The County of Dakota, Nebraska; The Sheet Metal Workers Local No. 40 Health Fund; The Harlem School District 122; 4DUBS BBQ, Inc., assignee of “Dustin’s Bar-B-Q Inc.” v. United Biosource Corporation, now known as “United Biosource LLC,” a wholly owned subsidiary of United Biosource Holdings, Inc.; Evernorth Health, Inc., formerly known as “Express Scripts Holding Company”; Express Scripts, Inc.; Priority Healthcare Corp. and Priority Healthcare Distribution, Inc., respectively doing business as “Curascript SD,” and “Curascript Specialty Distribution SD”; Curascript SD and Accredo Health Group, Inc.

CourtDistrict Court, E.D. Pennsylvania
DecidedMarch 5, 2026
Docket2:24-cv-04276
StatusUnknown

This text of The County of Dakota, Nebraska; The Sheet Metal Workers Local No. 40 Health Fund; The Harlem School District 122; 4DUBS BBQ, Inc., assignee of “Dustin’s Bar-B-Q Inc.” v. United Biosource Corporation, now known as “United Biosource LLC,” a wholly owned subsidiary of United Biosource Holdings, Inc.; Evernorth Health, Inc., formerly known as “Express Scripts Holding Company”; Express Scripts, Inc.; Priority Healthcare Corp. and Priority Healthcare Distribution, Inc., respectively doing business as “Curascript SD,” and “Curascript Specialty Distribution SD”; Curascript SD and Accredo Health Group, Inc. (The County of Dakota, Nebraska; The Sheet Metal Workers Local No. 40 Health Fund; The Harlem School District 122; 4DUBS BBQ, Inc., assignee of “Dustin’s Bar-B-Q Inc.” v. United Biosource Corporation, now known as “United Biosource LLC,” a wholly owned subsidiary of United Biosource Holdings, Inc.; Evernorth Health, Inc., formerly known as “Express Scripts Holding Company”; Express Scripts, Inc.; Priority Healthcare Corp. and Priority Healthcare Distribution, Inc., respectively doing business as “Curascript SD,” and “Curascript Specialty Distribution SD”; Curascript SD and Accredo Health Group, Inc.) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
The County of Dakota, Nebraska; The Sheet Metal Workers Local No. 40 Health Fund; The Harlem School District 122; 4DUBS BBQ, Inc., assignee of “Dustin’s Bar-B-Q Inc.” v. United Biosource Corporation, now known as “United Biosource LLC,” a wholly owned subsidiary of United Biosource Holdings, Inc.; Evernorth Health, Inc., formerly known as “Express Scripts Holding Company”; Express Scripts, Inc.; Priority Healthcare Corp. and Priority Healthcare Distribution, Inc., respectively doing business as “Curascript SD,” and “Curascript Specialty Distribution SD”; Curascript SD and Accredo Health Group, Inc., (E.D. Pa. 2026).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

THE COUNTY OF DAKOTA, CIVIL ACTION NEBRASKA, THE SHEET METAL WORKERS LOCAL NO. 40 HEALTH FUND, THE HARLEM SCHOOL DISTRICT 122, 4DUBS BBQ, INC., assignee of “DUSTIN’S NO. 24-4276 BAR-B-Q INC.,” Plaintiffs,

v.

UNITED BIOSOURCE CORPORATION, now known as “UNITED BIOSOURCE LLC,” a wholly owned subsidiary of United Biosource Holdings, Inc., EVERNORTH HEALTH, INC., formerly known as “EXPRESS SCRIPTS HOLDING COMPANY,” EXPRESS SCRIPTS, INC., PRIORITY HEALTHCARE CORP. and PRIORITY HEALTHCARE DISTRIBTION, INC., respectively doing business as “CURASCRIPT SD,” and “CURASCRIPT SPECIALTY DISTRIBUTION SD,” CURASCRIPT SD and ACCREDO HEALTH GROUP, INC., formerly known as “CURASCRIPT S.P.” Defendants.

