By Kevin E. Noonan –

In a decision that, in retrospect, is not surprising (in view of the haste with which the Court took up the case after granting certiorari; see “Solicitor General Proves Persuasive; Supreme Court Grants Hikma’s Certiorari Petition“), the Supreme Court in a unanimous opinion by Justice Jackson reversed the Federal Circuit’s decision that branded drugmaker Amarin had provided sufficient evidence of inducement to infringe under 35 U.S.C. § 271(b) by generic drugmaker Hikma to withstand the latter party’s motion to dismiss under Fed. R. Civ. Proc. 12(b)(6) in Hikma Pharmaceuticals USA Inc. v. Amarin Pharma, Inc.
To recap, the case arose over Amarin’s Vascepa® (icosapent ethyl) drug product, an omega-3 fatty acid from fish oil, for treatment of severe hypertriglyceridemia (blood triglyceride levels at least 500 mg/dL; normal range is less than 150 mg/dL) (the “SH indication”). Amarin also later received approval for a second indication, reducing cardiovascular disease risk (wherein the second approval removed a Limitation of Use in this regard on the original label) (the “CV indication”). Hikma filed its ANDA against the first approved indication for the Vascepa® product; upon Amarin receiving its second FDA approval, Hikma filed a section viii statement to carve-out the newer CV indication under 21 U.S.C. § 355(j)(2)(A)(viii) (the so-called “skinny label” approach). The FDA approved Hikma’s skinny label ANDA in 2020 not containing the CV Limitation of Use on the label.
Thereafter, in a series of press releases, Hikma asserted its product as a “generic version of Amarin’s Vascepa®.” In a particular press release, Hikma claimed its two-month U.S. sales to be $1.1 billion, a figure for all uses of its product, with up to 75% of these sales being for the putatively carved-out CV (off-label) indication (albeit there being other press releases emphasizing the limitation of FDA approval to the SH indication). And on Hikma’s website, while asserting an AB rating for its product (generic approval for all indications on the label), the website also said “Hikma’s generic version is indicated for fewer than all approved indications of the Reference Listed Drug.”
In its complaint, Amarin asserted Hikma’s press releases, website content, and product label as evidence of “specific intent to actively encourage physicians to directly infringe the asserted patents by prescribing its generic icosapent ethyl product for the off-label CV indication, an indication for which Hikma did not get FDA approval.” The District Court granted Hikma’s motion to dismiss under Fed. R. Civ. Pro. 12(b)(6) for failure to state a claim in Amarin’s complaint alleging inducement of infringement, based on its determination that the complaint failed to allege facts that Hikma had taken “affirmative steps” to induce infringement (a decision contrary to the recommendation of the Magistrate Judge to whom the District Court Judge referred the motion). The District Court Judge cited the cautionary language in Hikma’s label regarding side effects as “hardly instruction or encouragement” for the alleged off-label use and that removal of the CV Limitation of Use from Hikma’s label would not have been persuasive that its product had been “shown to reduce cardiovascular risk” and thus to have “encourage[d] its use for that purpose.” The distinction relied upon by the District Court was that “merely describing an infringing [treatment] mode is not the same as recommending, encouraging, or promoting an infringing use,” quoting, with alterations, Takeda Pharms. U.S.A., Inc. v. W.-Ward Pharm. Corp., 785 F.3d 625, 631 (Fed Cir. 2015). With regard to Hikma’s press releases and other public statements, the District Court considered that while they “may be relevant to Hikma’s intent to induce infringement” (emphasis in opinion), they were not evidence of “an inducing act” constituting a separate element for inducement under § 271(b). The website evidence was deemed insufficient because it did not “rise to the level of encouraging, recommending, or promoting taking Hikma’s generic for the reduction of CV risk,” comparing GlaxoSmithKline LLC v. Teva Pharms. USA, Inc., 7 F.4th 1320, 1336 (Fed. Cir. 2021) (per curiam) (“GSK”), with Grunenthal GmbH v. Alkem Lab’ys Ltd., 919 F.3d 1333, 1339 (Fed. Cir. 2019).
