The case, Astra USA v. Santa Clara County, Calif., was brought by Santa Clara and Santa Cruz counties, which alleged that AstraZeneca and eight other drugmakers overcharged safety net providers for drugs provided through the federal Medicaid Drug Rebate Program. The program is a national pricing scheme that aims to offer low-cost medications to providers serving the poor.
The counties argued that HHS and Congress weren't doing enough to enforce price ceilings for the program, so providers themselves should have the “private right of action” to litigate the matter.
The pharmaceutical companies—and the federal government, which filed an amicus brief—said that if every hospital or clinic—called “340Bs”—could sue over the prices, it would wreck havoc on the system.
Justice Ruth Bader Ginsburg, writing for the court, agreed with AstraZeneca. “Far from assisting HHS, suits by 340B entities would undermine the agency's efforts to administer both Medicaid and 340B entities harmoniously and on a uniform, nationwide basis,” Ginsburg wrote in the opinion. “With HHS unable to hold the control reins, the risk of conflicting adjudications would be substantial.”