United States ex rel. Deborah Sheldon v. Allergan Sales, LLC

CourtDistrict Court, D. Maryland
DecidedJune 29, 2026
Docket1:14-cv-02535
StatusUnknown

This text of United States ex rel. Deborah Sheldon v. Allergan Sales, LLC (United States ex rel. Deborah Sheldon v. Allergan Sales, LLC) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States ex rel. Deborah Sheldon v. Allergan Sales, LLC, (D. Md. 2026).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND

UNITED STATES ex rel. DEBORAH SHELDON, Plaintiffs, Civil Action No. ELH-14-2535 v.

ALLERGAN SALES, LLC Defendant.

MEMORANDUM OPINION

This qui tam case concerns an alleged fraudulent reporting scheme under the Medicaid Rebate Statute of 1990 (the “Rebate Statute”). See 42 U.S.C. § 1396r-8.1 Medicaid “provides health care to millions of low-income Americans through a cooperative federal and state program. 42 U.S.C. § 1395 et seq.” United States ex rel. Sheldon v. Allergan Sales, LLC, 170 F.4th 227, 234 (4th Cir. 2026) (Sheldon VII); see id. at 232; see also Pharm. Rsch. & Mfrs. of Am. v. Walsh, 538 U.S. 644, 650 (2003). Congress enacted the Rebate Statute in order “[t]o make sure that Medicaid programs receive ‘the benefit of the best price for which a manufacturer sells a prescription drug to any public or private purchaser.’” United States ex rel. Sheldon v. Allergan Sales, LLC, 24 F.4th 340, 345 (4th Cir. 2022) (Sheldon II) (citation omitted); see ECF 16, ¶ 26. It requires drug manufacturers “to report rebates and other discounts they provide to private companies” so as “to ensure that Medicaid receives the benefit of the lowest prices that [drug] manufacturers charge private companies.” Sheldon VII, 170 F. 4th at 232. In other words, Congress “tied the cost of

1 “Qui tam is short for ‘qui tam pro domino rege quam pro se ipso in hac parte sequitur,’ which means ‘who pursues this action on our Lord the King’s behalf as well as his own.’” Rockwell Int’l Corp. v. United States, 549 U.S. 457, 463 n.2 (2007). drugs prescribed to Medicaid patients to the lowest price offered by the manufacturers for drugs on the private market.” Id. at 234; see 42 U.S.C. § 1396r-8. Pursuant to the Rebate Statute, a drug manufacturer seeking coverage under Medicaid “must enter into a Rebate Agreement with the Secretary of HHS [i.e., Department of Health and Human Services] in order for its covered outpatient drugs” to qualify for payment under

Medicaid. ECF 16, ¶ 29 (citing 42 U.S.C. § 1396r-8(a)(1)); see Drug Rebate Agreement, 56 Fed. Reg. 7049, 7050 (Feb. 21, 1991) (“Rebate Agreement”). The Rebate Agreement obligates the manufacturer to adjust the “Best Price” if “cumulative discounts, rebates, or other arrangements subsequently adjust the prices actually realized.” 56 Fed. Reg. at 7050; see Sheldon VII, 170 F.4th at 234–35. “Best Price” is at the center of this litigation, which was initiated almost twelve years ago, on August 11, 2014, pursuant to the False Claims Act (“FCA” or the “Act”), 31 U.S.C. § 3729 et seq., and analogous State statutes. Troy Sheldon, as Relator,2 on behalf of the United States as well as numerous states and the District of Columbia (collectively, the “Qui Tam States”),3 filed

suit against his former employer, Forest Laboratories, LLC, as well as Forest Pharmaceuticals, Inc. and Allergan, PLC, alleging that defendants had engaged in fraud in calculating Best Price. ECF 1.