The Federal Circuit reversed, applying the standard of “whether the totality of the allegations, taken as true, plausibly plead that Hikma induced infringement” (emphasis in opinion) that would provide “substantial evidence to support a jury verdict of induced infringement.” The Court stated that it is responsible here for “reviewing allegations, not findings, for plausibility, not probability” under Bell Atl. Corp. v. Twombly, 550 U.S. 544, 556 (2007) (emphasis in opinion). The opinion states as being “undisputed” that there has been direct infringement by doctors and other healthcare providers in prescribing Hikma’s alleged infringing product for off-label use (the CV indication) and that Hikma had “the requisite intent and knowledge to induce that infringement” as found by the District Court. (These conclusions by the District Court and the Federal Circuit were adopted by the Supreme Court in its opinion.) On the merits, the Federal Circuit found that Hikma’s removal of the CV Limitation of Use regarding CV indications as well as including warnings of potential cardiovascular side effects from its drug communicated to physicians that its generic drug could be used off-label for the CV indication. Hikma countered that the FDA required that the label for generic copies of branded approved drugs be “the same as the labeling approved for the listed drug” under 21 U.S.C. § 355(j)(2)(A)(v), and that its silence regarding its product’s effects on risk of cardiovascular complications “cannot plausibly instruct infringement.” However, while conceding to some of Hikma’s contentions regarding evidentiary elements asserted by Amarin were by themselves insufficient to establish the requisite intent to induce infringement, the Federal Circuit asserted that it is the combination (emphasis in opinion) of the label and Hikma’s “public statements and marketing materials” that rendered the District Court’s grant of Hikma’s motion to dismiss to be in error.
In reversing these determinations by the Federal Circuit, Justice Jackson’s opinion began by noting that “a generic drug is, by definition, ‘biologically equivalent to . . . the brand-name drug’” according to Caraco Pharmaceutical Laboratories, Ltd. v. Novo Nordisk A/S, 566 U.S. 399, 405 (2012), and the reality is that “many medical providers use brand-name and generic drugs interchangeably, regardless of whether the intended use is covered by a patent.” While “[s]uch substitution is allowed (and sometimes required) by state laws across the Nation,” generic manufacturers may be subject to liability under federal law if they “actively induc[e] infringement of [the brand manufacturer’s] patent.” 35 U.S.C. § 271(b). The Court considered the basis for the Federal Circuit’s decision to reverse the District Court’s grant of Hikma’s motion to dismiss to be that it was “at least plausible that a physician could read” the relevant statements “as an instruction or encouragement to” infringe.” 104 F. 4th 1370, 1380 (2024). That, the Court said, was error. “The central question,” according to the opinion, “is whether Amarin plausibly alleged that Hikma actively encouraged infringing uses, not merely whether doctors could plausibly read the alleged statements as instructions to infringe.”
“[T]he skinny label may not give instructions for uses that would infringe the patented methods of use” but “[t]hese provisions do not foreclose the possibility that an approved ANDA may still interfere with a patented method of use” because “medical professionals routinely prescribe (and pharmacists routinely dispense) the former interchangeably with the latter, including for patented methods of use, under Inwood Laboratories, Inc. v. Ives Laboratories, Inc., 456 U.S. 844, 847, n. 4 (1982), according to the opinion. This substitution practice results from and “with the blessing of their States’ generic substitution laws, which, depending on the State, permit or require providing the cheaper generic version to patients,” which laws have been enacted in all 50 stated and the District of Columbia. The Court recognizes that under these circumstances “generic manufacturers surely know (and perhaps even expect) that their products will be put to infringing use.” But “mere knowledge of infringing potential or of actual infringing uses [is] not . . . enough . . . to subject a distributor to liability” under Metro-Goldwyn-Mayer Studios Inc. v. Grokster, Ltd., 545 U.S. 913, 937 (2005), and Cox Communications, Inc. v. Sony Music Entertainment, 607 U.S. ___, ___ (2026) (slip op., at 8), according to the opinion. (The Court as has been its wont is happy to rely on its decisions rendered in copyright cases to decide patent law matters, even where, as here, there is no statutory basis in copyright law for inducement of infringement; the justification (insofar as the Court has felt the need to provide one) is that both the power to grant patents and to grant copyrights reside in Article I of the Constitution.) Still, the opinion acknowledges that a generic manufacturer can cross the line into liability if it “actively induces infringement of [the brand manufacturer’s] patent.” 35 U.S.C. § 271(b).
