JEFFERSON CITY — A federal judge in Missouri has denied a request by AstraZeneca Pharmaceuticals LP to compel several nonparty hospitals and health systems to comply with subpoenas in an ongoing lawsuit challenging Missouri’s 340B contract pharmacy law, ruling that the information sought was not relevant to the company’s constitutional claims.
In his order issued, U.S. District Judge Douglas Harpool denied AstraZeneca’s motion to compel compliance with subpoenas served on several Missouri health care entities, including Mercy Health, SSM Health Care Corporation, the Curators of the University of Missouri, University Health, CoxHealth and Citizens Memorial Hospital District.
The case centers on Missouri Senate Bill 751, a law designed to protect the delivery of discounted drugs under the federal 340B program to contract pharmacies working on behalf of hospitals and federally qualified health centers.
According to the order, the 340B program incentivizes pharmaceutical manufacturers to provide certain discounted drugs to qualifying health care providers serving low-income patients.
Covered entities often use outside pharmacies, known as contract pharmacies, to distribute those medications.
The law at issue prohibits pharmaceutical manufacturers and related entities from denying, restricting or prohibiting the acquisition or delivery of 340B drugs to pharmacies contracted with covered entities unless federal authorities prohibit the arrangement.
Hanaway
AstraZeneca filed suit against Missouri Attorney General Catherine Hanaway and other defendants, arguing that the law unlawfully expands its obligations under federal pharmaceutical pricing agreements and violates the Contracts Clause of the U.S. Constitution.
According to the order, AstraZeneca issued subpoenas in September 2025 seeking three categories of documents from the nonparty health systems: 340B policy and procedure documents, representative contract pharmacy arrangements and documents showing how the entities account for and use 340B revenue.
The health systems objected, arguing the requests were irrelevant, burdensome and implicated confidentiality concerns.
Harpool concluded the requested materials had “little relevance” to the claims AstraZeneca must prove in the litigation.
The order explained that courts evaluating Contracts Clause claims apply a three-part test examining whether a contractual relationship exists, whether a change in law impairs that relationship, and whether any impairment is substantial.
If a substantial impairment exists, courts then evaluate whether the state had a significant and legitimate public purpose for the law and whether the adjustment of contractual rights was reasonable in light of that purpose.
AstraZeneca argued the subpoenas would help establish that Missouri’s law substantially impaired its pharmaceutical pricing agreements by requiring the company to provide discounted drugs for unlimited contract pharmacy sales.
The company also argued the discovery would show the law improperly redistributed benefits to hospitals and pharmacies and would demonstrate whether the statute was sufficiently tailored to survive constitutional scrutiny.
The intervening hospital associations and health systems countered that the requested information had little bearing on the constitutional analysis because the question of impairment turns on AstraZeneca’s own contractual expectations and obligations, not on internal hospital accounting practices or how hospitals use savings generated through the 340B program.
The court agreed with the health systems and intervenors, finding AstraZeneca could obtain relevant information regarding its own pricing agreements and drug distribution practices from its own records and wholesalers rather than from the subpoenaed hospitals.
The judge wrote that details about whether hospitals and contract pharmacies use “replenishment model” accounting systems would not meaningfully advance AstraZeneca’s claim that the Missouri law substantially impairs its contracts.
Harpool also rejected AstraZeneca’s argument that the subpoenas would show the law serves an impermissible purpose by enriching covered entities and pharmacies.
The order noted that covered entities participating in the 340B program are not required to pass savings directly on to patients and may instead use the savings to support services for low-income and rural communities.
The court further stated that Missouri enacted Senate Bill 751 in response to federal appellate decisions concerning pharmaceutical manufacturers’ restrictions on contract pharmacy arrangements.
In denying the motion, the court said the information AstraZeneca sought “does not further the claims it must prove and thus ultimately is not relevant.”
Because the court found the requests irrelevant, it declined to address the hospitals’ additional arguments that the subpoenas were overly burdensome or raised confidentiality concerns.
U.S. District Court for the Western District of Missouri, Central Division case number: 2:24-cv-04143
