Healthcare, Pharmaceutical, and Medical Device Antitrust

Antitrust and competition counsel for healthcare, pharmaceutical, and medical device markets — from the operating room to the Orange Book.

Bona Law is a boutique antitrust and competition law firm with one of the deepest healthcare litigation records of any firm its size. Our attorneys won a published Ninth Circuit antitrust decision for drug-price-comparison innovator PharmacyChecker.com — argued by Aaron Gott, who also led the defense of one of the nation's largest online contact-lens retailers in a nationwide price-fixing MDL. Luke Hasskamp leads our healthcare and pharmaceutical litigation work; before joining Bona Law, he served as special outside counsel to the Louisiana Attorney General in pharmaceutical enforcement actions involving Actos, Depakote, Neurontin, and Toprol-XL. Cansu Günel, before joining Bona Law, spent nearly a decade defending major pharmaceutical manufacturers in antitrust class actions. And our founder, Jarod Bona, is one of the country's leading authorities on the antitrust state-action doctrine and its healthcare applications — the firm filed U.S. Supreme Court amicus briefs in N.C. Dental and Phoebe Putney, the cases that define healthcare's state-action landscape.

We represent the full range of participants in these markets: physicians and physician groups, hospitals and providers, pharmaceutical and medical-device companies, pharmacies and drug-channel innovators, healthcare employers and staffing firms, and the investors and acquirers doing deals among them. We litigate, defend investigations, counsel, and clear transactions. We represent challengers against dominant systems and defendants against overreaching claims. Where matters require specialist FDA or healthcare-regulatory counsel, we work alongside them as antitrust co-counsel; our lane is competition.

The timing matters, because healthcare is where antitrust enforcement lives right now. The FTC has organized a cross-bureau Healthcare Task Force, rebuilt the PBM industry through landmark settlements, blocked medical-device deals, and obtained a record penalty for structuring a device acquisition to evade merger review. The Department of Justice is suing dominant hospital systems over the contracts they sign with insurers and won its first wage-fixing prison sentence against a healthcare staffing executive. Juries are returning record verdicts in pharmaceutical antitrust cases. And states from California to Maine now run their own healthcare-transaction review regimes that reach deals federal law never touches.

Featured Analysis

Clear Articulation and the Classic Antitrust Case of FTC v. Phoebe Putney Health System — Luke Hasskamp and Aaron Gott's explainer on the state-action doctrine that governs hospital-authority conduct and mergers. Companions: Jarod Bona's analysis of North Carolina State Board of Dental Examiners v. FTC (the firm filed an amicus brief in the case) and the firm's Certificate of Need analyses (Certificate-of-Need Laws, Evil Trolls, and the Minneapolis Star Tribune; COVID-19 Exposes Evil of Anticompetitive State Certificate of Need Laws).

Representative Experience

A published Ninth Circuit win for a drug-price-comparison innovator. We represented PharmacyChecker.com in antitrust litigation alleging that a verification rival and a network of pharmacy-industry groups conspired to exclude it from the online-pharmacy verification and drug-price-comparison markets. Our victory in the Ninth Circuit's published decision — PharmacyChecker.com v. LegitScript, 137 F.4th 1031 (9th Cir. 2025) — rejected the argument that a plaintiff's business model strips it of antitrust standing, and in January 2026 the district court dismissed LegitScript's RICO and Lanham Act counterclaims against our client. In a companion action, we are prosecuting a Lanham Act claim against the National Association of Boards of Pharmacy over its “Not Recommended Sites” list.

Defense of a leading online contact-lens retailer in a nationwide price-fixing MDL. In In re Disposable Contact Lens Antitrust Litigation (M.D. Fla.), we defended one of the nation's largest online contact-lens retailers against class-action price-fixing claims involving uniform pricing policies — and persuaded plaintiffs to drop our client from the case. We have also served as outside U.S. general and litigation counsel to a major online contact-lens retailer, submitted an FTC comment on competition in contact-lens distribution, filed a Tenth Circuit amicus brief in Johnson & Johnson Vision Care v. Reyes, and won an attorneys'-fee award against a patent assertion entity for an online lens retailer.