2 Mr. Sheldon died on November 10, 2017. His wife, Deborah Sheldon, as Executrix of the Estate of Troy Sheldon, was substituted as the plaintiff on March 19, 2018. ECF 31 (Order Granting Motion to Substitute Party). I shall refer to the plaintiff generically as “Sheldon,” the “Relator,” or the “plaintiff.” I shall refer to Troy Sheldon as “Mr. Sheldon.” 3 The qui tam states are California; Colorado; Connecticut; Florida; Georgia; Hawaii; Illinois; Indiana; Iowa; Louisiana; the Commonwealth of Massachusetts; Michigan; Minnesota; Montana; Nevada; New Hampshire; New Jersey; New Mexico; New York; North Carolina; Oklahoma; Rhode Island; Tennessee; Texas; Vermont; the Commonwealth of Virginia; Washington; and Wisconsin. The District of Columbia is also a qui tam plaintiff. Maryland and Delaware were qui tam plaintiffs, but withdrew from the suit. See Docket; ECF 46. That same year, Forest Laboratories, LLC was acquired by Actavis, PC, an entity that subsequently changed its name to Allergan Sales, LLC (“Allergan”). Sheldon VII, 170 F.4th at 235 n.3. By Order of March 3, 2020 (ECF 75), Allergan, PLC was dismissed from the case.4 In addition, Allergan was substituted for the Forest entities as the sole defendant. See also ECF 71.5 The Amended Complaint, which is the operative pleading, was filed on August 30, 2016.

ECF 16. In the 179-page pleading, Sheldon alleges that between 2005 and 2014, Allergan, “a leading manufacturer of pharmaceutical drugs,” defrauded the government and the Qui Tam States of more than $680 million. Id. at 6. In particular, Sheldon claims that Allergan failed to include certain customer price concessions in its calculation of “Best Price,”6 as that term is used in 42 U.S.C. § 1396r-8(b)(3)(A)(i)(II) and related regulations. Id. The Rebate Statute defines “Best Price” as follows, 42 U.S.C. § 1396r-8(c)(1)(C)(i): The term “best price” means, with respect to a single source drug or innovator multiple source drug of a manufacturer (including the lowest price available to any entity for any such drug of a manufacturer that is sold under a new drug application approved under section 505(c) of the Federal Food, Drug, and Cosmetic Act), the lowest price available from the manufacturer during the rebate period to any wholesaler, retailer, provider, health maintenance organization, nonprofit entity, or governmental entity within the United States . . . . According to the Relator, defendant “paid rebates to two separate customers on the same dispensed drug units provided to the same patient.” ECF 16 at 6; see also id. ¶¶ 60, 61, 66–68.

4 According to the parties, as of January 1, 2018, Forest Laboratories, LLC and Forest Pharmaceuticals, Inc. merged into Allergan and “no longer exist.” ECF 71, ¶ 3. Allergan is the successor in interest to the two Forest entities. Id. 5 This Court previously referred to the defendant as “Forest.” See, e.g., ECF 92 at 1; ECF 135 at 1. But, I have decided to adopt the terminology used by the defendant. See, e.g., ECF 147 at 5; ECF 150 at 1; ECF 152 at 1. Therefore, I shall refer to the defendant as Allergan, not Forest, except for an occasional quotation. 6 Following the example of Sheldon in the Amended Complaint, I shall capitalize “Best Price,” unless the term appears otherwise in quoted material. The Relator argues that Allergan was obligated to calculate “Best Price” by aggregating, or adding, the two rebates. Id. at 6–7. The government conducted a lengthy investigation to determine whether to intervene in the case. Ultimately, on September 17, 2019, the government declined to intervene. ECF 41. Since then, the defense has filed two motions to dismiss, which led to two rulings by this Court

and multiple appeals. ECF 72; ECF 86; ECF 87; ECF 88; ECF 92; ECF 112; ECF 130; ECF 131; ECF 132; ECF 135. This Memorandum Opinion addresses a motion filed by defendant, pursuant to Fed. R. Civ. P. 54(b).

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United States ex rel. Deborah Sheldon v. Allergan Sales, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-ex-rel-deborah-sheldon-v-allergan-sales-llc-mdd-2026.