Merck & Co., Inc. v. Becerra

District Court, District of Columbia·Decided August 24, 2026·No. Civil Action No. 2023-1615·Published

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

MERCK & CO., INC. and MERCK SHARP & DOHME LLC,

Plaintiffs,

v.

Civil Action No. 23-1615 (CKK)

ROBERT F. KENNEDY, JR., in his official capacity as Secretary of the Department of Health and Human Services, et al.,

Defendants.

MEMORANDUM OPINION

(August 24, 2026)

Created in 2003, Medicare Part D is a voluntary prescription drug benefit program for Medicare beneficiaries administered by the Centers for Medicare and Medicaid Services (“CMS”). Congress initially prevented CMS from using its market share to negotiate lower prices for the drugs it covers. But Congress changed course by enacting the Inflation Reduction Act’s Drug Price Negotiation Program (the “Program”), which directs CMS to negotiate prices for a subset of drugs that lack a generic competitor and represent the highest expenditures to the government.

Plaintiffs Merck & Co., Inc., and Merck Sharp & Dohme LLC (together, “Merck”) develop and market drugs subject to the Program. Merck challenges the Program on constitutional grounds and moves for summary judgment, arguing that the Program effects (i) an uncompensated taking of their property in violation of the Fifth Amendment, (ii) compels speech in violation of the First Amendment, and (iii) imposes unconstitutional conditions on participation. The federal Defendants oppose these arguments and move for summary judgment against Merck.

Upon consideration of the parties’ submissions, 1 the relevant legal authority, and the entire record, the Court shall DENY Merck’s [23] Motion for Summary Judgment in full and GRANT the Government’s [24] Cross-Motion for Summary Judgment in full.

I. BACKGROUND

Medicare is “a federal medical insurance program for people ages sixty-five and older and for younger people with certain disabilities,” and Medicaid is “a joint federal and state program that provides medical coverage for people with limited incomes.” AstraZeneca Pharms. LP v. Sec’y United States Dep’t of Health & Hum. Servs., 137 F.4th 116, 119 (3d Cir. 2025), cert. denied sub nom. AstraZeneca v. Kennedy, 224 L. Ed. 2d 830 (May 18, 2026) (citing 42 U.S.C. § 1395 et seq.). Through these two programs, the federal government pays for “almost half the annual nationwide spending on prescription drugs.” Sanofi Aventis U.S. LLC v. U.S. Dep’t of Health & Hum. Servs., 58 F.4th 696, 699 (3d Cir. 2023) (citing Cong. Budget Off., Prescription Drugs: Spending, Use, and Prices 8 (2022)).

The Medicare program is made up of Parts that serve to “reimburse[] medical providers for services they supply to eligible patients.” Ne. Hosp. Corp. v. Sebelius, 657 F.3d 1, 2 (D.C. Cir. 2011) (citing 42 U.S.C. § 1395 et seq.). Part D is “a voluntary prescription drug benefit program that subsidizes the cost of prescription drugs and prescription drug insurance premiums for Medicare enrollees.” United States ex rel. Spay v. CVS Caremark Corp., 875 F.3d 746, 749 (3d Cir. 2017). Part D “operates as a public-private partnership” between the Centers for Medicare

1 The Court’s consideration has focused on Plaintiffs’ Memorandum in Support of their Motion for Summary Judgment, Dkt. No. 23-1 (“Pls.’ Mem.”) and the attachments thereto; Defendants’ Memorandum in Opposition to Plaintiffs’ Motion for Summary Judgment and in Support of Defendants’ Cross-Motion for Summary Judgment, Dkt. No. 24-1 (“Defs.’ Mem.”) and the attachments thereto; Plaintiffs’ Amended Complaint, Dkt. No. 51 (“Am. Compl.”); Plaintiffs’ Reply in Support of their Motion for Summary Judgment and in Opposition to Defendants’ Cross-Motion for Summary Judgment, Dkt. No. 52 (“Pls.’ Reply”) and the attachments thereto; and Defendants’ Reply in Support of their Cross-Motion for Summary Judgment, Dkt. No. 63 (“Defs.’ Reply”).

