Takeda Pharmaceuticals U.S.A., Inc. v. West-Ward Pharmaceutical Corp. ( 2015 )


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  •   United States Court of Appeals
    for the Federal Circuit
    ______________________
    TAKEDA PHARMACEUTICALS U.S.A., INC.,
    Plaintiff-Appellant
    v.
    WEST-WARD PHARMACEUTICAL CORPORATION,
    HIKMA AMERICAS INC., HIKMA
    PHARMACEUTICALS PLC,
    Defendants-Cross-Appellants
    ______________________
    2015-1139, 2015-1142
    ______________________
    Appeals from the United States District Court for the
    District of Delaware in No. 1:14-cv-01268-SLR, Judge Sue
    L. Robinson.
    ______________________
    Decided: May 6, 2015
    ______________________
    JEFFREY I. WEINBERGER, Munger, Tolles & Olson LLP,
    Los Angeles, CA, argued for plaintiff-appellant. Also
    represented by TED G. DANE, ELIZABETH LAUGHTON; ERIC
    KELVIN CHIU, AMY GREYWITT, San Francisco, CA; MARY
    W. BOURKE, Womble, Carlyle, Sandridge & Rice, PLLC,
    Wilmington, DE; TRYN T. STIMART, Tysons Corner, VA .
    2    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    CHARLES B. KLEIN, Winston & Strawn LLP, Washing-
    ton, DC, argued for defendants-cross appellants. Also
    represented by JOVIAL WONG, STEFFEN NATHANAEL
    JOHNSON; SAMUEL S. PARK, Chicago, IL; WILLIAM G.
    JAMES, II, WILLIAM M. JAY, Goodwin Procter LLP, Wash-
    ington, DC.
    EDWARD A. MARSHALL, Arnall Golden Gregory LLP,
    Atlanta, GA, for amicus curiae The American College of
    Rheumatology.
    MELISSA ARBUS SHERRY, Latham & Watkins LLP,
    Washington, DC, for amicus curiae Generic Pharmaceuti-
    cal Association.
    ______________________
    Before NEWMAN, DYK, and HUGHES, Circuit Judges.
    Opinion for the court filed by Circuit Judge DYK.
    Dissenting opinion filed by Circuit Judge NEWMAN.
    DYK, Circuit Judge.
    Takeda Pharmaceuticals U.S.A., Inc. (“Takeda”) ap-
    peals the order of the United States District Court for the
    District of Delaware denying its motion for preliminary
    injunction. Takeda sought to enjoin West-Ward Pharma-
    ceutical Corporation, Hikma Americas Inc., and Hikma
    Pharmaceuticals PLC (collectively “Hikma”) from continu-
    ing its launch of Mitigare, a colchicine product for prophy-
    lactic treatment of gout, and from launching an
    authorized generic version of Mitigare. We affirm.
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   3
    BACKGROUND
    Takeda owns several asserted patents 1 that cover
    several methods of administering colchicine products to
    treat gout. Colchicine itself, which has been used for
    centuries, is not covered by Takeda’s patents. The ’647
    and ’938 patents (the “acute gout patents”) are directed to
    methods of treating acute gout flares. The ’655, ’648 and
    ’722 patents (the “drug-drug-interaction (DDI) patents”)
    are directed to methods for administering colchicine for
    prophylaxis of gout in patients who are concomitantly
    taking certain drug inhibitors known as “CYP3A4” and
    “P-gp” inhibitors.
    The acute gout patents recite methods of treating
    acute gout by administering 1.2 mg of oral colchicine at
    the onset of the flare, followed by 0.6 mg of colchicine
    about one hour later.
