OPINION
GREENAWAY, JR., Circuit Judge.
Plaintiff-Appellants (“Plaintiffs.”)» several workers’ compensation insurance providers, are Travelers Indemnity Company, Travelers Casualty
&
Surety Company, St. Paul Fire
&
Marine Insurance Company, and the Standard Fire Insurance Company. Defendant-Appellees (“Defendants”) are Cephalon, Inc., Teva Pharmaceuticals USA, Inc., and Teva Pharmaceutical Industries Ltd.
Plaintiffs brought claims against Defendants for intentional misrepresentation, negligent misrepresentation, violations of state consumer protection laws, and unjust enrichment, and seek damages and an injunction.
The District Court dismissed Plaintiffs’ claims for lack of standing under Federal Rule of Civil Procedure 12(b)(1) and for failure to state a claim under Rule 12(b)(6). Because Plaintiffs have failed to set out their fraud claims with sufficient specificity under Federal Rule of Civil Procedure 9(b) and have failed to plead the necessary elements under Connecticut’s Unfair Trade Practices Act (“CUTPA”), Conn. Gen.Stat. Ann. §§ 42-110a, we will affirm the District Court’s dismissal for failure to state a claim. Plaintiffs also appeal the District Court’s denial of their motion to amend the judgment of dismissal and for leave to file an amended complaint. We will affirm that denial because amendment would have been futile.
I. Background
Actiq and Fentora are powerful painkillers approved by the Food and Drug Administration (“FDA”) to manage breakthrough pain in cancer patients who were already receiving and were tolerant to opioid pain medications. Both Actiq and Fentora include warning labels indicating that they are only for the treatment of persistent cancer pain in patients who are tolerant to opioid therapy, and that they are contraindicated for acute or post-operative pain management in. opioid non-tolerant patients. Plaintiffs allege that Cephal-on marketed Actiq and Fentora for off-label uses, specifically by promoting these medications to doctors for use in non-cancer patients for the treatment of non-cancer pain. Plaintiffs allege that Cephalon’s marketing “goes beyond mere off-label promotion of Actiq [and Fentora] and includes untruthful, factually inaccurate, incomplete and/or otherwise misleading promotion of the drug[s], and the promotion of Actiq [and Fentora] for contraindicated uses.” (Am. Compl. ¶ 80.) Plaintiffs also allege that they and their claimants spent more than $18 million on Actiq and Fento-ra since 2004. Plaintiffs provide illustrative examples of claimants who were prescribed Actiq and Fentora for off-label uses and the amount of money Plaintiffs paid for the medications prescribed in these examples. However, Plaintiffs do not allege that they or their claimants heard or relied on fraudulent statements or misrepresentations. Rather, they allege that Cephalon directed its off-label marketing at doctors treating claimants whose claims would be reimbursed by
Plaintiffs. Plaintiffs identify five doctors who prescribed Fentora to Plaintiffs’ claimants and who also “received payments/benefits from Cephalon” during the same time period. (Am. Compl. ¶ 162.) Plaintiffs also identify one claimant who received Actiq prescriptions from a doctor who attended “field rides” with Cephalon representatives, Am. Compl. ¶ 94, though Plaintiffs allege neither that this doctor received payments or benefits from Ce-phalon, nor that misleading or fraudulent information was provided or relied upon.
The Federal Food, Drug, and Cosmetic Act (“FDCA”), 21 U.S.C. § 301,
et seq.,
“regulates the manufacturing, marketing and sale of prescription drugs, and provides that a drug cannot be sold in interstate commerce unless it is approved by the FDA for the 'specific medical use, or ‘indication,’ listed on the drug’s labeling.”
In re Schering Plough Corp. Intron/Temodar Consumer Class Action,
678 F.3d 235, 239 (3d Cir.2012) (citing 21 U.S.C. § 355(a)). Although, “[prescription drugs frequently have therapeutic uses other than their FDA-approved indications^] [t]he FDCA ... generally prohibits manufacturers from marketing, advertising, or otherwise promoting drugs for such unapproved or ‘off-label’ uses.”
Id.
at 239-40 (citing 21 U.S.C. § 331(a) and (d)). However, “[b]ecause the FDCA does not regulate the practice of medicine, physicians may lawfully prescribe drugs for off-label uses.”
