Amgen Inc. v. Azar
Amgen Inc. v. Azar
Opinion of the Court
Amgen brought this action to challenge the decision of the Food and Drug Administration ("FDA") denying Amgen pediatric exclusivity for its drug, Sensipar (cinacalcet hydrochloride). In an earlier opinion and order, the Court granted the FDA summary judgment on all but one of Amgen's claims: its claim that the agency's denial of pediatric exclusivity for Sensipar was inconsistent with its decision to grant pediatric exclusivity for Johnson & Johnson's drug Ortho Tri-Cyclen. Amgen Inc. v. Hargan ,
*67I. BACKGROUND
Because the Court has already recounted the factual and legal background at length, see Amgen ,
The FDA denied Amgen's request for pediatric exclusivity for Sensipar because Amgen's studies did not, in the agency's view, "fairly respond" to the written request, AR 1389, and it reaffirmed that decision in subsequent administrative proceedings, AR 1484; AR 1632. According to the FDA, Amgen's studies did not fully comply with the requirements of the written request: for one of the studies, the written request required a minimum of fifteen patients ages 28 days to < 6 years, but only four patients completed the study, AR 1645, and, in the FDA's view, Amgen's data did not yield "clinically meaningful" information on cinacalcet's safety in that age group-a key objective of the written request, AR 1647-48. Amgen brought this action under the Administrative Procedure Act,
On January 26, 2018, the Court issued a memorandum opinion and order resolving most of Amgen's claims in the FDA's favor. Amgen , --- F.Supp.3d at ----,
The Court concluded that, because the FDA's administrative determination did not "explain [its] rationale and [did not] identify the relevant evidence," the Sensipar decision was "at least in this one respect ... arbitrary and capricious." Amgen ,
The FDA issued its Remand Decision and supplemented the administrative record on February 5, 2018. See Remand Decision. The FDA explained in its Remand Decision that it granted pediatric exclusivity to Ortho Tri-Cyclen based on the agency's understanding in December 2003, when it was statutorily required to make the exclusivity determination, that Johnson & Johnson's studies met the terms of the written request. Id. at 1, 3-4. The FDA cited several internal documents that, it asserted, show that it believed Johnson & Johnson had "fulfill[ed] the terms" of the written request when "eligibility for [pediatric exclusivity] was decided." Id. at 3. The FDA further explained that "the realization that a majority of enrolled study subjects had not, in fact, met DSM-IV criteria for [anorexia nervosa ] came after [Johnson & Johnson's] final study reports had been submitted ... and evaluated" and "postdates the [exclusivity] decision." Id. at 4. The agency therefore concluded that it applied the same standard to both Ortho Tri-Cyclen and Sensipar and that Amgen's failure to meet the terms of its written request distinguishes the agency's exclusivity denial for Sensipar from the agency's grant of exclusivity for Ortho Tri-Cyclen. Id. at 4.
The day after it issued its Remand Decision, the FDA notified the Court that it had discovered an additional document showing that, before the FDA granted pediatric exclusivity for Ortho Tri-Cyclen, it asked Johnson & Johnson whether its study "subjects met the enrollment criteria." Dkt. 78 at 3. The Court held a status conference the following day. In light of the parties' representations at the status conference, the Court again remanded the case to the FDA to address the relevance of the "newly discovered information" to its Remand Decision and set an expedited briefing schedule. Minute Order (Feb. 7, 2018).
On February 8, 2018, the FDA issued an addendum to its Remand Decision and further supplemented the administrative record with newly discovered documents relating *69to its Ortho Tri-Cyclen decision. See Remand Addendum. These documents fill in several holes in the timeline discussed above. First, and most significantly, the medical officer who reviewed the interim Ortho Tri-Cyclen data, Dr. Eric Colman, contacted Johnson & Johnson before he recommended granting exclusivity to ask "whether all of the subjects had Body Mass Index (BMI) values below the 10th percentile for age." Id. at 1-2; see AR3d 7. This benchmark, the FDA explains, provides one way to "fulfill[ ] one of the DSM-IV criteria." Remand Addendum at 1 n.5. Second, Johnson & Johnson responded to the FDA's inquiry on December 5 and December 8, 2003-once again, before the FDA granted exclusivity on December 18. Id. at 2; see AR3d 10-12, 14-18. Johnson & Johnson indicated that 74 out of 123 patients had BMIs above the tenth percentile, and it "provided a rationale that purported to explain why, in [its] opinion, the terms of the [written request] had been met." Remand Addendum at 2. Third, Dr. Colman "contributed to the annotated Written Request for the Pediatric Exclusivity Board, which concluded ... that '[a]ll patients had a diagnosis of [anorexia nervosa ] by DSM-IV criteria.' " Id. (quoting AR2d 18); see also AR3d 13. Finally, as noted, Dr. Colman recommended granting exclusivity on the grounds that "the requested study was conducted in agreement with the [w]ritten [r]equest." AR 1885; see Remand Addendum at 2.
