Pharmaceutical Research & Manufacturers of America v. Thompson
United States Court of Appeals for the District of Columbia Circuit
362 F.3d 817 (2004)
- Written by Mary Phelan D'Isa, JD
Facts
A Michigan Department of Community Health (DCH) program adopted a best-practices initiative (initiative) to limit Medicaid drug coverage for certain drugs to secure price concessions from drug manufacturers on sales of those drugs to non-Medicaid recipients of two state health-care programs for the low-income elderly and certain pregnant mothers. The initiative, which was approved by the Secretary of the United States Department of Health and Human Services (Thompson) (defendant), basically required drug manufacturers to provide rebates for those drugs or the state would withhold Medicaid coverage for those drugs subject to prior authorization. Pharmaceutical Research & Manufacturers of America (PhRMA) and two nonprofit organizations (plaintiffs) challenged Thompson’s approval of the initiative and alleged that it violated: (1) federal formulary Medicaid regulations; (2) the general requirement that Medicaid services be provided in a manner consistent with the recipients’ best interests; and (3) the Commerce Clause of the United States Constitution because it requires drug manufacturers to charge the same prices in and outside of Michigan. The district court granted summary judgment for Thompson and the DCH. PhRMA and the nonprofit organizations appealed.
Rule of Law
Issue
Holding and Reasoning (Henderson, J.)
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