County of Santa Clara V.astra USA, Inc.

CourtCourt of Appeals for the Ninth Circuit
DecidedAugust 27, 2008
Docket06-16471
StatusPublished

This text of County of Santa Clara V.astra USA, Inc. (County of Santa Clara 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 Clara V.astra USA, Inc., (9th Cir. 2008).

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 CORPORATION; BRISTOL-MYERS No. 06-16471 SQUIBB COMPANY; PFIZER, INC.; SCHERING-PLOUGH CORPORATION  D.C. No. CV-05-03740-WHA TAP PHARMACEUTICAL PRODUCTS, OPINION INC.; ZENECCA INC.; ZLB BEHRING 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

Filed August 27, 2008

Before: Stephen Reinhardt, Melvin Brunetti and Raymond C. Fisher, Circuit Judges.

Opinion by Judge Fisher

11761 11764 COUNTY OF SANTA CLARA v. ASTRA USA

COUNSEL

Patrick J. Coughlin, Sanford Svetcov (argued), Jeffrey W. Lawrence, Jacqueline E. Mottek, Aelish M. Baig and Jennie COUNTY OF SANTA CLARA v. ASTRA USA 11765 Lee Anderson, Coughlin Stoia Geller Rudman & Robbins LLP, San Francisco, California; Ann Miller Ravel and Cheryl A. Stevens, Santa Clara County Counsel’s Office, San Jose, California; Steve W. Berman and Douglas C. McDermott, Hagens Berman Sobol Shapiro LLP, Seattle, Washington, for plaintiff-appellant County of Santa Clara.

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

OPINION

FISHER, Circuit Judge:

Certain federally funded medical clinics — so-called “Sec- tion 340B covered entities” — are able to purchase prescrip- 11766 COUNTY OF SANTA CLARA v. ASTRA USA 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 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 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). COUNTY OF SANTA CLARA v. ASTRA USA 11767 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)].

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 2 Hereinafter, all citations are to Title 42 of the United States Code unless otherwise noted. 3 Section 602 of the Veterans Health Care Act of 1992 added a new Sec- tion 340B to Part D of Title III of the Public Health Service Act. See 106 Stat. at 4967. The Public Health Service Act is itself codified at Chapter 6A of Title 42 of the United States Code. See National Institutes of Health Revitalization Act of 1993 § 2008(i)(1)-(2), Pub. L. No. 103-43, 107 Stat. 122, 212-13. 4 The PPA establishes different discounts for other classes of drugs that are not relevant here. See PPA §§ II(b)-(c). 11768 COUNTY OF SANTA CLARA v. ASTRA USA be charged under the PPA is calculated using proprietary sales and pricing information the Manufacturers disclose only to the Secretary.

The genesis of the present appeal is a putative class action filed in California state court by the county of Santa Clara and a number of county-operated medical facilities (“Santa Clara”), which are covered entities within the meaning of § 256b(a)(4) and PPA § I(e).

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