§ 43-15-31.7) is separately authorized but expressly EXCLUDES Schedule II controlled substances, antidepressants, antipsychotics, chemotherapy agents, biologics, and narrow-therapeutic-index drugs.
Written agreement
Not required
False reflects the § 43-15-31.6 independent-list tier, which needs no agreement. Broader prescriptive practice — initiating/modifying drug therapy outside that enumerated list — requires a written collaborative agreement with a physician or APRN under § 43-15-31.4, executed either individually or via a medical-director/pharmacist-in-charge umbrella agreement covering multiple providers.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement was confirmed this research pass — ND's pharmacy-specific ownership statute was not independently pulled; treat as an open item pending direct citation.
Not independently verified against primary source this research pass.
Legal sources for these rules (4)
- N.D. Cent. Code § 43-15-31.4 — Limited prescriptive practices under collaborative agreement
- N.D. Cent. Code § 43-15-31.5 — Drug administration authority
- N.D. Cent. Code § 43-15-31.6 — Independent statutory prescriptive authority
- N.D. Cent. Code § 43-15-31.7 — Therapeutic substitution
What a collaborating physician costs here
Typical monthly cost in North Dakota
$500 – $600
Estimate for one Pharmacist. Standard-tier state.
About North Dakota's rules
H.B. 1175 (2019, eff. 2020) and a 2022 rule amendment repealed ND's old PA supervision-contract/ratio/countersignature model — PAs are now CONDITIONAL only below 4,000 practice hours or outside a qualifying facility. All four APRN roles (NP, CRNA, CNM, CNS) are FULL independent practice with no collaboration agreement of any kind.
Other clinicians in North Dakota: see the state overview.