County of Santa Clar v. Astra USA, Inc.

CourtCourt of Appeals for the Ninth Circuit
DecidedDecember 9, 2009
Docket06-16471
StatusPublished

This text of County of Santa Clar v. Astra USA, Inc. (County of Santa Clar v. Astra USA, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
County of Santa Clar v. Astra USA, Inc., (9th Cir. 2009).

Opinion

FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

COUNTY OF SANTA CLARA,  Plaintiff-Appellant, v. ASTRA USA, INC.; ASTRAZENECA PHARMACEUTICALS LP; AVENTIS PHARMACEUTICALS, INC.; BAYER No. 06-16471 CORPORATION; BRISTOL-MYERS D.C. No. SQUIBB COMPANY; PFIZER, INC.; SCHERING-PLOUGH CORPORATION  CV-05-03740-WHA TAP PHARMACEUTICAL PRODUCTS, ORDER AND INC.; ZENECCA INC.; ZLB BEHRING OPINION* LLC; SMITHKLINE BEECHAM CORPORATION; SMITHKLINE BEECHAM CORPORATION, dba GlaxoSmithKline; WYETH, INC.; WYETH PHARMACEUTICALS, INC., Defendants-Appellees.  Appeal from the United States District Court for the Northern District of California William H. Alsup, District Judge, Presiding

Argued and Submitted March 11, 2008—San Francisco, California

*After we published an opinion in this case and remanded it to the dis- trict court, the district court certified a subsequent immediate appeal, No. 09-15216, under 28 U.S.C. § 1292(b) so that we could clarify a statement in the opinion that had an unexpected bearing on a discovery issue. Because reconsideration of that statement could have also required us to revisit the primary jurisdiction issue, we invited the Secretary of Health and Human Services to file an amicus brief. We now withdraw our earlier opinion and replace it with this opinion.

16561 16562 COUNTY OF SANTA CLARA v. ASTRA USA Filed December 9, 2009

Before: Stephen Reinhardt, Barry G. Silverman and Raymond C. Fisher, Circuit Judges.**

Opinion by Judge Fisher

**After the original opinion was published, Judge Silverman was sub- stituted for the late Judge Melvin Brunetti. COUNTY OF SANTA CLARA v. ASTRA USA 16565

COUNSEL

Patrick J. Coughlin, Sanford Svetcov (argued), Jeffrey W. Lawrence, Jacqueline E. Mottek, Aelish M. Baig and Jennie Lee Anderson, Coughlin Stoia Geller Rudman & Robbins LLP; Tamara Lange, Lead Deputy County Counsel, Ann Mil- ler Ravel and Cheryl A. Stevens, Santa Clara County Coun- sel’s Office; Steve W. Berman and Douglas C. McDermott, Hagens Berman Sobol Shapiro LLP for plaintiff-appellant County of Santa Clara.

Robert S. Litt (argued), Jeffrey L. Handwerker and Sharon Douglass Mayo, Arnold & Porter LLP for defendants- appellees Astra USA, Inc., AstraZeneca Pharmaceuticals, LP and Zeneca Inc.; Alicia J. Donahue and Sara Romano, Shook, Hardy & Bacon LLP for defendants-appellees Aventis Phar- maceuticals, Inc. and ZLB Behring LLC; Timothy T. Scott, Geoffrey M. Ezgar and Paul Yanosy, Sidley Austin LLP for defendant-appellee Bayer Corporation; Paul J. Riehle and Matthew A. Fischer, Sedgwick Detert Moran & Arnold LLP for defendant-appellee Bristol-Myers Squibb Company; Federick G. Herold, Valerie M. Wagner and Philip Barilovits, 16566 COUNTY OF SANTA CLARA v. ASTRA USA Dechert LLP for defendant-appellee SmithKline Beecham Corporation; Molly M. Lane and Tera Heinz, Morgan, Lewis & Bockius LLP for defendant-appellee Pfizer Inc.; Kirke M. Hasson and Colin T. Kemp, Pillsbury Winthrop Shaw Pittman LLP for defendant-appellee Schering-Plough Corporation; Peter N. Larson, Jones Day for defendant-appellee TAP Phar- maceutical Products, Inc.; Fletcher Alford, Gordon & Rees, LLP for defendants-appellees Wyeth, Inc. and Wyeth Phar- maceuticals Inc.