    DDI patent ’655 recites administering colchicine con-
    comitantly with clarithromycin by reducing the typical
    prophylactic dosage of colchicine by 75%, including a dose
    of 0.3 mg once a day. DDI patent ’648 recites concomitant
    administration with ketoconazole, where the reduced
    daily dose of colchicine is 25% to 50% of the daily dose,
    including a dose of 0.3 mg once a day. DDI patent ’722
    recites concomitant administration with 240 ml of vera-
    pamil, where the reduced daily dose of colchicine is 50% to
    75% of the daily dose.
    In 2009, Mutual was the first drug manufacturer to
    receive approval from the Food and Drug Administration
    (“FDA”) to market colchicine for treatment and prophylax-
    1     The asserted patents are U.S. Patent Nos.
    7,964,648 (“the ’648 patent”), 7,981,938 (“the ’938 pa-
    tent”), 8,097,655 (“the ’655 patent”), 8,440,722 (“the ’722
    patent”), and 7,964,647 (“the ’647 patent”).
    4    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    is of gout flares. Takeda acquired Mutual and the ap-
    proved New Drug Application (“NDA”). Takeda sells the
    colchicine product under the brand name Colcrys.
    In 2010, Hikma sought FDA approval of a colchicine
    product for prophylaxis of gout flares. It submitted an
    NDA under § 505(b)(2) of the Drug Price Competition and
    Patent Term Restoration Act of 1984 (the “Hatch-
    Waxman Act”), codified at 
    21 U.S.C. § 355
    (b)(2). On
    September 26, 2014, the FDA granted Hikma approval to
    market its Mitigare colchicine capsule.
    On October 3, 2014, Hikma launched Mitigare, and
    Takeda filed suit against Hikma, asserting induced
    infringement under 
    35 U.S.C. § 271
    (b) based on Hikma’s
    labeling of the Mitigare product. Hikma planned on
    launching an authorized generic version of Mitigare as
    early as October 10, 2014. However, the district court
    granted Takeda’s request for a temporary restraining
    order (“TRO”) on October 9, 2014, restraining Hikma from
    selling Mitigare and from launching a generic colchicine
    product. The district court also restrained Takeda from
    launching an authorized generic version of its branded
    Colcrys product during the TRO and required that
    Takeda “provide notice to Hikma at least 10 business
    days before the launch of any authorized generic of Col-
    crys.” J.A. 20.
    On November 4, 2014, the district court denied
    Takeda’s motion for preliminary injunction on the
    grounds that Takeda did not meet its burden of showing a
    likelihood of success on the merits for its induced in-
    fringement claims or irreparable injury. On the issue of
    the likelihood of success on the merits, the district court
    concluded that, although Hikma failed to raise a substan-
    tial question regarding the validity of the patents, Takeda
    had not met its burden of showing likelihood of proving
    induced infringement. On the issue of irreparable harm,
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   5
    the district court concluded that Takeda had not shown a
    causal nexus between Hikma’s infringement and Takeda’s
    alleged harm.
    In the order denying a preliminary injunction, the
    court also ordered that, if Takeda took an immediate
    appeal (the next day), “the status quo [would] be main-
    tained pending appeal” by extending the TRO, including
    its 10-day notice provision. J.A. 16–17.
    Takeda timely appealed the denial of preliminary in-
    junction, and Hikma cross-appealed. In its cross-appeal,
    Hikma argues that the extension of the TRO was based
    solely on its “consent,” and it should not have been ex-
    tended past oral argument in this appeal. After oral
    argument on January 9, 2015, we issued, without dissent,
    an order affirming the district court’s denial of prelimi-
    nary injunction and vacating the TRO, including its 10-
    day notice provision. 2 Our order mooted Hikma’s cross-
    appeal and Takeda’s argument that the 10-day notice
    provision in the TRO was improper. Our vacating of the
    order did not affect Takeda’s liability under the bond. We
    have jurisdiction pursuant to 
    28 U.S.C. § 1292
    (c).
    2   The order stated:
    The district court’s order denying Takeda
    Pharmaceuticals U.S.A., Inc.’s motion for prelim-
    inary injunction is affirmed, opinion to follow.
