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Missouri health organizations granted intervention in AstraZeneca lawsuit over drug discount program

ST. LOUIS RECORD

Wednesday, December 4, 2024

Missouri health organizations granted intervention in AstraZeneca lawsuit over drug discount program

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SPRINGFIELD — The U.S. District Court for the Western District of Missouri has granted a motion allowing two health organizations to intervene in a lawsuit filed by AstraZeneca Pharmaceuticals LP against Missouri officials over the enforcement of Senate Bill (SB) 751, a state law protecting access to discounted drugs through the federal 340B program.

Judge Douglas Harpool approved the Missouri Hospital Association (MHA) and Missouri Primary Care Association (MPCA) as intervenors, citing their substantial and legally protectable interests in the case, according to the opinion filed Nov. 15 in U.S. District Court for the Western District of Missouri.

Both organizations represent healthcare providers who rely on 340B drug pricing discounts to serve low-income and medically underserved populations.

SB 751 aims to safeguard hospitals and federally qualified health centers (FQHCs) from drug manufacturer restrictions on the use of contract pharmacies, the document states.

Under the 340B program, qualified healthcare providers, known as "covered entities," receive drug pricing discounts to improve access for patients living below the federal poverty line.

Contract pharmacies allow covered entities to expand their reach and provide medications at lower costs.

AstraZeneca is challenging SB 751, arguing that it overreaches by mandating protections for these contract pharmacies. 

The lawsuit targets Missouri Attorney General Andrew Bailey, Missouri Board of Pharmacy President James L. Gray and other board members tasked with implementing the law.

MHA and MPCA filed their motion to intervene on Oct. 15, arguing that the outcome of the case could significantly impact their members. 

MHA represents 139 hospitals, approximately half of which participate in the 340B program. 

MPCA advocates for community health centers that serve Missouri’s underserved populations, all of whom rely on 340B drug pricing.

Harpool ruled that both organizations have standing to intervene because their members face concrete and imminent harm if SB 751 is invalidated.

"Here, the Proposed Intervenors have shown that it stands to gain or lose from the litigation in a way different from the public at large," Harpool wrote. "Members of the Proposed Intervenors are entities that have been affected by the 340B program and drug manufacturers’ actions to block shipment of 340B medications to contract pharmacies of covered entities. Their members would be the benefactors of SB 751’s protections of contract pharmacies, and they are the entities providing care to low income and medically under-served Missourians. These actions are sufficiently different then those of the public and thus the Proposed Intervenors are not adequately represented by the government and are opposed by Plaintiff."

The judge noted that without the law’s protections, drug manufacturers’ limitations on contract pharmacies could impede the ability of these healthcare providers to deliver discounted medications.

The court found that MHA and MPCA’s interests in preserving SB 751’s protections differ from those of the general public. 

Their members directly benefit from the law’s provisions, which help ensure access to affordable medications for vulnerable populations.

Harpool also determined that the state does not adequately represent the organizations, as their interests are narrower and more specific than the broader public interest the government represents.

MHA and MPCA are represented by Alexa Brianne Barton, Lowell D. Pearson and Bryan O. Wade of Husch Blackwell; Ronald S. Connelly

AstraZeneca is represented by Samuel Ferenc, Jeffrey Handwerker, Allon Kedem, Carmela T. Romeo and Stephen K. Wirth of Arnold & Porter; and Lora Jennings Mizell of Martin, Pringle, Oliver, Wallace & Bauer.

The Attorney General's Office and the other state defendants are represented by Maria Ann Lanahan of the Attorney General's Office.

Attorneys for the parties declined to comment on ongoing litigation.

U.S. District Court for the Western District of Missouri case number: 2:24-cv-04143

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