and Medicaid Services (“CMS”) and private insurance companies (referred to as “sponsors”) that administer prescription drug plans. Id. When Congress first enacted Part D in 2003, it included a non-interference provision that barred CMS from “interfer[ing] with the negotiations between drug manufacturers and pharmacies and . . . sponsors” and from “institut[ing] a price structure for the reimbursement of covered part D drugs.” Bristol Myers Squibb Co. v. Sec’y, 155 F.4th 245, 252 (3d Cir. 2025), cert. denied sub nom. Bristol Myers Squibb Co. v. Kennedy, 224 L. Ed. 2d 830 (May 18, 2026), and cert. denied sub nom. Janssen Pharms., Inc. v. Kennedy, 224 L. Ed. 2d 830 (May 18, 2026) (quoting 42 U.S.C. § 1395w-111(i) (2003)). Congress later created an exception to this non-interference provision, however, through the Inflation Reduction Act’s (“IRA”) Drug Price Negotiation Program (the “Program”).

The Program directs CMS to select a limited number of eligible drugs and “negotiate . . .

maximum fair prices” for those drugs subject to price ceilings derived from the price on the private market. AstraZeneca, 137 F.4th at 120 (quoting 42 U.S.C. § 1320f(a)(3) and citing id. § 1320f- 3(c)). The pool of drugs that CMS may select from is limited to “those that have been approved by the Food and Drug Administration for at least seven years, lack a generic competitor, and represent the highest expenditures under Medicare Part B or D.” 2 Bristol Myers Squibb, 155 F.4th at 252–53 (citing AstraZeneca, 137 F.4th at 120). The IRA directs CMS to prioritize “the drugs that represent the largest expenditures to Medicare.” AstraZeneca, 137 F.4th at 120–21 (citing 42 U.S.C. § 1320f-1(b)(1)(B)). Once CMS selects and publishes a list of the negotiation-eligible drugs that will be subject to negotiation for the relevant pricing period, it enters a “negotiation” phase with the pharmaceutical manufacturers that hold regulatory approval for the selected drugs. 3

2 Part B covers prescription drugs administered through outpatient care, while Part D covers self-administered drugs. See AstraZeneca, 137 F.4th at 120. 3 The Program directs CMS to select up to 10 for negotiation in 2026, up to 15 for 2027 and 2028, and up to 20 for 2029 and subsequent years. Defs.’ Opp’n at 5 (citing 42 U.S.C. § 1320f-1(a)-(b)).

Id. at 121; see also Bristol Myers Squibb, 155 F.4th at 253. During this negotiation phase, CMS must “aim[] to achieve the lowest maximum fair price for each selected drug . . . and is barred from offering or agreeing to a price that is more than 75 percent of the private market price for the drug.” Id.

A manufacturer of a selected drug “must choose whether to participate in the Program.”

Bristol Myers Squibb, 155 F.4th at 253. Those that choose to participate must execute two contracts with CMS. First, before the negotiation phase begins, a manufacturer must execute a Medicare Drug Price Negotiation Program Agreement (the “Agreement”) with CMS. Id. The Agreement “summarizes the statutory process for the exchange of offers and counteroffers” and states that the parties agree to negotiate to determine a “maximum fair price” in accordance with the statutory scheme. 4 Id. The Agreement also “specifies that the ‘[u]se of the term “maximum fair price” and other statutory terms throughout this Agreement reflects the parties’ intention that such terms be given the meaning specified in the statute and does not reflect any party’s views regarding the colloquial meaning of those terms.’” Id. (citing CMS template agreement). Next, if CMS and a manufacturer agree on a “maximum fair price” for the selected drug, then they memorialize it by executing a Negotiated Maximum Fair Price Addendum (the “Addendum”) to the Agreement. Id. “The manufacturer then must provide Medicare beneficiaries ‘access to such price’ for the drug until CMS determines that a generic competitor is on the market.” Id. (quoting 42 U.S.C. § 1320f-2(a)(1), (b)). And CMS will publish the substance of the agreement to the public. 42 U.S.C. § 1320f–4(a); see also Pls.’ Mem. at 26 (explaining CMS guidance documents).

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