Group-boycott litigation for a cardiothoracic surgeon against a hospital system. We represented a board-certified cardiothoracic surgeon — the region's only minimally invasive/robotic cardiac surgeon — and his practice in a Sherman Act Section 1 action alleging that a hospital system and others conspired to force him out of the market for cardiovascular and thoracic surgical services in two Northern California counties. The court denied the defendants' motion to dismiss the antitrust and unfair-competition claims, and the case resolved by settlement.

Antitrust litigation against a state medical board. In Petrie v. Virginia Board of Medicine (E.D. Va.; 4th Cir.), we represented a doctor of chiropractic alleging that the medical doctors controlling the Board agreed to restrict the scope of chiropractic practice to limit competition. The case survived the Board's motion to dismiss and anchors our nationally recognized practice on antitrust claims against licensing boards controlled by active market participants — the framework the Supreme Court confirmed in North Carolina State Board of Dental Examiners v. FTC, where we filed an amicus brief.

The leading ambulance-market antitrust portfolio in the country. We filed twelve federal antitrust actions against Orange County, California municipalities for monopolizing emergency and non-emergency ambulance markets, litigated the state-action immunity issues through the Ninth Circuit, and took the appealability question to the U.S. Supreme Court on a petition for certiorari. In Western Star Hospital Authority (Metro Health) v. City of Richmond, 986 F.3d 354 (4th Cir. 2021), we challenged an exclusive municipal ambulance franchise under Section 2. This is healthcare-market litigation through the lens of our challenges to anticompetitive government action practice.

Criminal antitrust and investigations defense in healthcare markets. We defended a company under a DOJ Antitrust Division grand-jury subpoena investigating alleged price fixing of medical supplies — and persuaded the Division not to seek an indictment. We represented a medical-device company and its CEO in a DOJ price-fixing investigation that closed with no charges against our clients. And we represented an individual in a federal criminal no-poach investigation involving healthcare workers, including cooperation tied to a former employer's DOJ leniency petition.

Certificate of Need and healthcare-entry counseling. We advised a university seeking to establish a medical center on antitrust and constitutional challenges to state Certificate of Need laws and incumbents' use of them to impede entry, and we counsel clients on CON applications and strategy.

Licensing-board, professional, and provider counseling. We counsel licensed professionals on antitrust issues arising from state licensing-board conduct; we represented a California group practice providing behavioral-analyst services to children with autism in an administrative writ proceeding challenging a six-figure audit clawback; and we advise medical-industry clients on potential disputes with competitors, government and quasi-government entities, and other medical entities.

Appellate and amicus leadership in healthcare antitrust. Beyond our party appeals, we have filed amicus briefs in the defining healthcare-competition cases of the era: North Carolina State Board of Dental Examiners v. FTC (U.S. Supreme Court), FTC v. Phoebe Putney Health System (U.S. Supreme Court), the Illumina–Grail merger review (Fifth Circuit, on behalf of 34 Members of Congress), Johnson & Johnson Vision Care v. Reyes (Tenth Circuit), a U.S. Supreme Court brief on Kentucky's home-health Certificate of Need regime, and Colon Health Centers v. Hazel (Fourth Circuit, Virginia CON).

Recent Developments We're Watching

July 14, 2026 — The FTC announces its Caremark settlement, the second of the three largest pharmacy benefit managers to settle the landmark insulin case, following Express Scripts (February 2026), with the Optum Rx matter in consent negotiations.
July 13, 2026 — The FTC and DOJ obtain a record $12 million penalty from Edwards Lifesciences and Genesis MedTech for allegedly structuring a medical-device acquisition to avoid HSR filing — the largest failure-to-file penalty in the statute's history.
June 2026 — DOJ and the Ohio Attorney General settle their restrictive payor-contracting case against OhioHealth; DOJ's parallel Sherman Act suit against NewYork-Presbyterian (filed March 2026) remains pending.
June 29, 2026 — The Ninth Circuit hears argument in Surgical Instrument Service v. Intuitive Surgical, the surgical-robotics aftermarket monopolization appeal. (Decision pending as of July 30, 2026.)
May 2026 — A Boston jury returns the first reverse-payment verdict since FTC v. Actavis — approximately $885 million before trebling — against Takeda over delayed generic Amitiza.
March 20, 2026 — FTC Chairman Ferguson launches a cross-bureau Healthcare Task Force.
January 2026 — The FTC wins a preliminary injunction blocking Edwards Lifesciences' acquisition of JenaValve; California's AB 1415 and SB 351 take effect, extending healthcare-transaction review to private equity and management services organizations.
November 2025 — A healthcare staffing executive receives a 40-month prison sentence in DOJ's first successful wage-fixing prosecution; the FTC issues noncompete warning letters targeting healthcare employers and staffing companies (September 2025).