Id.
at 240 (citing
Buckman Co. v. Plaintiffs’ Legal Comm.,
531 U.S. 341, 350, 121 S.Ct. 1012, 148 L.Ed.2d 854 (2001)). Furthermore, “violations of the FDCA do not create private rights of action.”
Gile v. Optical Radiation Corp.,
22 F.3d 540, 544 (3d Cir.1994).
II. Analysis
A. Plaintiffs’ Fraud Claims Are Not Pled with Sufficient Particularity Under Rule 9(b)
Plaintiffs’ claims are premised upon Ce-phalon’s allegedly fraudulent scheme to. mislead doctors with respect to the proper use and effectiveness of Actiq and Fentora, thereby causing those doctors to improperly prescribe those drugs to Plaintiffs’ claimants. Because this theory sounds in fraud, Plaintiffs’ pleadings must satisfy the “stringent” Rule 9(b) requirements for particularity.
Frederico v. Home Depot,
507 F.3d 188, 200 (3d Cir.2007);
see
Fed. R.Civ.P. 9(b) (“In alleging fraud or mistake, a party must state with particularity the circumstances constituting fraud or mistake.”). “In order to satisfy Rule 9(b), plaintiffs must plead with particularity ‘the “circumstances” of the alleged fraud in order to place the defendants on notice of the precise misconduct with which they are charged, and to safeguard defendants against spurious charges of immoral and fraudulent behavior.’ ”
Lum v. Bank of
Am.,
361 F.3d 217, 223-24 (3d Cir.2004) (quoting
Seville Indus. Mach. Corp. v. Southmost Mach. Corp.,
742 F.2d 786, 791 (3d Cir.1984)),
abrogated in part on other grounds by Bell Atl. Corp. v. Twombly,
550 U.S. 544, 557, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007).
Free access — add to your briefcase to read the full text and ask questions with AI
OPINION
GREENAWAY, JR., Circuit Judge.
Plaintiff-Appellants (“Plaintiffs.”)» several workers’ compensation insurance providers, are Travelers Indemnity Company, Travelers Casualty
&
Surety Company, St. Paul Fire
&
Marine Insurance Company, and the Standard Fire Insurance Company. Defendant-Appellees (“Defendants”) are Cephalon, Inc., Teva Pharmaceuticals USA, Inc., and Teva Pharmaceutical Industries Ltd.
Plaintiffs brought claims against Defendants for intentional misrepresentation, negligent misrepresentation, violations of state consumer protection laws, and unjust enrichment, and seek damages and an injunction.
The District Court dismissed Plaintiffs’ claims for lack of standing under Federal Rule of Civil Procedure 12(b)(1) and for failure to state a claim under Rule 12(b)(6). Because Plaintiffs have failed to set out their fraud claims with sufficient specificity under Federal Rule of Civil Procedure 9(b) and have failed to plead the necessary elements under Connecticut’s Unfair Trade Practices Act (“CUTPA”), Conn. Gen.Stat. Ann. §§ 42-110a, we will affirm the District Court’s dismissal for failure to state a claim. Plaintiffs also appeal the District Court’s denial of their motion to amend the judgment of dismissal and for leave to file an amended complaint. We will affirm that denial because amendment would have been futile.
I. Background
Actiq and Fentora are powerful painkillers approved by the Food and Drug Administration (“FDA”) to manage breakthrough pain in cancer patients who were already receiving and were tolerant to opioid pain medications. Both Actiq and Fentora include warning labels indicating that they are only for the treatment of persistent cancer pain in patients who are tolerant to opioid therapy, and that they are contraindicated for acute or post-operative pain management in. opioid non-tolerant patients. Plaintiffs allege that Cephal-on marketed Actiq and Fentora for off-label uses, specifically by promoting these medications to doctors for use in non-cancer patients for the treatment of non-cancer pain. Plaintiffs allege that Cephalon’s marketing “goes beyond mere off-label promotion of Actiq [and Fentora] and includes untruthful, factually inaccurate, incomplete and/or otherwise misleading promotion of the drug[s], and the promotion of Actiq [and Fentora] for contraindicated uses.” (Am. Compl. ¶ 80.) Plaintiffs also allege that they and their claimants spent more than $18 million on Actiq and Fento-ra since 2004. Plaintiffs provide illustrative examples of claimants who were prescribed Actiq and Fentora for off-label uses and the amount of money Plaintiffs paid for the medications prescribed in these examples. However, Plaintiffs do not allege that they or their claimants heard or relied on fraudulent statements or misrepresentations. Rather, they allege that Cephalon directed its off-label marketing at doctors treating claimants whose claims would be reimbursed by
Plaintiffs. Plaintiffs identify five doctors who prescribed Fentora to Plaintiffs’ claimants and who also “received payments/benefits from Cephalon” during the same time period. (Am. Compl. ¶ 162.) Plaintiffs also identify one claimant who received Actiq prescriptions from a doctor who attended “field rides” with Cephalon representatives, Am. Compl. ¶ 94, though Plaintiffs allege neither that this doctor received payments or benefits from Ce-phalon, nor that misleading or fraudulent information was provided or relied upon.
