A Delaware federal court jury has ruled in favor of Regeneron Pharmaceuticals in a significant antitrust lawsuit against Amgen, awarding Regeneron $407 million in damages. The verdict, announced on May 15, 2025, found Amgen liable for violating multiple antitrust and tort laws through anticompetitive bundling practices that effectively blocked Regeneron's cholesterol-lowering drug Praluent (alirocumab) from competing in the PCSK9 inhibitor market.
The jury determined that Amgen had created an illegal bundling scheme that leveraged its blockbuster anti-inflammatory medications Enbrel (etanercept) and Otezla (apremilast) to pressure pharmacy benefit managers (PBMs) into selecting Amgen's Repatha (evolocumab) as the exclusive PCSK9 inhibitor while excluding Praluent.
Damages and Legal Violations
The jury awarded Regeneron $135.6 million in compensatory damages and $271.2 million in punitive damages. The punitive damages, which more than double the compensatory amount, reflect the jury's assessment of the egregious nature of Amgen's conduct and serve as a deterrent against similar anticompetitive practices in the future.
According to the court findings, Amgen violated multiple laws, including:
- The Clayton Act
- The Sherman Act
- The New York State Donnelly Act
- The California Cartwright Act
- Delaware tort law
The Anticompetitive Bundling Scheme
At the heart of the case was Amgen's practice of cross-therapeutic bundling. The company threatened to withhold rebates on its popular anti-inflammatory drugs unless PBMs gave preferential treatment to Repatha and excluded Praluent from formularies. This strategy was particularly effective because Enbrel and Otezla treat entirely different conditions than the PCSK9 inhibitors, which are prescribed for high cholesterol and cardiovascular disease prevention.
"Amgen prevented Regeneron from competing on a level playing field and unfairly denied patients access to Praluent," stated Regeneron in its announcement of the verdict. "This anticompetitive practice shut out an innovative therapy from the PCSK9 marketplace, not based on clinical merit or price."
Industry Implications
The case has been closely watched throughout the pharmaceutical industry, as it addresses the increasingly common practice of portfolio-based contracting and bundled rebates. The verdict establishes an important precedent regarding the limits of such practices, particularly when they involve leveraging market power across unrelated therapeutic areas.
Leonard S. Schleifer, M.D., Ph.D., Board co-Chair, President and Chief Executive Officer of Regeneron, emphasized the importance of fair competition in the pharmaceutical market: "Patients rely on the biotech industry to find solutions for their most urgent medical conditions. At Regeneron, we take this responsibility very seriously and are committed to delivering breakthrough therapies that improve patient lives. To achieve this, companies must be able to compete fairly based on the clinical and economic value of their products."
History of the Dispute
The antitrust case represents the latest chapter in a long-running dispute between the two companies over the PCSK9 inhibitor market. Joseph J. LaRosa, Executive Vice President, General Counsel and Secretary of Regeneron, noted that "Since the FDA approved Praluent in 2015, Amgen has tried to remove and exclude Praluent from the market. After a failed patent litigation campaign, they pivoted toward an anticompetitive bundling scheme."
Praluent, developed by Regeneron in collaboration with Sanofi, was one of the first PCSK9 inhibitors to reach the market, alongside Amgen's Repatha. Both medications work by inhibiting PCSK9 binding to LDL receptors, thereby increasing the liver's ability to remove LDL cholesterol from the bloodstream.
About the Competing Drugs
Praluent (alirocumab) is a fully human monoclonal antibody developed using Regeneron's proprietary VelocImmune technology. It is approved in the U.S. and 60 other countries for reducing the risk of cardiovascular events in adults with established cardiovascular disease and for lowering LDL cholesterol in patients with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH).
Repatha (evolocumab), Amgen's competing PCSK9 inhibitor, has similar indications and efficacy profile. Both drugs represented significant advances in cholesterol management when they were introduced, particularly for patients who cannot achieve adequate LDL reduction with statins alone.
Market Access Implications
The verdict highlights ongoing challenges in pharmaceutical market access and the complex interplay between manufacturers, PBMs, and insurers. Bundled contracting practices have become increasingly common as pharmaceutical companies with diverse portfolios seek to leverage their market position across therapeutic areas.
Healthcare policy experts suggest that this ruling could potentially influence how pharmaceutical companies structure their rebate agreements with PBMs and insurers going forward, potentially creating more opportunities for competition based on clinical value and price rather than portfolio breadth.
Looking Forward
While the jury has rendered its verdict, the case may still face post-trial motions or appeals. Regeneron was represented by Jonathan D. Polkes of White & Case LLP in the proceedings.
The outcome of this case could have far-reaching implications for pharmaceutical competition and pricing strategies, potentially reshaping how drug manufacturers negotiate formulary placement with PBMs and health insurers. For patients, increased competition in the PCSK9 inhibitor market could potentially improve access and affordability of these important cholesterol-lowering medications.
