United States ex rel. Streck v. Allergan, Inc.

894 F. Supp. 2d 584, 2012 WL 2594157, 2012 U.S. Dist. LEXIS 92936
CourtDistrict Court, E.D. Pennsylvania
DecidedJuly 3, 2012
DocketCivil Action No. 08-5135
StatusPublished
Cited by24 cases

This text of 894 F. Supp. 2d 584 (United States ex rel. Streck v. Allergan, 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
United States ex rel. Streck v. Allergan, Inc., 894 F. Supp. 2d 584, 2012 WL 2594157, 2012 U.S. Dist. LEXIS 92936 (E.D. Pa. 2012).

Opinion

MEMORANDUM

EDUARDO C. ROBRENO, District Judge.

TABLE OF CONTENTS

I. INTRODUCTION.........................................................587

II. BACKGROUND...........................................................588

III. STANDARDS OF REVIEW................................................590

A. Pleading Under Rule 8(a) ...............................................590

B. Pleading Under Rule 9(b) ...............................................590

IV. DISCUSSION.............................................................591

A. Whether Plaintiffs Fourth Amended Complaint Meets the Pleading Requirements of Rule 8(a)............................................................592

1. Statutory and Regulatory Scheme for AMP Calculations.................593

2. Discount Defendants................................................594

a. Whether Discount Defendants’ AMP interpretation was reckless before 2007 ..........................................-........595

b. Whether Discount Defendants’ AMP interpretation was reckless after 2007....................................................596

3. Service Fee Defendants.............................................598

B. Whether Plaintiffs Fourth Amended Complaint Meets the Pleading Requirements Under Rule 9(b)............................................................601

C. Whether Plaintiffs State Law Claims Should be Dismissed..................603

1. Delaware and New Mexico, Claims....................................603

2. New Hampshire and Texas Claims....................................604

3. Remaining State Law Claims.........................................605

V. CONCLUSION............................................................605

I. INTRODUCTION

Relator Ronald J. Streck (“Plaintiff’) brings this health care fraud qui tam suit in accordance with the False Claims Act (“FCA”), 31 U.S.C. § 3729 (2006 & Supp. IV 2011). Plaintiff alleges that Defendants Allergan, Inc., Amgen, Inc., AstraZeneca Pharmaceuticals, L.P., Biogen Idee, Inc., Bradley Pharmaceuticals, Inc., Cephalon, Inc., Eisai, Inc., Genzyme Corp., Mallinckrodt, Inc., Novo Nordisk, Inc., Reliant Pharmaceuticals, Inc., Sepracor, Inc., [588]*588and Upsher-Smith Laboratories, Inc. (collectively, “Defendants”) fraudulently reported their Average Manufacturer Price (“AMP”) to the Government in an effort to pay a smaller Medicaid rebate. In his Fourth Amended Complaint, Plaintiff pleads twenty-eight counts. Counts I through III allege violations of the FCA. Counts IV through XXVIII allege violations of the false claims statutes of the District of Columbia and the following states: Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Louisiana, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Rhode Island, Tennessee, Texas, Virginia, and Wisconsin. Defendants collectively filed a Motion to Dismiss Plaintiffs Fourth Amended Complaint.

For the reasons that follow, the Court will grant Defendants’ Motion in part and deny it in part.

II. BACKGROUND1

Plaintiff is a pharmacist and lawyer with over forty years of experience in the pharmaceutical industry. Plaintiff spent eleven years as the president and chief executive officer of the Healthcare Distribution Management Association. In 2008, when Plaintiff filed this lawsuit, he was the chief executive officer of Rx Distribution Network, a network of regional pharmaceutical wholesalers. While in this role, Plaintiff avers he became familiar with the practices of pharmaceutical manufacturers, including Defendants, and the agreements Defendants entered into with various wholesalers and retailers.

Defendants are pharmaceutical manufactures and all participate in the Medicaid Drug Rebate Program. This program endeavors to “establish a rebate mechanism in order to give Medicaid the benefit of the best price for which a manufacturer sells a prescription drug to any public or private purchaser.” H.R.Rep. No. 101-881, at 96 (1990), reprinted in 1990 U.S.C.C.A.N. 2017, 2108. In compliance with this program, Defendants pay rebates to state Medicaid programs. This rebate is calculated based, at least in part, on each manufacturer’s AMP.2 AMP, generally speaking, is the price that a wholesaler or retailer pays directly to the manufacturer for a product, on a per unit basis. To determine the amount of the rebate, each manufacturer must submit its calculated AMP to the Center for Medicaid and Medicare Services (“CMS”), a federal agency. According to Plaintiff, a lower reported AMP will result in Defendants paying a smaller rebate.

Plaintiff avers that Defendants engaged in two practices that fraudulently lowered the AMPs they reported. Plaintiff avers that from 2004 to the present Defendants and the pharmaceutical industry’s wholesalers began executing and implementing distribution service agreements. Wholesalers generally purchase drugs from the manufacturer and then act as the distributor to retailers for the manufacturer’s drugs. These agreements generally discussed a service arrangement between Defendants and wholesalers where wholesalers would perform services for Defendants such as warehousing goods, distributing [589]*589goods, various accounting, and other services. In exchange for these services, Defendants generally paid wholesalers a certain percentage of the net sales each wholesaler purchased from Defendants.

These agreements are at the heart of Plaintiffs claims and are broken down into two types. One, there are agreements that facilitated certain Defendants (“Discount Defendants”)3 to report a lower AMP by illegally deducting the service fees under these agreements from the calculated AMP. Two, there are agreements that facilitate certain other Defendants (“Service Fee Defendants”)4 to report a lower AMP by concealing pricé increases and preventing such price increases from being considered in the AMP calculation. Plaintiffs FCA claims rest on these two types of alleged fraudulent dealings.

Briefly, the allegations are summarized as follows: (1) Discount Defendants characterize service fees for the following types of services as “discounts”: distribution services, data reporting services, inventory management services, chargeback and returns processing services, customer service support, new product launch services, consolidated deliveries to providers, consolidated accounts receivable management, and sophisticated ordering technology. Fourth Am. Compl. ¶¶ 66-67. Certain discounts may be deducted from an AMP calculation, but “bona fide service fees” are expressly excluded from the calculation of AMP. The services listed above that Discount Defendants contracted for, according to Plaintiff, are statutorily and regulatorily defined as bona fide service fees and should not be characterized as discounts.

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Bluebook (online)
894 F. Supp. 2d 584, 2012 WL 2594157, 2012 U.S. Dist. LEXIS 92936, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-ex-rel-streck-v-allergan-inc-paed-2012.