Senate committee substitute makes the following changes to the 1st edition.  
Part I.
Modifies the term, pharmacy desert, in GS 58-51-37 so that it now means either (1) an urban community or neighborhood without a pharmacy within a 2-mile radius of any point in the community or neighborhood or (2) a rural community without a pharmacy within a 15-mile radius of any point in the community (was, either an urban community or neighborhood without a pharmacy within a one-mile radius of any point in the community or neighborhood or a rural community without a pharmacy within a ten-mile radius of any point in the community). Makes technical changes. Now excludes those monetary advantages imposed upon a county with a population of fewer than 20,000 residents (was, 5,000 residents) from prohibited monetary advantage practices.
Part II.
Removes new GS 58-56B-25 which would have required certain patient cost-sharing assistance by a Pharmacy Services Administrative Organization (PSAO)’s as described.
Enacts GS 58-56B-45, requiring a PSAO to act as a fiduciary and perform its duties to a pharmacy exercising good faith and fair dealing, including avoiding self-dealing and conflicts of interest. Changes statutory codification of the Commissioner of Insurance (COI) rulemaking authority under new Article 56B of GS Chapter 58 from GS 58-56B-45 to GS 58-56B-50. Requires the COI to adopt rules necessary to implement new Article 56. Makes conforming change to Part’s effective date.  
Part III.
Changes the annual report due date under new GS 58-56A-22 from March 1 to May 1 (requiring all Pharmacy Benefits Managers (PBM) to submit an annual report to the Commissioner by March 1 of each year on the specified information regarding prescription drug benefits specific to insurers within the State with which a pharmacy benefits manager has a contract). Modifies the third, fourth, sixth, and seventh required components of the report so that the PBM must now instead provide the following information:

The aggregated amount of difference between the amount paid by the health benefit plan for prescription drugs and the aggregated amount paid to pharmacies for claims paid under the health benefit plan, including point-of-sale and retroactive charges.
The spread between aggregate amount paid to pharmacies for prescription drugs and the aggregated amount charged to insurers for prescription drugs.
A pharmacy benefits manager that is affiliated with a retail pharmacy shall provide the aggregated amount of any differences between what the pharmacy benefits manager reimburses or charges affiliated retail pharmacies and what it reimburses or charges non-affiliated retail pharmacies.
The aggregate amount of all fees or other assessments, including point-of-sale and retroactive charges, that are imposed on, or collected from, contracted, preferred, or in-network pharmacies. Retroactive charges shall not include any funds recouped from an audit conducted under Part 8 of Article 50 of Chapter 58 of the General Statutes.

Removes required reporting on details on any fees, other than a rebate that a PBM receives from a drug manufacturer or wholesale distributor. Makes organizational changes.  Changes the scope of the new GS 58-56A-4(g) and GS 90-58-40(i) so that it only applies to independent pharmacies (was, a pharmacy or pharmacist).
Part V.
Requires the NC Board of Pharmacy (Board) to implement rules to implement Part V of the act by no later than October 1, 2025. Makes conforming changes to effective date.
Part VI.
Adds defined term claim to GS 58-50-400 (the NC Pharmacy Practice Act). Makes technical change to GS 58-50-405 (rights of a pharmacy/audits). Modifies number of total prescriptions to be audited in an audit conducted for a reason other than an identified problem to the lesser of 1% of claims or 100 claims (was, 25 prescriptions, including refills) under GS 58-50-405 (pharmacy rights during an audit). Makes technical change. Specifies that the 14-day notice provisions do not apply in the case of an audit conducted because of an identified problem in GS 58-50-405(a)(8), as created by and amended by the act.  Now requires the auditing entity to provide the pharmacy with an approximate date when recoupment will occur under GS 58-50-410(j), as created by and amended by the act (was, auditing entity had to provide pharmacy with actual date of recoupment).
Part VII.
Clarifies that GS 58-56A-20’s reimbursement requirements apply when PBM’s are reimbursing a pharmacy or pharmacist in the State.
Part VIII.
When calculating an insured's defined cost-sharing for a covered prescription drug at the point of sale under new GS 58-3-182, now directs the insurer to base the calculation on the price of the prescription drug after considering all rebates (was, pharmacy rebates) associated with that prescription drug.
Part IX.
Adds new term price to the definitions provisions of new Article 4D (Prescription Drug Transparency) in GS Chapter 90. Changes the types of price increases that a manufacturer is required to disclose under GS 90-85.56 from the 20 highest drug price increases to those drugs with a price of $100 or more for a 30-day supply that were increased in price by 15% or greater during the prior calendar year.  Changes the triggering event for the manufacturer’s notification requirements pertaining to new prescription drugs from after it receives FDA approval to after it is made available for purchase in the State. Specifies that a manufacturer’s obligations are fulfilled under GS 90-85.56 by the submission of information and data that a manufacturer includes in its annual consolidated report on Securities and Exchange Commission Form 10-K or any other public disclosure. Specifies that nonpublic information is considered a trade secret and exempt from public records disclosure. Makes conforming changes to GS 90-85.58 to account for new confidentiality provisions, and removes requirement that Secretary submit a plan for the implementation of data collection as part of its first annual report.
Part X.
Enacts GS 90-85.42, requiring the Board, by no later than October 1 of each year, to report on the five specified matters to the Department of Insurance and the specified NCGA Committee, including the number of chain pharmacies (defined) and independent pharmacies (defined) that have opened and closed in the preceding five years.
Makes organizational changes.

Statutes affected:
Filed: 90-85.40, 90-85.3, 90-85.3A
Edition 1: 90-85.40, 90-85.3, 90-85.3A
Edition 2: 90-85.40, 90-85.3, 90-85.3A