Benjamin M. Shultz, United States Department of Justice, for the United States as amicus curiae.

ORDER

The mandate issued September 18, 2008, is hereby recalled.

The opinion filed August 27, 2008, see County of Santa Clara v. Astra USA, Inc., 540 F.3d 1094 (9th Cir. 2008), is withdrawn. A superseding opinion will be filed concurrently with this order. Petitions for rehearing or petitions for rehear- ing en banc may be filed.

OPINION

FISHER, Circuit Judge:

Certain federally funded medical clinics — so-called “Sec- tion 340B covered entities” — are able to purchase prescrip- tion drugs at a discount from drug manufacturers under a standardized agreement between the federal government and the drug companies. During 2003, for example, these covered entities spent $3.4 billion on outpatient prescription drugs. They claim in this lawsuit that they have been overcharged for COUNTY OF SANTA CLARA v. ASTRA USA 16567 those drugs in violation of pharmaceutical pricing agreements between the Secretary of Health and Human Services (“Secretary”) and the drug manufacturer defendants-appellees (“Manufacturers”). Applying the federal common law of con- tracts, we hold that the covered entities are intended direct beneficiaries of these agreements and thus have the right to enforce the agreements’ discount provisions against the Man- ufacturers and sue them for reimbursement of excess pay- ments. We have jurisdiction under 28 U.S.C. § 1291, and reverse the district court’s dismissal of the complaint under Federal Rule of Civil Procedure 12(b)(6) for failure to state a claim.

BACKGROUND1

In part to “enable . . . certain Federally-funded clinics to obtain lower prices on the drugs that they provide to their patients,” see H.R. Rep. No. 102-384(II), at 7 (1992), Con- gress enacted Section 602 of the Veterans Health Care Act of 1992, Pub. L. No. 102-585, 106 Stat. 4943, 4967. That provi- sion, entitled “Limitations on Prices of Drugs Purchased by Covered Entities,” requires the Secretary of Health and Human Services to:

enter into an agreement with each manufacturer of covered drugs under which the amount required to be paid . . . to the manufacturer for covered drugs . . . purchased by a covered entity . . . does not exceed an amount equal to the average manufacturer price for the drug under [§ 1396r-8(k)(1)] in the preceding calendar quarter, reduced by [a] rebate percentage described in [§ 256b(a)(2)]. 1 Because this is an appeal from an order granting a motion to dismiss, we accept all facts alleged as true and construe them in the light most favorable to the plaintiff. See Karam v. City of Burbank, 352 F.3d 1188, 1192 (9th Cir. 2003). 16568 COUNTY OF SANTA CLARA v. ASTRA USA 42 U.S.C. § 256b(a)(1).2 This drug discounting program is commonly known as the “Section 340B program,” tracing back to its original location within the Public Health Service Act.3 The program is managed by the Health Resources and Services Administration (“HRSA”), a subdivision of the Department of Health and Human Services (“DHHS”). See Statement of Organizations, Functions, and Delegations of Authority, 58 Fed. Reg. 19,137-02 (Apr. 12, 1993). In accor- dance with statute, the Secretary entered into a standard Phar- maceutical Pricing Agreement (“PPA”) with each of the Manufacturers.

One of the Manufacturers’ principal obligations under the PPA is “to charge covered entities a price . . . that does not exceed . . . the [average manufacturer price] for the covered outpatient drug reported . . . to the Secretary in accordance with the Manufacturer’s responsibilities under [§ 1396r- 8(b)(3)], reduced by the rebate percentage.” See PPA § II(a).4 The PPA defines “average manufacturer price,” “covered entity,” “manufacturer” and “rebate percentage” to “have the meanings specified in [§§ 256b and 1396r-8], as interpreted and applied herein.” See PPA §§ I(a)-(o). Also known as the “ceiling price,” the maximum price that covered entities may be charged under the PPA is calculated using proprietary sales and pricing information the Manufacturers disclose only to the Secretary. 2 Hereinafter, all citations are to Title 42 of the United States Code unless otherwise noted.

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