HODGE, J. March 5, 2026 MEMORANDUM This case concerns an alleged scheme by non-party Mallinckrodt ARD LLC (“Mallinckrodt”), the manufacturer of the prescription drug H.P. Acthar Gel (“Acthar”), and a conglomerate of United Biosource Corporation; Evernorth Health, Inc.; Express Scripts, Inc.; Priority Healthcare Corp. and Priority Healthcare Distribution, Inc.; Curascript SD; and Accredo Health Group, Inc. (together, “Defendants” or the “Express Scripts Entities”) to remove Acthar

from retail distribution and raise its price by over 100,000%. Plaintiffs, the County of Dakota, Nebraska (“Dakota County”), the Sheet Metal Workers Local No. 40 Health Fund (“SMW Local 40”), the Harlem School District 122 (“Harlem SD 122”), and Dustin’s Bar-B-Q Inc. (“Dustin’s”) (together, “Plaintiffs”), are third party payors seeking to recover overpayments for Acthar caused by Defendants’ alleged scheme to inflate the price of the drug. Before the Court is Defendants’ Motion to Dismiss the Amended Complaint (ECF No. 23 (the “Motion”)), Plaintiffs’ Response in Opposition (ECF No. 28), and Defendants’ Reply to Plaintiffs’ Opposition (ECF No. 29). Also before the Court are the Parties’ notices of supplemental authority in support of their briefing on the Motion (ECF Nos. 30, 31, 32, 35, 37), as well as Plaintiffs’ Motion to Strike Defendants’ Notice of Supplemental Authority (ECF No. 33),

Defendants’ Response thereto (ECF No. 34), and Plaintiffs’ Reply in further support of their Motion to Strike (ECF No. 36). Plaintiffs’ Amended Complaint (ECF No. 8 (“Am. Compl.”)) alleges violations of the Racketeer Influenced and Corrupt Organizations Act (“RICO”) (Counts 1–2), violations of various state consumer protection laws (Counts 3–6, 8), negligent misrepresentation (Count 7), aiding and abetting (Count 8), unjust enrichment (Count 9), violations of state and federal antitrust statutes (Counts 10–12), and conspiracy to defraud (Count 13), and requests declaratory and injunctive relief (Count 14). For the reasons that follow, Defendants’ Motion to Dismiss is granted. I. FACTUAL BACKGROUND1

The following allegations are taken from the Amended Complaint, and the Court accepts, as it must, all non-conclusory allegations as true for the purposes of the Motion to Dismiss. i. The Parties2 Mallinckrodt manufactures, markets, distributes, and sells Acthar. (Am. Compl. ¶ 17.) Acthar is an adrenocorticotropic hormone (“ACTH”), which causes the body to produce cortisone and other steroid hormones. (Id. ¶ 134.) In July 2001, Questcor Pharmaceuticals, Inc. (“Questcor”) acquired Acthar from Aventis Pharmaceutical Products, Inc. for $100,000. (Id. ¶ 237.) The FDA approved Acthar for two indications on its label: monotherapy for the treatment of infantile spasms (“IS”) and treatment of acute exacerbations of Multiple Sclerosis (“MS”). (Id. ¶ 219.)3 In 2014, Mallinckrodt acquired Questcor for approximately $5.9 billion.4 (Id. ¶ 114.) In October 2020,

Mallinckrodt filed for Chapter 11 bankruptcy in Delaware. In re Mallinckrodt PLC, Case No. 1:20-