The Court then enunciates the three elements for showing inducement. First, “there must be direct infringement by a third party,” citing Limelight Networks, Inc. v. Akamai Technologies, Inc., 572 U.S. 915, 920–921 (2014). Second, “the inducer must know that “the induced acts constitute patent infringement,” citing Global-Tech Appliances, Inc. v. SEB S.A., 563 U.S. 754, 766 (2011). Third, and most relevant here, the inducer must take “active steps . . . to encourage direct infringement,” citing Grokster, 545 U.S., at 936. The parties and each Court below having recognized that the first two elements are satisfied here, the Supreme Court then assesses the propriety (or rather, lack of it) of the Federal Circuit’s determination that the steps taken by Hikma were sufficiently “active” to satisfy the third.
The Court recognized four allegations for this third element of inducement:
• “First, the label omitted the CV Limitation of Use and retained information about a clinical study in which some of the patients were taking statins.”
• “Second, the patient information leaflet that accompanied the label warned against possible side effects for “people who have heart (cardiovascular) disease”—the target population for Vascepa’s patented CV-indication method of use—and noted that “[m]edicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet.”
• “Third, Hikma’s website described its generic drug as “AB” rated, and listed the drug’s therapeutic category as “[h]ypertriglyceridemia,” a category that includes but is broader than SH.”
• “Finally, prior to the launch of its generic drug, Hikma issued a series of press releases describing the product as “‘generic Vascepa’ without mentioning that th[e] approved use was limited to the far-lesser-known SH indication,” and touting Vascepa’s U.S. sales figures attributable to both the SH and CV indications.
The Federal Circuit had found that on this evidence it was “at least plausible that a physician could read” the label, website, and press releases “as an instruction or encouragement to prescribe [Hikma’s generic] for any of the approved uses of icosapent ethyl.”
Importantly, the opinion notes that “[o]ur well-established federal pleading standards (Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007), and Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009)) are not up for debate in this case,” thus addressing the concern of some of the Justices at oral argument that the parties were asking for a change or new application of those standards in skinny label situations. Under those established standards, “If the complaint ‘pleads facts that are merely consistent with a defendant’s liability, it stops short of the line between possibility and plausibility of entitlement to relief.’” The required standard, according to the Court, is that a claim cross the line from “‘conceivable to plausible’ if the facts pleaded ‘allo[w] the court to draw the reasonable inference that the defendant is liable for the misconduct alleged’ . . . and rule out ‘obvious alternative explanation[s]’ for the defendant’s conduct” under Twombly.
The Court then applied these standards to the third element of the requirements for showing induced infringement claim: “that the inducer took ‘active steps . . . to encourage direct infringement’” under Grokster. With regard to what comprises an active step, the opinion asserts that “inducement must involve the taking of affirmative,” as opposed to passive, “steps to bring about the desired result” of patent infringement, citing Global-Tech., 563 U.S., at 760; Grokster, 545 U.S., at 935 (requiring “statements or actions directed to promoting infringement”), and Cox Communications, 607 U.S., at ___ (slip op., at 9) (citing lack of “evidence of express promotion [or] marketing” as a reason for no liability (internal quotation marks omitted)). To avoid “trenching on regular commerce,” the opinion states that “ordinary acts incident to product distribution” are insufficient to support liability under Grokster, 545 U.S., at 937. In view of these standards, the opinion states that Amarin “misses the mark” by arguing that they “need not do more than “allege . . . a plausible chain of events through which statements made by [Hikma] could lead a healthcare provider . . . to prescribe or dispense Hikma’s drug to reduce a patient’s cardiovascular risk,” relying (unsuccessfully as it turns out) on National Rifle Association of America v. Vullo, 602 U.S. 175 (2024), and, ironically, on Grokster.
The Court rejected Amarin’s argument on NRA because it would import (unnecessarily) First Amendment considerations into the inducing infringement standard. Regarding Grokster, the Court distinguished statements in Grokster “designed to stimulate others” to infringe from other statements that “could stimulate others” as here, citing affirmative and much more direct statements and actions by Grokster than those Hikma assertions and statements relied upon by Amarin here.
The fundamental teachings from this opinion can be found in the statement that “[a]ll in all, inducement cannot be based only on ‘vague’ language’ combined with speculation about how [others] may act,” citing Takeda Pharmaceuticals U.S.A., Inc. v. West-Ward Pharmaceutical Corp., 785 F.3d 625, 632 (Fed. Cir. 2015); and Grokster, 545 U.S., at 937 (requiring “purposeful, culpable expression and conduct”).