    The injunction pending appeal ordered by the
    district court is vacated effective immediately.
    The consequence of vacating the injunction pend-
    ing appeal is that both parties are free to imme-
    diately offer colchicine products for prophylactic
    use, without regard to the 10-day provision of the
    district court’s order.
    6    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    DISCUSSION
    We review a denial of a preliminary injunction for
    abuse of discretion. Abbott Labs. v. Sandoz, Inc., 
    544 F.3d 1341
    , 1345 (Fed. Cir. 2008) (citing Doran v. Salem Inn,
    
    422 U.S. 922
    , 932 (1975)). A court abuses its discretion if
    it “ma[kes] a clear error of judgment in weighing relevant
    factors or exercise[s] its discretion based upon an error of
    law or clearly erroneous factual findings.” 
    Id.
     (quoting
    Novo Nordisk of N. Am., Inc. v. Genentech, Inc., 
    77 F.3d 1364
    , 1367 (Fed. Cir. 1996)).
    In general, a party seeking a preliminary injunction
    must establish that it is likely to succeed on the merits,
    that it is likely to suffer irreparable harm in the absence
    of relief, that the balance of equities is in its favor, and
    that an injunction is in the public interest. See Titan Tire
    Corp. v. Case New Holland, Inc., 
    566 F.3d 1372
    , 1375–76
    (Fed. Cir. 2009).
    I
    The relevant statutory provisions here are in the
    Hatch-Waxman Act. The Hatch-Waxman Act allows
    generic manufacturers to rely on certain streamlined FDA
    approval processes by which generic drug manufacturers
    can bring their products to market without submitting all
    of the extensive drug and clinical data ordinarily required
    of an NDA under 
    21 U.S.C. § 355
    (b)(1). In particular, an
    applicant seeking approval to market a generic version or
    variant of a drug may file either an Abbreviated New
    Drug Application (“ANDA”) or a “505(b)(2) application,”
    sometimes called a “paper NDA.” 
    Id.
     §§ 355(b)(2), (j). An
    ANDA allows applicants seeking approval for generic
    versions of existing drugs to rely on the safety and effica-
    cy information for an approved drug listed in the Ap-
    proved Drug Products with Therapeutic Equivalence
    Evaluations, or the “Orange Book.” A paper NDA allows
    applicants seeking approval for a new drug or a change to
    TAKEDA PHARMACEUTICALS U.S.A.    v. HIKMA AMERICAS INC.     7
    an approved drug to rely on existing FDA findings of
    safety and effectiveness or studies not performed by the
    NDA applicant.
    Both the ANDA and paper NDA pathways generally
    require applicants to submit one of several kinds of patent
    certifications,    see     id.   §§ 355(j)(2)(A)(vii)(I)-(IV),
    355(b)(2)(A)–(B), including a “Paragraph IV” certification
    that the relevant patents are either invalid or not in-
    fringed, which may in turn trigger patent litigation under
    the artificial act of infringement created by 
    35 U.S.C. § 271
    (e)(2)(A).          See        §§ 355(j)(2)(A)(vii)(IV),
    355(b)(2)(A)(iv); Eli Lilly & Co. v. Medtronic, Inc., 
    496 U.S. 661
    , 675 (1990).
    Here Colcrys was an FDA-approved drug, and Hikma
    elected to file a paper NDA pursuant to 
    21 U.S.C. § 355
    (b)(2). Hikma did not, however, file a Paragraph IV
    certification with respect to Takeda’s patents because it
    relied on prior FDA findings of safety and efficacy con-
    cerning colchicine, and did not seek FDA approval for a
    use covered by Takeda’s patents. As Takeda concedes,
    “[a]dministering colchicine for prophylaxis of gout flares is
    not covered by Takeda’s asserted patents, except when it
    involves concomitant administration with certain other
    drugs.” Appellant’s Br. 4 n.1.