1 The Court adopts the pagination supplied by the CM/ECF docketing system. 2 The Court notes that the Amended Complaint incorrectly defines “Defendants” as Mallinckrodt and Express Scripts (Am. Compl. ¶ 130), but Mallinckrodt is not and has never been a defendant in this action. The Court cannot evaluate allegations that do not state with particularity which Defendant (or non-party) they relate to. (See, e.g., id. ¶ 293 (“Further, Plaintiffs have paid the inflated AWPs directly set and charged by Defendants.”).) If Plaintiffs choose to replead, they must clearly articulate which allegations in the second amended complaint refer to what parties and non-parties to this action. 3 The Amended Complaint is unclear regarding what indications Acthar is currently approved for. Plaintiffs allege that Acthar was approved by the FDA in 1952 for over 50 conditions, and this list has been reduced to “19 indications” in the “present day.” (Am. Compl. ¶¶ 132, 206–11.) However, the Amended Complaint also alleges that “the FDA has only ever approved Acthar for two narrow indications: Infantile Spasms (IS) and acute exacerbations of multiple sclerosis (MS). It has never been approved for the long-term treatment of any disease.” (Id. ¶ 133.) Plaintiffs do not provide any further information regarding this discrepancy. 4 Throughout the Amended Complaint, Plaintiffs inconsistently refer to Questcor and Mallinckrodt as interchangeable entities. The same is true of other legacy and present-day entities, such as Accredo and CuraScript SP, which Plaintiffs sometimes also refer to as “Accredo/Curascript SP.” For simplification purposes the Court refers to all entities by their current, non-legacy name, including when they were in their legacy form. bk-12522 (Bankr. D. Del.) (the “Bankruptcy Proceedings”); (Id. ¶ 117.). In April 2022, claims

against Mallinckrodt arising prior to October 2020, and similar to those asserted against Defendants here, were discharged in the Bankruptcy Proceedings. (Am. Compl. ¶ 117.) Mallinckrodt is not, nor has it ever been, a party to the current action. Plaintiffs Dakota County, SMW Local 40, Harlem SD 122, and Dustin’s are third party payors (“TPPs”) who provide healthcare benefits, including prescription drug benefits, to their employees through contracts with other healthcare organizations. (Id. ¶¶ 93–111.) Express Scripts, Inc. (“Express Scripts”) is a pharmacy benefits manager (“PBM”) that contracted with TPPs like Plaintiffs to lower the costs of drugs. (Id. ¶ 82.) Express Scripts also contracted with Mallinckrodt for price discounts. (Id.) Priority Healthcare Corp. and Priority Healthcare Distribution, Inc., d/b/a Curascript, SD, f/k/a CuraScript Pharmacy, Inc. (“CuraScript”)

is a wholly owned subsidiary of Express Scripts. (Id. ¶ 119.) It was acquired by Express Scripts in January 2004 and was expanded when Express Scripts acquired Priority Healthcare Corporation in October 2005. (Id.) CuraScript is Mallinckrodt’s exclusive specialty pharmacy distributor for Acthar. (Id. ¶ 120.) Accredo Health Group, Inc., f/k/a CuraScript S.P. (“Accredo”) is Express Script’s legacy specialty pharmacy operation. (Id. ¶¶ 68, 121.) Express Scripts merged with Medco in 2012, and CuraScript S.P. was integrated into Medco’s specialty pharmacy business, Accredo. (Id. ¶ 68.) The new, integrated operation was called Accredo. (Id.) Accredo received Acthar from CuraScript’s warehouse, dispensed it directly to some of Plaintiffs’ beneficiaries, then billed the patients and their TPPs. (Id.)

Beginning in 2007, Healthbridge was Express Script’s legacy “hub” operation. (Id. ¶¶ 70, 123, 128.) As a hub, Healthbridge was responsible for controlling prescription processing and benefits coordination with patients and TPPs. (Id. ¶ 33.) Healthbridge was integrated into United

BioSource (“UBC”) when Express Scripts merged with Medco in 2012. (Id. ¶ 70.) The new integrated operation was called UBC.

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The County of Dakota, Nebraska; The Sheet Metal Workers Local No. 40 Health Fund; The Harlem School District 122; 4DUBS BBQ, Inc., assignee of “Dustin’s Bar-B-Q Inc.” v. United Biosource Corporation, now known as “United Biosource LLC,” a wholly owned subsidiary of United Biosource Holdings, Inc.; Evernorth Health, Inc., formerly known as “Express Scripts Holding Company”; Express Scripts, Inc.; Priority Healthcare Corp. and Priority Healthcare Distribution, Inc., respectively doing business as “Curascript SD,” and “Curascript Specialty Distribution SD”; Curascript SD and Accredo Health Group, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/the-county-of-dakota-nebraska-the-sheet-metal-workers-local-no-40-health-paed-2026.