The Opportunity — and the Antitrust Risk

Healthcare rewards scale, integration, and data — and every one of those strategies draws antitrust attention. Risk (and opportunity) concentrates where:

Consolidation meets review — hospital, physician-group, and device transactions now face the 2023 Merger Guidelines, expanded HSR rules, FTC task-force scrutiny, and state regimes (California OHCA/AB 1415, Massachusetts, Maine, Oregon, Washington) that reach deals far below federal thresholds.
Contract exclusions — anti-steering, anti-tiering, all-or-nothing, exclusive-dealing, and bundled-rebate provisions are the subject of active DOJ litigation and nine-figure private verdicts.
Intermediaries concentrate — PBM, GPO, and repricing-platform structures are being reshaped by FTC consent orders, state legislation, and Class Action MDLs.
Patents meet competition law — reverse-payment settlements, product hopping, and Orange Book listing practices carry treble-damages exposure that a Boston jury just repriced.
Aftermarkets lock in — device service, parts, and consumables restrictions face Kodak-line Section 2 claims, with the surgical-robotics appeal pending.
Labor markets tighten — no-poach agreements, wage benchmarking, and noncompete portfolios in healthcare are now criminal-enforcement and class-action territory.
Boards and regimes exclude — licensing boards controlled by market participants and Certificate of Need regimes remain powerful exclusion tools — and powerful targets, under N.C. Dental and the accelerating CON-reform wave.

How We Help Healthcare, Pharmaceutical & Medical Device Clients

Antitrust litigation — monopolization, group boycott, exclusive dealing, and conspiracy claims, for challengers and defendants alike.
Class-action defense — price-fixing, no-poach, and consumer class actions and MDLs; we do not bring private class actions, so we defend them without conflict.
Government investigations — DOJ Antitrust Division grand-jury and civil investigations, FTC investigations, and state AG matters, for companies and individuals.
Merger review and transaction counseling — HSR strategy and filings, second requests, and the new state healthcare-transaction regimes.
Counseling and compliance — pricing, distribution, information exchange, trade-association activity, labor-market practices, and compliance programs.
Licensing-board and CON matters — challenges, defense, applications, and strategy under the state-action doctrine we helped shape.
Appeals — party appeals and amicus advocacy in state courts, federal courts of appeals and the U.S. Supreme Court.
Antitrust co-counsel — we team with health-law and regulatory firms that need dedicated antitrust litigation strength.

Why Bona Law for Healthcare, Pharmaceutical & Medical Device Antitrust

A published Ninth Circuit antitrust win (PharmacyChecker, 137 F.4th 1031) and a Fourth Circuit ambulance-franchise appeal in this sector — plus U.S. Supreme Court amicus work in N.C. Dental and Phoebe Putney, the cases that define healthcare's state-action-immunity landscape.
Both directions, no class-action conflicts. We represent physicians, innovators, and challengers against dominant players, and we defend companies in class actions and investigations. We never represent private class-action plaintiffs.
A real pharmaceutical bench. Attorneys who defended In re Bystolic (the Second Circuit's first Actavis application), In re Vitamins, Asacol product-hopping claims, and state AG pharmaceutical enforcement actions — now at boutique economics.
The nation's leading antitrust-federalism practice. Licensing boards, Certificate of Need, state-action immunity, and municipal healthcare monopolies are our signature issues.
Focused where your regulator isn't. We are competition lawyers. Where FDA, CMS, or state healthcare-regulatory issues run alongside, we coordinate with specialist regulatory counsel rather than pretending to be one.

Frequently Asked Questions

Can a physician or physician group bring an antitrust case against a hospital system? Yes — and it is one of the things we are known for. We represented a cardiothoracic surgeon whose Sherman Act claims against a hospital system survived a motion to dismiss and resolved by settlement. We have also sued a state medical board on behalf of an excluded practitioner, won a published Ninth Circuit decision for a drug-price-comparison company excluded by industry gatekeepers, and litigated a twelve-case ambulance-monopolization portfolio through the Ninth Circuit. Exclusion by a dominant system, a staffing decision dressed up as peer review, or a board controlled by your competitors can be an antitrust problem.