The Federal Food, Drug, and Cosmetic Act (“FDCA”), 21 U.S.C. § 301,
et seq.,
“regulates the manufacturing, marketing and sale of prescription drugs, and provides that a drug cannot be sold in interstate commerce unless it is approved by the FDA for the 'specific medical use, or ‘indication,’ listed on the drug’s labeling.”
In re Schering Plough Corp. Intron/Temodar Consumer Class Action,
678 F.3d 235, 239 (3d Cir.2012) (citing 21 U.S.C. § 355(a)). Although, “[prescription drugs frequently have therapeutic uses other than their FDA-approved indications^] [t]he FDCA ... generally prohibits manufacturers from marketing, advertising, or otherwise promoting drugs for such unapproved or ‘off-label’ uses.”
Id.
at 239-40 (citing 21 U.S.C. § 331(a) and (d)). However, “[b]ecause the FDCA does not regulate the practice of medicine, physicians may lawfully prescribe drugs for off-label uses.”
Id.
at 240 (citing
Buckman Co. v. Plaintiffs’ Legal Comm.,
531 U.S. 341, 350, 121 S.Ct. 1012, 148 L.Ed.2d 854 (2001)). Furthermore, “violations of the FDCA do not create private rights of action.”
Gile v. Optical Radiation Corp.,
22 F.3d 540, 544 (3d Cir.1994).
II. Analysis
A. Plaintiffs’ Fraud Claims Are Not Pled with Sufficient Particularity Under Rule 9(b)
Plaintiffs’ claims are premised upon Ce-phalon’s allegedly fraudulent scheme to. mislead doctors with respect to the proper use and effectiveness of Actiq and Fentora, thereby causing those doctors to improperly prescribe those drugs to Plaintiffs’ claimants. Because this theory sounds in fraud, Plaintiffs’ pleadings must satisfy the “stringent” Rule 9(b) requirements for particularity.
Frederico v. Home Depot,
507 F.3d 188, 200 (3d Cir.2007);
see
Fed. R.Civ.P. 9(b) (“In alleging fraud or mistake, a party must state with particularity the circumstances constituting fraud or mistake.”). “In order to satisfy Rule 9(b), plaintiffs must plead with particularity ‘the “circumstances” of the alleged fraud in order to place the defendants on notice of the precise misconduct with which they are charged, and to safeguard defendants against spurious charges of immoral and fraudulent behavior.’ ”
Lum v. Bank of
Am.,
361 F.3d 217, 223-24 (3d Cir.2004) (quoting
Seville Indus. Mach. Corp. v. Southmost Mach. Corp.,
742 F.2d 786, 791 (3d Cir.1984)),
abrogated in part on other grounds by Bell Atl. Corp. v. Twombly,
550 U.S. 544, 557, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). “Plaintiffs also must allege who made a misrepresentation to whom and the general content of the misrepresentation.”
Id.
at 224.
Here, Plaintiffs’' conclusory allegations that Cephalon’s marketing and promotion of Actiq and Fentora were deceptive, improper, false or misleading do not satisfy that burden.
Indeed, Plaintiffs’ argument boils down to an assertion that Cephalon’s off-label promotion of Actiq and Fentora was inherently fraudulent and created a private cause of action. However, Plaintiffs fail to identify any specific fraudulent statements, omissions, or misrepresentations that were made to doctors who prescribed Actiq and Fentora. We agree with the District Court that Plaintiffs fail to allege “the contents of these statements and materials”
and do not “specify when, where, or to whom any sales pitch was made.” (App. 32, n. 18.) Because Plaintiffs have not alleged the particular facts surrounding the alleged fraud, as required under Rule 9(b), their claims sounding in fraud cannot stand. Thus, we will affirm the District Court’s dismissal of those claims.