    As we explained in Warner-Lambert Co. v. Apotex
    Corp., 
    316 F.3d 1348
     (Fed. Cir. 2003), Congress intended
    “that a single drug could have more than one indication
    and yet that [an] ANDA applicant could seek approval for
    less than all of those indications.” 
    Id. at 1360
    . A patent
    certification such as a Paragraph IV certification need not
    be provided “for a patent claiming a use for which the
    ANDA applicant is not seeking approval.” 
    Id. at 1361
    ; see
    
    21 U.S.C. § 355
    (j)(2)(A)(viii); Caraco Pharm. Labs. v. Novo
    Nordisk A/S, 
    132 S. Ct. 1670
    , 1677 (2012); see also 
    21 U.S.C. §§ 355
    (b)(2)(A)(i)–(iv), (b)(2)(B) (parallel provisions
    8    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    in the paper NDA process). In such a situation, a generic
    manufacturer may avoid infringement by proposing a
    label that does not claim a patented method of use, Cara-
    co, 
    132 S. Ct. at
    1676–77, ensuring that “one patented use
    will not foreclose marketing a generic drug for other
    unpatented ones,” 
    id. at 1682
    .
    II
    With this statutory scheme in mind, we address the
    question of whether Takeda showed a likelihood of suc-
    cess on the merits of the induced infringement claim.
    Such likelihood is not shown if an alleged infringer raises
    a substantial question regarding either infringement or
    validity of the asserted patents. See Genentech, Inc. v.
    Novo Nordisk A/S, 
    108 F.3d 1361
    , 1364 (Fed. Cir. 1997).
    A
    We first consider induced infringement with respect to
    the acute gout patents. Since Hikma did not seek FDA
    approval to market Mitigare for treatment of acute gout
    flares, Mitigare’s label stated that Mitigare is “indicated
    for prophylaxis” and that the “safety and effectiveness of
    [it] for acute treatment of gout flares during prophylaxis
    has not been studied.” J.A. 138. The label also said that
    “[i]f you have a gout flare while taking [Mitigare], tell
    your healthcare provider.” J.A. 148. Takeda argued that
    this latter statement induced infringement because, in
    the case of the patient taking Mitigare for prophylaxis,
    the physician would likely tell the patient to use the
    Mitigare product to treat the acute flare. The district
    court concluded that the latter instruction was not suffi-
    cient to establish induced infringement. We agree.
    “Whoever actively induces infringement of a patent
    shall be liable as an infringer.” 
    35 U.S.C. § 271
    (b). “[The]
    sale of a lawful product by lawful means, with the
    knowledge that an unaffiliated, third party may infringe,
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   9
    cannot, in and of itself, constitute inducement of in-
    fringement.” Dynacore Holdings Corp. v. U.S. Philips
    Corp., 
    363 F.3d 1263
    , 1276 n.6 (Fed. Cir. 2004) (internal
    quotation marks and citation omitted). The accused
    infringer must have “knowingly aided and abetted” direct
    infringement. Warner-Lambert, 
    316 F.3d at 1363
     (cita-
    tions omitted).
