PERRI v. NOVARTIS PHARMACEUTICALS CORPORATION

CourtDistrict Court, D. New Jersey
DecidedApril 16, 2020
Docket2:15-cv-06547
StatusUnknown

This text of PERRI v. NOVARTIS PHARMACEUTICALS CORPORATION (PERRI v. NOVARTIS PHARMACEUTICALS CORPORATION) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
PERRI v. NOVARTIS PHARMACEUTICALS CORPORATION, (D.N.J. 2020).

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY

UNITED STATES OF AMERICA

ex rel. JOSEPH PERRI, Civ. No. 15-6547 Plaintiff, v.

OPINION and ORDER NOVARTIS PHARMACEUTICALS CORPORATION and EXPRESS SCRIPTS, INC.,

Defendants.

KEVIN MCNULTY, U.S.D.J.: This qui tam matter, brought by relator Joseph Perri (“Relator”) on behalf of the United States, originally alleged that defendants Novartis Pharmaceuticals Corporation (“Novartis”) and Express Scripts, Inc. (“ESI”) engaged in a scheme in relation to Gilenya, a prescription drug, a scheme said to violate the Anti-Kickback Statute (“AKS”). The original complaint asserted four counts under the False Claims Act (“FCA”), the fourth of which was a claim that Perri was terminated in retaliation for objecting to the kickback scheme, in violation of 31 U.S.C. § 3730(h). In a substantial opinion (“Op.”, DE 38), I granted the defendant’s motion to dismiss the original complaint, granting leave to amend. Now the plaintiff has filed a First Amended Complaint. (“1AC”, DE 46) The 1AC nevertheless retains most of the factual allegations of the original, while adding a few more in response to deficiencies noted in the Court’s prior opinion. The 1AC does not, however, amend or attempt to reinstate the three main FCA claims. It reasserts only the claim of retaliatory dismissal, in an amended version. Now before the Court is the motion of the defendant, Novartis, to dismiss the 1AC for failure to state a claim, pursuant to Fed. R. Civ. P. 12(b)(6). (DE 48) For the reasons stated herein, the motion is denied. Familiarity with the case is assumed; this opinion should be read in conjunction with my prior Opinion. I. Standard Federal Rule of Civil Procedure 8(a) does not require that a complaint contain detailed factual allegations. Nevertheless, “a plaintiff’s obligation to provide the ‘grounds’ of his ‘entitlement to relief’ requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007); see Phillips v. Cnty. of Allegheny, 515 F.3d 224, 232 (3d Cir. 2008) (Rule 8 “requires a ‘showing’ rather than a blanket assertion of an entitlement to relief.” (citation omitted)). Thus, the complaint’s factual allegations must be sufficient to raise a plaintiff’s right to relief above a speculative level, so that a claim is “plausible on its face.” Twombly, 550 U.S. at 570; see also West Run Student Hous. Assocs., LLC v. Huntington Nat. Bank, 712 F.3d 165, 169 (3d Cir. 2013). That facial-plausibility standard is met “when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Twombly, 550 U.S. at 556). While “[t]he plausibility standard is not akin to a ‘probability requirement’ . . . it asks for more than a sheer possibility.” Id. Rule 12(b)(6) provides for the dismissal of a complaint if it fails to state a claim upon which relief can be granted. The defendant, as the moving party, bears the burden of showing that no claim has been stated. Animal Science Products, Inc. v. China Minmetals Corp., 654 F.3d 462, 469 n.9 (3d Cir. 2011). For the purposes of a motion to dismiss, the facts alleged in the complaint are accepted as true and all reasonable inferences are drawn in favor of the plaintiff. New Jersey Carpenters & the Trustees Thereof v. Tishman Const. Corp. of New Jersey, 760 F.3d 297, 302 (3d Cir. 2014).1

1 In my prior opinion, I applied the heightened pleading standard of Fed. R. Civ. P. 9(b) to the allegations of fraud in the submission of false claims. Those dismissed counts, however, are not reasserted in the 1AC. I apply the II. Discussion The single count of the 1AC alleges that Relator was terminated from employment in retaliation for his having objected to an illegal kickback scheme, in violation of 31 U.S.C. § 3730(h). That kickback was the foundation of the now-dismissed False Claims Act counts. (A claim is said to be “legally false” if accompanied by a false certification that the claimant is in compliance with federal law—here, the AKC.) Relator asserts, correctly, that a retaliation claim does not require that the underlying conduct have turned out to be illegal under the FCA. See Hutchins v. Wilentz, Goldman & Spitzer, 253 F.3d 176, 187 (3d Cir. 2001) (holding that the FCA’s anti-retaliation provisions “do[ ] not require the plaintiff to have developed a winning qui tam action”; they “only require [ ] that the plaintiff engage in acts [made] in furtherance of an [FCA] action.”) (citations, internal quotations, and alterations omitted). The FCA claims from the original complaint, then, although deceased, continue to haunt the case; they form the basis of Relator’s alleged whistleblowing, which allegedly led to his dismissal. A. Dismissal of Former Counts I, II, and III I refer only briefly to Relator’s allegations of FCA violations based on the kickback scheme; they are summarized more thoroughly in my prior opinion. They arise from the relationship between Novartis, the manufacturer of Gilenya, and ESI, a Pharmacy Benefit Manager (“PBM”) that sponsors commercial, Medicare Part D (“Part D”), and Medicaid health plans. PBMs like ESI administer prescription drug benefits and develop formularies, a list of prescription drugs that are covered under a member’s prescription drug health plan. PBMs generally negotiate with drug manufacturers, who offer discounts and rebates to secure placement of their medications on the formulary. Relator’s original theory of liability was that Novartis provided substantial

ordinary Rule 8 standard to the remaining retaliation claim, which does not sound in fraud. commercial discounts and rebates on Gilenya for ESI’s commercial health plans in return for ESI’s Medicare Part D business. Effective January 1, 2013, Novartis and ESI agreed to a 6.375% discount on Gilenya for ESI’s Part D plans. For commercial plans, however, there was no discount on Gilenya as of January 1, 2013. In October 2013, Relator alleges, ESI threatened to remove Gilenya from both its Part D and commercial formularies after a competitor placed a cheaper, safer, and comparably efficacious drug on the market. In response, Novartis allegedly provided a discount on Gilenya for ESI’s commercial plans (but not its Part D plans) in exchange for the “continued” placement of Gilenya on the formularies. This arrangement, according to Relator, amounted to a kickback to the commercial plans at the expense of the Part D plan. I dismissed the allegations of false claims under the FCA. The “threat” by ESI was not alleged in a factual manner.

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PERRI v. NOVARTIS PHARMACEUTICALS CORPORATION, Counsel Stack Legal Research, https://law.counselstack.com/opinion/perri-v-novartis-pharmaceuticals-corporation-njd-2020.