However, it should be kept in mind that the Court also states that “Hikma overshoots by urging that active inducement must be ‘express,’” because “[a] defendant can achieve active inducement through implicit encouragement, as StreamCast did through the ‘suggestiv[e]’ name of its ‘OpenNap program’” in Grokster, 545 U.S., at 937, 938. But implicit or explicit, the necessary inducement must be “clear” to the relevant audience and “affirmative” in its expression.
In the Court’s opinion, Amarin failed this test, for not alleging “more than a sheer possibility” that Hikma had actively induced infringement of the patents in the CV indication. The opinion then goes through each of Amarin’s allegations and describes these failures.
First, there are “obvious alternative explanations” for many of Hikma’s statements that Amarin asserted to be evidence of infringements under Twombly. Moreover, some of these statements were “just complying with the law or with standard industry practice,” citing FDA regulations as the obvious alternative explanation for acts including omitting the CV Limitation of Use and retaining information about a clinical study involving patients taking statins, because these were features of Amarin’s label that FDA approval required Hikma to do by statute 21 U.S.C. § 355(j)(2)(A)(v).
In addition, Hikma’s description of its approved product as “generic Vascepa” or the “‘generic equivalent’ of Vascepa” were “normal industry practice,” citing Inwood Laboratories, 456 U.S., at 847–48. In this regard, the opinion asserts that the Court “decline[s] to put generic manufacturers between a rock and a hard place by turning adherence to the law and industry standards into building blocks for illegal conduct.”
Second, active inducement cannot be supported by “mere omissions, inactions, or nonfeasance” under Twitter, Inc. v. Taamneh, 598 U.S. 471, 489 (2023). It would take “a healthy stretch of the imagination” for “one [to] believe that some medical providers could read between the lines and draw improper conclusions from the skinny label’s omission of the CV Limitation of Use” and the press releases’ failure to “mentio[n] that [Hikma’s] approved use was limited to the far-lesser-known SH indication,” according to the Court. This is not enough to support inducement to infringe; the opinion stating that the Court “look[s] for affirmative ‘statements or actions’ precisely to avoid ‘trenching on regular commerce’ based on such a contingent chain of events” under Grokster (emphasis in opinion). Echoing the Court’s concerns in a copyright case regarding overextension of infringement liability, Kirstaeng v. J. Wiley & Sons, the opinion states that if permitting less that the stringent requirements clearly enunciated here, “ordinary merchants could become liable for any misuse of their goods and services, no matter how attenuated their relationship with the wrongdoer” might be.
The opinion finds the remainder of Amarin’s evidence for inducement to be the kind of “‘vague’ statements ‘combined with speculation about how [medical providers] may act” in response to those statements under Takeda. These include Amarin’s argument that “medical providers ‘would plausibly understand’ the label’s patient information leaflet to encourage infringing uses because it identifies potential side effects for people with cardiovascular diseases and notes that medication is sometimes prescribed for uses other than those specifically indicated.” The question, the opinion recites, is not “whether the statements could be ‘plausibly underst[oo]d’ to induce infringement, but whether they plausibly constitute ‘affirmative steps to bring about the desired result’ of infringement” under Global Tech. Amarin’s assertions regarding statements in Hikma’s leaflet “are implausibly roundabout ways to induce medical providers to infringe.” The consequence of not rejecting the sufficiency of this evidence is characterized in the opinion thusly:
Treating them otherwise would turn any statement extraneous to the unpatented method of use—even one warning people against the patented method of use—into active inducement of infringement. Our case law leaves generic manufacturers more breathing room than that.
The opinion finds equally inadequate the statements on Hikma’s website regarding the AB rating and the therapeutic category of its generic drug to be “hypertriglyceridemia” (as opposed to “severe hypertriglyceridemia”) saying “[i]t is not plausible that Hikma ‘designed’ these statements ‘to stimulate others to commit’ infringement” under Grokster. The opinion analogizes the “hypertriglyceridemia” description to be akin to describing a drug for leukemia as being a “cancer drug.” And the “AB rating” description is limited to the limitations set forth in the label, which “excludes unapproved, patented methods of use” under GlaxoSmithKline LLC v. Teva Pharmaceuticals USA, Inc., 7 F.4th 1320, 1335 (Fed. Cir. 2021), and “in any event” the opinion notes that Hikma’s website itself provides some correction by stating that its generic version of the drug “is indicated for fewer than all approved indications of the Reference Listed Drug,” Vascepa.