B. Connecticut Unfair Trade Practices Act
The District Court dismissed Plaintiffs’ claims under CUTPA on the grounds that Plaintiffs’ did not adequately establish a cognizable injury. However, we will not reach the question of injury because even assumipg arguendo that Plaintiffs had established injury, they have failed to sufficiently plead causation, as required by CUTPA. Thus, we will affirm for that reason.
See Stevenson Lumber Co.-Suffield v. Chase Assocs.,
284 Conn. 205, 932 A.2d 401, 406 (2007) (“[I]n order to prevail in a CUTPA action, a plaintiff must establish both that the defendant has engaged in a prohibited act
and
that, ‘as a result of this act, the plaintiff suffered an injury. The language ‘as a result of requires a showing that the prohibited act was the proximate cause of a harm to the plaintiff.” (quoting Conn. Gen.Stat. Ann. § 42-110g)). “Proximate cause is an actual cause that is a substantial factor in the resulting harm.”
Artie’s Auto Body, Inc. v. Hartford Fire Ins. Co.,
287 Conn. 208, 947 A.2d 320, 330 (008) (alterations, citations and internal quotation marks omitted).
Here, the allegations in the Amended Complaint fail to establish proximate cause. Indeed, Plaintiffs did not allege that any doctor relied on Defendants’ alleged misrepresentations in prescribing Actiq or Fentora, or that, these prescriptions would not have been written if these physicians had not received the allegedly fraudulent information from Cephalon. Thus, Plaintiffs have not sufficiently pleaded causation, as required by CUTPA, and we will affirm the District Court’s dismissal of the CUTPA claims.
C. Amendment
Plaintiffs also appeal the District Court’s denial of their motion to partially amend the judgment of dismissal pursuant to Federal Rule of Civil Procedure 59(e) and for leave to file a Second Amended Complaint (“SAC”). The District Court denied this motion because Plaintiffs had already filed one amended complaint and had discovery, the motion to dismiss had been pending for over a year, and the District Court had already heard argument on it. The District Court found that Plaintiffs strategically delayed filing their SAC to see if their Amended Complaint survived Defendants’ Motion to Dismiss. The District Court also reviewed the SAC and determined that it “fail[ed] to cure the deficiencies” that the District Court identified in dismissing the Amended Complaint. (App. 47.) Thus, amendment would have been futile.
See In re Burlington Coat Factory Sec. Litig.,
114 F.3d 1410, 1434 (3d Cir.1997) (“Among the grounds that could justify a denial of leave to amend ... [is] futility.”).
We agree that amendment would have been futile and will affirm on that ground. Although Plaintiffs did include additional detail in the proposed SAC, such as information regarding conferences sponsored by Cephalon, and physician attendees who later prescribed Actiq, the SAC still fails to satisfy causation, which is a required element of each of Plaintiffs’ claims.
See Sturm v. Harb Dev., LLC,
298 Conn. 124, 2 A.3d 859, 872 (2010) (requiring party claiming intentional misrepresentation “ ‘to have suffered harm as a result of ... reliance [on the false representation]’”) (quoting
Suffield Dev. Assocs. P’ship v. Nat’l Loan Investors, L.P.,
260 Conn. 766, 802 A.2d 44 (2002));
Platinum Funding Servs., LLC v. Petco Insulation Co.,
No. 3:09-CV-1133, 2011 WL 1743417, at *10 (D.Conn. May 2, 2011) (“A plaintiff asserting an unjust enrichment claim must show ... that the plaintiff suffered a detriment as a result of the defendant’s failure to pay the plaintiff.”);
Stevenson,
932 A.2d at 406 (requiring a showing of proximate causation under CUTPA). Allegations that physicians attended presentations and interacted with Cephalon sales representatives do not sufficiently demonstrate that these interactions
caused
the physicians to write the prescriptions at issue. Because the facts alleged in the SAC do not create a sufficient causal connection between Defendants’ alleged actions and the alleged injury suffered by Plaintiffs, amendment would have been futile. Thus, we will affirm the District Court’s denial of Plaintiffs motion to amend the judgment of dismissal and for leave to file an SAC.
III. Conclusion
For the foregoing reasons, we will affirm the final judgment of the District Court.