    As the Supreme Court held in the analogous context
    of copyright infringement, there is no indirect infringe-
    ment “when a defendant merely sells a commercial prod-
    uct suitable for some lawful use.” Metro-Goldwyn-Mayer
    Studios Inc. v. Grokster, Ltd., 
    545 U.S. 913
    , 936 (2005)
    (citing Water Techs. Corp. v. Calco, Ltd., 
    850 F.2d 660
    ,
    668 (Fed. Cir. 1988)). Infringement only exists where
    there is evidence that “goes beyond a product’s character-
    istics or the knowledge that it may be put to infringing
    uses.” Id. at 935. Inducement can be found where there is
    “[e]vidence of active steps taken to encourage direct
    infringement,” which can in turn be found in “advertising
    an infringing use or instructing how to engage in an
    infringing use.” Id. at 936 (citations and internal quota-
    tion marks omitted). 3 But such instructions need to
    3    We have specifically approved Grokster’s defini-
    tion in the patent context. See Ricoh Co., Ltd. v. Quanta
    Computer Inc., 
    550 F.3d 1325
    , 1341 (Fed. Cir. 2008)
    (noting that “we turn to Grokster and its analysis of the
    law of active inducement,” quoting Grokster, and stating
    that inducement requires evidence of promotion, active
    steps, or encouragement). Well before Grokster, we had
    adopted a virtually identical test. For example, in Water
    Technologies (a patent case cited approvingly by the
    Supreme Court in Grokster in its analysis of inducement,
    see 
    545 U.S. at 936
    ), we noted that inducement requires
    “actively . . . aiding and abetting another’s direct in-
    10   TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    evidence “intent to encourage infringement.” Vita-Mix
    Corp. v. Basic Holding, Inc., 
    581 F.3d 1317
    , 1329 (Fed.
    Cir. 2009) (emphasis added). The question is not just
    whether instructions “describ[e] the infringing mode,”
    Toshiba Corp. v. Imation Corp., 
    681 F.3d 1358
    , 1365 (Fed.
    Cir. 2012) (distinguishing Fujitsu Ltd. v. Netgear Inc., 
    620 F.3d 1321
     (Fed. Cir. 2010)), but whether the “instructions
    teach an infringing use of the device such that we are
    willing to infer from those instructions an affirmative
    intent to infringe the patent,” Vita-Mix, 
    581 F.3d at
    1329
    n.2 (emphasis added). Merely “describ[ing],” Toshiba, 681
    F.3d at 1365, an infringing mode is not the same as
    “recommend[ing],” id., “encourag[ing],” Grokster, 
    545 U.S. at 930
    , or “promot[ing],” Metabolite Labs., Inc. v. Lab.
    Corp. of Am. Holdings, 
    370 F.3d 1354
    , 1365 (Fed. Cir.
    2004), an infringing use, or suggesting that an infringing
    use “should” be performed, see Arthrocare Corp. v. Smith
    & Nephew, Inc., 
    406 F.3d 1365
    , 1377 (Fed. Cir. 2005)
    (finding inducement where instruction manuals indicated
    product should be used in infringing manner).
    fringement.” Water Techs., 
    850 F.2d at 668
     (emphasis
    added); see also Warner-Lambert, 
    316 F.3d at 1364
     (“In
    the absence of any evidence that Apotex has or will pro-
    mote or encourage doctors to infringe the neurodegenera-
    tive method patent, there has been raised no genuine
    issue of material fact [as to inducement]” (emphases
    added)); Tegal Corp. v. Tokyo Electron Co., 
    248 F.3d 1376
    ,
    1378–79 (Fed. Cir. 2001) (explaining that inducement
    requires an “affirmative act,” including that which “caus-
    es, or urges, or encourages, or aids another to infringe a
    patent” (citation omitted)); Manville Sales Corp. v. Para-
    mount Sys., Inc., 
    917 F.2d 544
    , 553 (Fed. Cir. 1990) (in-
    ducement requires “intent to encourage another’s
    infringement”).
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.    11
    The principles that can be distilled from these cases
    are applicable in the Hatch-Waxman Act context where,
    as here, it is alleged that the drug label induces infringe-
    ment by physicians. The label must encourage, recom-
    mend, or promote infringement. See Grokster, 
    545 U.S. at 936
    ; Toshiba, 681 F.3d at 1365; Metabolite, 
    370 F.3d at 1365
    . The mere existence of direct infringement by physi-
    cians, while necessary to find liability for induced in-
    fringement, is not sufficient for inducement. As we stated
    in Warner-Lambert in the ANDA context, it is well-
    established that “mere knowledge of possible infringe-
    ment by others does not amount to inducement; specific
    intent and action to induce infringement must be proven.”