The last (and even more vague in the Court’s opinion) of the vague statements cited by Amarin are press releases on Amarin’s sales figures. Amarin had maintained that those quoted figures included sales for the drug for treatment the patented CV indication as well as sales for the unpatented SH indication, and in doing so “encouraged using its generic for the patented CV indication.” As an indication of Hikma’s acts supporting inducement, this evidence fails because “there are myriad steps between those statements and induced infringement that Amarin fails to mention.” In the Court’s understanding of the link between inducement and these statements:
[M]edical provider[s] would have to look up and read the press releases, which were directed to investors rather than doctors and pharmacists; have enough background knowledge of pharmaceutical sales to understand the quoted sales figures to be attributable to both the SH-indication and the CV-indication methods of use; and draw from this fact a subtle encouragement to start prescribing Hikma’s generic to hypertriglyceridemia patients who already take statins.
While acknowledging that Amarin’s “chain of events” was possible (with the somewhat disparaging caveat that “anything is possible”), the opinion finds that this evidence, “without more,” is not a plausible scenario sufficient to satisfy the third element of inducement.
With this opinion of the Court addresses the (in its opinion, overbroad) scope of evidence supporting liability for inducement under 35 U.S.C. § 271(b) that the Federal Circuit has applied and has been castigated for in earlier cases (even by members of the Federal Circuit itself) as frustrating Congressional intent for permitting if not promoting the skinny label route to generic competition for unpatented indications. The Court (albeit in a footnote) frankly connects these jurisprudential dots in the opinion:
To Amarin’s credit, this argument reflects the recent approach of the Federal Circuit, which has increasingly trained its focus on whether the relevant statements could be read by medical providers as instructions to infringe. See, e.g., GlaxoSmithKline LLC v. Teva Pharmaceuticals USA, Inc., 7 F. 4th 1320, 1336–1337 (2021). The decision below appears to follow this trend line. See 104 F. 4th, at 1378–1380 (resting reversal on the conclusion that it is “at least plausible that a physician could read “the relevant statements “as an instruction or encouragement” to infringe). We reject that trend today, and hereby emphasize that the key question is whether a defendant actively encouraged infringement through its statements, not merely how others may understand those statements.
The decision while completely clear in establishing the standard for inducement of infringement, does raise some concerns, however, particularly with regard to potential unintended consequences. While generic drugmakers have been liberated from the stringency of the test for inducement set forth by the Federal Circuit (which under certain circumstance has the potential for devolving into a “nod, nod, wink, wink, nudge, nudge” standard), the decision also provides a roadmap regarding the extent to which generic drug manufacturers can take advantage of off-label use without incurring infringement liability. While one consequence may be greater patient access to drugs for certain indications (depending on how payers treat such uses) another consequence may be reducing incentives for innovator research on finding additional indications. Some may dismiss any such concerns on the basis that branded drugmakers may reap the lionshare of the profits from later-patented, follow-on indications, the economic realities that may ensue certainly present the possibility that any such prognostications are not as incentive-promoting as expected.
As for Amarin, the interesting question is whether the District Court will permit the company to file an amended complaint. The factual basis for this might be the additional evidence Amarin contended they had acquired due to the District Court not staying fact discovery while the appeals progressed. Amarin has asserted at oral argument and in some of its briefing that it had amassed significant new evidence supporting its inducement claim which will go for naught should the District Court dismiss with prejudice. The Supreme Court provided additional support for Amarin’s entitlement to an opportunity to file an amended complaint in its statements that “[t]o Amarin’s credit, this argument reflects the recent approach of the Federal Circuit, which has increasingly trained its focus on whether the relevant statements could be read by medical providers as instructions to infringe. See, e.g., GlaxoSmithKline LLC v. Teva Pharmaceuticals USA, Inc., 7 F. 4th 1320, 1336–1337 (2021).” A fair interpretation of this statement would be that Amarin should not be penalized for following the law as it existed when they filed their first complaint and should not be penalized now that the Court has clarified the legal requirements for establishing inducement of infringement against generic drug makers in skinny label cases provided that the new evidence satisfies the new standards. It would be ironic indeed if Hikma prevailed in changing the standard for generic drug companies in skinny label cases to a more friendly one while at the same time ultimately being found liable for inducing infringement in view of new evidence submitted by Amarin under that new standard.
Hikma Pharmaceuticals USA Inc. v. Amarin Pharma, Inc. (2026)
Opinion or a unanimous Court by Justice Jackson









