In Re: Pharmacy Benefit v.

CourtCourt of Appeals for the Third Circuit
DecidedNovember 15, 2012
Docket12-1430
StatusPublished

This text of In Re: Pharmacy Benefit v. (In Re: Pharmacy Benefit v.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re: Pharmacy Benefit v., (3d Cir. 2012).

Opinion

PRECEDENTIAL

UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT ____________

No. 12-1430 _____________

IN RE: PHARMACY BENEFIT MANAGERS ANTITRUST LITIGATION (MDL 1782)

BELLEVUE DRUG CO; ROBERT SCHREIBER INC, d/b/a BURNS PHARMACY; REHN-HUERBINGER DRUG CO., d/b/a PARKWAY DRUGS #4, on behalf of themselves and all others similarly situated; PHARMACY FREEDOM FUND; NATIONAL COMMUNITY PHARMACISTS ASSOCIATION

v.

CAREMARKSPCS, f/k/a ADVANCEPCS (D.C. Civil No. 03-cv-04731)

BELLEVUE DRUG CO., ROBERT SCHREIBER, INC., d/b/a BURNS PHARMACY; REHN-HUERBINGER DRUG CO., d/b/a PARKWAY DRUGS #4, on behalf of themselves and all others similarly situated, Appellants ______________

APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA (D.C. Civil No. 03-cv-04731) District Judges: Honorable Eduardo C. Robreno Honorable C. Darnell Jones, II ____________ H. Laddie Montague, Jr., Esq (Argued) David A. Langer, Esq. Martin I. Twersky, Esq. Berger & Montague 1622 Locust Street Philadelphia, PA 19103

Counsel for Appellants

Michael D. Leffel, Esq. (Argued) Foley & Lardner 150 East Gilman Street Suite 5000 Madison, WI 53703 -and- Robert H. Griffith, Esq. Foley & Lardner 321 North Clark Street Suite 2800 Chicago, IL 60654

Counsel for Appellee

____________

Argued: September 10, 2012 ____________

Before: SCIRICA, ROTH and BARRY, Circuit Judges

(Opinion Filed: November 15, 2012) ____________

OPINION OF THE COURT ____________

BARRY, Circuit Judge

Plaintiffs Bellevue Drug Co., Robert Schreiber, Inc., and Rehn-Heurbinger Drug Co. (collectively “Plaintiffs”) appeal the District Court’s order granting Defendant 2 AdvancePCS’s motion to compel arbitration. Plaintiffs argue that the District Court erred in ordering them to arbitrate their antitrust claims because: (1) AdvancePCS waived its right to arbitrate by actively litigating the case in federal court for more than ten months prior to demanding arbitration; and (2) the arbitration clause is unenforceable because it limits the remedies that Plaintiffs can receive under the Sherman Act, and contains a fee-shifting provision that deters Plaintiffs from proceeding in arbitration. Because we agree with Plaintiffs that AdvancePCS waived its right to arbitrate, we will reverse the order of the District Court compelling arbitration, and need not reach those issues addressed to the clause itself.

I. Background

The factual and procedural background underlying this case was extensively summarized in this Court’s precedential decision disposing of an earlier appeal, In re Pharmacy Benefit Managers Antitrust Litigation, 582 F.3d 432 (3d Cir. 2009). We will not reprise the entire background here, but will set forth those facts necessary to our analysis of the waiver issue, and most particularly those facts preceding AdvancePCS’s motion to compel arbitration.

AdvancePCS is a prescription benefits manager (“PBM”) for drug benefit plans sponsored by employers, unions, government agencies, insurance plans and others (“Plan Sponsors”). PBMs are retained by Plan Sponsors to efficiently manage their benefit plans and to achieve cost savings for Plan Sponsors and plan members. PBMs achieve efficiencies and cost savings in a variety of ways, including negotiating discounts or rebates from drug manufacturers, providing mail order prescription service to plan members, contracting with retail pharmacies for reimbursement when prescriptions are filled for plan members, and electronic processing and paying of claims.

Plaintiffs are retail pharmacy businesses that entered into written Pharmacy Provider Agreements (“the Agreements” or “PPA”) with AdvancePCS to provide 3 prescription drugs and related pharmacy services to persons covered by drug benefit plans administered by AdvancePCS. The PPA establishes the terms and conditions under which the Plaintiffs were to provide prescription drugs and services to plan members, and sets forth an agreed reimbursement rate that AdvancePCS will pay to the pharmacies. The PPA also contains an arbitration clause which provides:

Arbitration. Any and all controversies in connection with or arising out of this Agreement will be exclusively settled by arbitration before a single arbitrator in accordance with the Rules of the American Arbitration Association. The arbitrator must follow the rule of law, and may only award remedies provided in this Agreement. The award of the arbitrator will be final and binding on the parties, and judgment upon such award may be entered in any court having jurisdiction thereof. Arbitration under this provision will be conducted in Scottsdale, Arizona, and Provider hereby agrees to such jurisdiction, unless otherwise agreed to by the parties in writing or mandated by Law, and the expenses of the arbitration, including attorneys’ fees, will be paid by the party against whom the award of the arbitrator is rendered. This Section 9.5 and the parties’ rights hereunder shall be governed by the Federal Arbitration Act, 9 U.S.C. §§ 1 et seq.

(App. 381-82.) The PPA also includes a severability clause, which provides:

Lawful Interpretation. Whenever possible, each provision of this Agreement will be interpreted so as to be effective and valid under applicable Law, but if any provision of this Agreement should be rendered unenforceable or invalid under applicable Law, that provision will be ineffective to the extent of such 4 unenforceability or invalidity without invalidating the remaining provisions of this Agreement.

(App. 381.)

On August 15, 2003, Plaintiffs filed a putative class action lawsuit on behalf of themselves and all other similarly- situated pharmacies that contracted with AdvancePCS to sell drugs for a prescription drug benefit plan. The complaint asserted an antitrust claim against AdvancePCS, alleging that it had engaged in an unlawful conspiracy with its Plan Sponsors to restrain competition in violation of the Sherman Act, 15 U.S.C. § 1. In particular, Plaintiffs alleged that AdvancePCS used the combined economic power of its Plan Sponsors to reduce the contractual amount it pays to retail pharmacies below the levels that would prevail in a competitive marketplace. Plaintiffs also alleged that the Agreements impose certain limitations on drug refills and co- payment charges to plan members. The complaint sought treble damages, injunctive relief, attorneys’ fees, and costs. The case was initially assigned to Judge Eduardo C. Robreno.

As noted at the outset, for more than ten months following the filing of the complaint, AdvancePCS actively— and, indeed, aggressively—litigated the case without mentioning arbitration, much less filing a motion to compel arbitration. On September 25, 2003, more than a month after the complaint was filed, AdvancePCS filed a nineteen-page motion to dismiss the complaint under Fed. R. Civ. P. 12(b)(6), arguing that Plaintiffs suffered no antitrust injury, failed to allege a per se price-fixing agreement, and failed to allege any rule of reason price-fixing agreement. With the motion, AdvancePCS submitted a binder of allegedly judicially-noticeable exhibits—as “thick as the yellow pages,” we are told, including three lengthy government-sponsored studies of the efficiency enhancing effects of PBMs, as well as AdvancePCS’s own annual report to the SEC (Form 10-K), and other materials.

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