Do you defend healthcare, pharmaceutical, and medical-device companies, or only represent challengers? Both. We defended one of the nation's largest online contact-lens retailers in a nationwide price-fixing MDL — plaintiffs dropped our client — persuaded the DOJ Antitrust Division not to indict in a medical-supplies grand-jury investigation, and represented a device company and its CEO through a DOJ price-fixing investigation that closed with no charges. Our team includes lawyers who defended major pharmaceutical manufacturers in the defining reverse-payment and product-hopping class actions. What we never do is bring private plaintiff-side class actions — so we defend them without conflict.

Federal HSR doesn't apply to our deal — do we still have an antitrust problem? Increasingly, yes. California, Massachusetts, and other states now run healthcare-transaction review regimes that reach physician-group, MSO, and private-equity deals far below federal thresholds — and California's general antitrust premerger filing arrives in 2027. And the FTC's record $12 million penalty against Edwards Lifesciences and Genesis MedTech for structuring a device acquisition to stay under the HSR threshold shows that threshold engineering is itself an enforcement target. We assess federal and state filing obligations together, early, before deal structure hardens. And we coordinate with international counsel when filings outside the U.S. are necessary.

Do you handle FDA, reimbursement, or healthcare-regulatory matters? No. We are competition lawyers. When FDA, CMS, Stark, AKS, or state healthcare-regulatory issues run alongside an antitrust matter, we coordinate with specialist regulatory counsel, including the health-law firms that regularly bring us in as antitrust co-counsel.

Healthcare Antitrust Resources

Selected analysis from The Antitrust Attorney Blog and our Legal Resources. For more, browse the blog's Health Care and Hospitals and State-Action Immunity categories:

Clear Articulation and the Classic Antitrust Case of FTC v. Phoebe Putney Health System — the state-action framework that governs hospital-authority conduct and mergers.
The Seventh Circuit Explains the “Co-Conspiracy Exception” to the Illinois Brick Rule in Healthcare Antitrust Lawsuit — who can sue for overcharges in healthcare distribution chains.
My Analysis of the Supreme Court's North Carolina State Board of Dental Examiners v. FTC Decision — the decision that defines licensing-board antitrust exposure.
The Supreme Court Makes It Easier to Sue State Licensing Boards Under the Antitrust Laws — what N.C. Dental means for boards and the professionals they regulate.
Certificate-of-Need Laws, Evil Trolls, and the Minneapolis Star Tribune and COVID-19 Exposes Evil of Anticompetitive State Certificate of Need Laws — why CON regimes exclude entrants, and what challengers and applicants can do.
State Action Immunity and Active Supervision: The Ninth Circuit Rejects the Board's Claim for Immunity and SmileDirectClub Wins Again — what happens when a dental board tries to shut out a teledentistry competitor.
Do Bundled Discounts Violate the Antitrust Laws? LePage's, PeaceHealth, and the Discount-Attribution Test — the standard, born in a hospital-competition case, that governs bundled pricing by dominant health systems and device makers.
What Are the Available Exemptions to Antitrust Liability? — including the McCarran-Ferguson insurance exemption and other immunities that shape healthcare antitrust claims.
Antitrust in Labor Markets — no-poach, wage-fixing, and noncompete exposure for healthcare employers and staffing firms.
Texas Federal Court Acts for Teladoc in Antitrust Case Against State Medical Board — an early application of N.C. Dental when a state medical board tried to shut out telehealth competition.
Hospitals, Antitrust, the Department of Justice, and Agreements to Not Compete on Marketing — why even non-price agreements between competing hospital systems draw DOJ enforcement.
California's Mini-HSR Antitrust Filing Arrives in 2027: A Practical Compliance Checklist — the state filing layer that will reach California-nexus healthcare deals.

Contact Us

If your company, practice, or client faces an antitrust problem in healthcare, pharmaceutical, or medical-device markets — as challenger, defendant, or dealmaker.

Contact Bona Law for an initial discussion