In light of these new records, the FDA's Remand Addendum "correct[s] a factual inaccuracy in the [original] Remand Decision," acknowledging that the "FDA questioned whether subjects met the enrollment criteria before the date of the [e]xclusivity [d]ecision, contrary to what the Remand Decision stated." Remand Addendum at 1-2. But the new records, in the FDA's view, do not alter its conclusion that it applied the same standard to Sensipar and Ortho Tri-Cyclen. According to the FDA, the Sensipar studies fell short of full compliance with the written request, whereas the "FDA determined that the DSM[-]IV criteria had been met" when it granted exclusivity for Ortho Tri-Cyclen. Id. at 4. Reflecting some uncertainty about what happened, the FDA's Remand Addendum also advances two alternative arguments: (1) that the requirement that study subjects meet the DSM-IV criteria was not, in fact, a requirement at all but a mere recommendation or suggestion, id. at 3; and (2) that "it cannot be entirely ruled out that [the] FDA relied on some other rationale to determine Ortho Tri-Cyclen's eligibility for [exclusivity]" and "[e]ven if [the] FDA were mistaken about whether the enrollment criteria were met ..., that mistake would not justify making a similar mistake when evaluating other sponsors' studies," id. at 4.
Amgen has now renewed its motion for summary judgment with respect to its claim of inconsistent treatment. See Dkt. 83. It asserts that "there is nothing in the record that explains the [Pediatric Exclusivity] Board's ... analysis," id. at 3, and that the FDA's "current musings are completely implausible in light of the record," which shows that a majority of the Ortho Tri-Cyclen subjects "did not meet the specified enrollment criteria," id. at 5-6. Amgen further contends that, to the extent the FDA applied different "fairly respond" standards to Sensipar and Ortho Tri-Cyclen, its decision on Ortho Tri-Cyclen "reinvigorates" Amgen's fair notice and retroactive rulemaking arguments. Id. at 8; see id. at 6-8. The FDA has also renewed its motion for summary judgment. Dkt. 84. The agency contends that it applied the same standard to both applications and that the FDA decided that the Ortho Tri-Cyclen studies "met the enrollment criteria *70in the [written request] at the time of the [exclusivity] decision." Id. at 3.
II. ANALYSIS
Amgen, as the party challenging the FDA's exclusivity decision, "has the burden of showing that the agency action was 'arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law.' " Advocates for Highway & Auto Safety v. Fed. Motor Carrier Safety Admin. ,
Applying these principles here, the Court concludes that the FDA has offered a reasoned explanation for why it reached different outcomes in response to the Ortho Tri-Cyclen and Sensipar applications for pediatric exclusivity. According to the FDA's Remand Decision and Remand Addendum, the agency applied the same standard to Ortho Tri-Cyclen and Sensipar and granted exclusivity for Ortho Tri-Cyclen because the agency "decided" that the Ortho Tri-Cyclen studies, unlike the Sensipar studies, "met the enrollment criteria in the [written request] at the time of the [exclusivity] decision." Dkt. 84 at 3. Although the FDA's description of the basis for its Ortho Tri-Cyclen decision may lack "crystal clarity," Rauch ,
As explained in the Remand Addendum, the DSM-IV "does not specify a particular BMI" for an anorexia nervosa diagnosis. Remand Addendum at 3 n.16. Rather, it asks more generally whether the patient "[r]efus[es] to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during the period of growth, leading to body weight less than 85% of that expected)." AR 1919. In its Remand Addendum, the FDA stresses that diagnosing anorexia nervosa according to the DSM-IV criteria "involves ... professional judgment" and that the DSM-IV does not employ "precise language about a purely objective criterion." Remand Addendum at 3.
According to "documents contemporaneous with the Ortho Tri-Cyclen [exclusivity] decision," Dr. Colman apparently "considered the issue" of whether the study participants *71satisfied the DSM-IV criterion and "consulted with [the sponsor]."
The FDA posits that Dr. Colman found this response satisfactory in part because he "viewed the enrollment criteria as not requiring patients to have a specific BMI." Dkt. 84 at 6; see Remand Addendum at 4. Dr. Colman then, according to the FDA, "determined that [Johnson & Johnson's] study had met the DSM-IV criteria and the terms of the [written request]." Remand Addendum at 2. The FDA points to two documents to buttress this account of the agency's decisionmaking process. First, before the Pediatric Exclusivity Board convened to issue a decision on Ortho Tri-Cyclen, Dr. Colman e-mailed an attachment containing his "portion of the exclusivity table," that is, the annotated Written Request.
Although the FDA candidly acknowledges some uncertainty about what occurred, this account makes sense of the documentary record and reasonably supports the FDA's conclusion that the agency believed that the Ortho Tri-Cyclen studies met the terms of the written request at the time it granted Johnson &
*72Johnson pediatric exclusivity. With that premise in hand, the remainder of the FDA's reasoning is straightforward: For both Sensipar and Ortho Tri-Cyclen, the FDA applied a standard in which full compliance with the terms of the written request constitutes a "fair response." In the FDA's scientific judgment at the time of the relevant decisions, however, the Ortho Tri-Cyclen studies met the terms of the written request, and the Sensipar studies did not. Whether the FDA was, in fact, correct in determining that the Ortho Tri-Cyclen study subjects met the DSM-IV criteria is not the relevant question. All that matters for present purposes is whether the FDA applied an interpretation of "fairly respond" to Amgen that differed from the standard it applied to Johnson & Johnson, and the agency has reasonably explained that it did not do so.
Amgen pushes back on the FDA's characterization of the record, but the Court is unpersuaded. Most notably, Amgen argues that the Ortho Tri-Cyclen studies "failed to meet the terms of the written request," Dkt. 85 at 3, because Dr. Gierhart concluded in 2005 that a majority of the patients "did not meet ... the DSM-IV diagnostic criteria for anorexia nervosa," AR 1916. But the FDA has offered a "satisfactory explanation" for that discrepancy. As the FDA has explained, "documents contemporaneous with the Ortho Tri-Cyclen... decision show that Dr. Colman considered the issue, consulted with [Johnson & Johnson], and determined that [the] study [subjects] had met the DSM-IV criteria and the terms of the [written request]." Remand Addendum at 2. In addition, Dr. Colman "likely viewed the DSM[-]IV criteria more flexibly than [Dr. Gierhart]," and Dr. Colman's opinion controls because his findings-not Dr. Gierhart's-informed the FDA's decision on pediatric exclusivity. Id. at 4; see id. at 2 ("[Dr. Colman's] conclusion was presented to the [Pediatric Exclusivity Board], which in turn decided to recognize [exclusivity] for Ortho Tri-Cyclen."). Because Dr. Colman is deceased, Remand Addendum at 1 n.3, the FDA cannot be absolutely certain about all that occurred in 2003. But it doesn't need to be. It is enough that the FDA has considered the relevant material and has offered a reasoned explanation that supports the agency's conclusion that it applied the same "fairly respond" standard to the Ortho Tri-Cyclen and Sensipar study reports.
The question before the Court is whether the FDA applied an interpretation of "fairly respond" to Johnson & Johnson's request for exclusivity that is inconsistent with the one it applied to Amgen and that, if applied to Amgen, would require the FDA to grant exclusivity. Amgen has not met its burden of demonstrating that the FDA applied different standards. The Court, accordingly, is now satisfied that the FDA has offered a reasoned-and reasonable-basis for distinguishing the Ortho Tri-Cyclen precedent.
CONCLUSION
For the reasons stated above, the Court will DENY Amgen's renewed motion for summary judgment, Dkt. 83, and GRANT the FDA's renewed motion for summary judgment, Dkt. 84.
A separate Order will issue.
Amgen's submission is captioned "Supplemental Brief in Support of Amgen's Motion for Summary Judgment," Dkt. 83 at 1, and the FDA's filing is captioned "Response to Plaintiff's Supplemental Brief in Support of Summary Judgment," Dkt. 84 at 1. Both parties request that the Court grant their motions for summary judgment. See Dkt. 83 at 11; Dkt. 84 at 11. The Court will, accordingly, construe Amgen's supplemental brief and the FDA's response as renewed motions for summary judgment.
Dr. Colman is, unfortunately, deceased. Remand Addendum at 1 n.3. As a result, the FDA can rely only on the documentary record of what occurred.
Initially, the FDA did not provide the Court with the attachment to Dr. Colman's email "due to concerns with waiving deliberative privilege." Dkt. 84 at 4. At the Court's request, however, and with Amgen's consent, the FDA submitted an unredacted version of the attachment to the Court for in camera, ex parte review. See Minute Order (Feb. 16, 2018); Dkt. 86; Dkt. 87. The Court has reviewed the attachment and concludes that the attachment does not alter its conclusion. The Court has also ordered the FDA to file a redacted version of the attachment on the docket. Minute Order (Feb. 16, 2018).
In light of this holding, the Court need not reach Amgen's arguments on its fair notice and retroactive rulemaking claims, which rely on the premise that the agency applied a new or different standard to evaluate the Sensipar studies.
Reference
- Full Case Name
- AMGEN INC. v. Alex AZAR II, Secretary, U.S. Department of Health and Human Services, and Amneal Pharmaceuticals, LLC, Intervenor-Defendant.
- Cited By
- 1 case
- Status
- Published