    
    316 F.3d at 1364
     (citation omitted).
    This requirement of inducing acts is particularly im-
    portant in the Hatch-Waxman Act context because the
    statute was designed to enable the sale of drugs for non-
    patented uses even though this would result in some off-
    label infringing uses. See Caraco, 
    132 S. Ct. at
    1681–82
    (“Congress understood [that] a single drug may have
    multiple methods of use, only one or some of which a
    patent covers” and that the statute “contemplates that
    one patented use will not foreclose marketing a generic
    drug for other unpatented ones.”); Warner-Lambert, 
    316 F.3d at 1359
     (the Hatch-Waxman Act was not intended
    “as a sword against any competitor’s ANDA seeking
    approval to market an off-patent drug for an approved use
    not covered by the patent”).
    Takeda concedes that mere knowledge of off-label in-
    fringing uses of Mitigare’s product would not establish
    inducement. Similarly insufficient is Hikma’s knowledge,
    acquired from the FDA, that colchicine is used to treat
    acute gout flares. The FDA has previously told healthcare
    providers to prescribe Colcrys for acute gout flares, and
    the FDA told Hikma that “it may be natural for the
    provider to use [Mitigare] for acute treatment.” Appel-
    12       TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    lant’s Br. 37. So too the guidelines from the American
    College of Rheumatology (“ACR”) that recommend pre-
    scribing Colcrys for acute gout flares are irrelevant to the
    question of inducement. All of this, without more, is mere
    knowledge of infringing uses and does not establish
    inducement.
    But Takeda argues that Mitigare’s label, though indi-
    cated only for prophylaxis of gout, induces infringement
    by stating that “[i]f you have a gout flare while taking
    Mitigare, tell your healthcare provider,” J.A. 148. Alt-
    hough this is neither an explicit nor implicit instruction to
    take Mitigare for acute gout treatment, Takeda argues
    that the instruction to “tell your healthcare provider” will
    “inevitably” lead to physicians who are consulted to advise
    patients taking Mitigare for prophylaxis to simply in-
    crease their dose of Mitigare to treat acute gout flares,
    and that Hikma was aware of or willfully blind to this
    possibility. Hikma argues that the label’s statement that
    the “safety and effectiveness” of Mitigare “for acute
    treatment of gout flares during prophylaxis has not been
    studied” bars a finding of inducement, relying on Bayer
    Schering Pharma AG v. Lupin, Ltd., 
    676 F.3d 1324
     (Fed.
    Cir. 2012). We need not address whether or not lack of
    approval language precludes a finding of inducement.
    Given the statutory scheme explained above, vague
    label language cannot be combined with speculation about
    how physicians may act to find inducement. This would
    seem to too easily transform that which we have held is
    “legally irrelevant,” Warner-Lambert, 
    316 F.3d at
    1364—
    mere knowledge of infringing uses—into induced in-
    fringement. 4
    4 Takeda even goes so far as to suggest that the la-
    bel needs to contain a “clear statement” to show that it
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.    13
    But we need not decide whether evidence as to the in-
    variable response of physicians could ever transform a
    vague label into active encouragement. Here, even if we
    do look outside the label, there is no evidence that the
    label would necessarily lead doctors who are consulted by
    patients taking Mitigare to prescribe an off-label use of it
    to treat acute gout flares.
    First, Takeda does not dispute that there are a host of
    alternatives for treating gout flares. These alternatives
    include non-steroidal anti-inflammatory drugs such as
    indomethacin or naproxen and systemic and intra-
    articular corticosteroids. As the 2012 ACR Guidelines for
    Gout Management explain, “it is at the discretion of the
    prescribing physicians to choose the most appropriate
    monotherapy based on the patient’s preference, prior
    response to pharmacologic therapy for an acute gout
    attack, and associated comorbidities.” J.A. 387. Takeda
    points to no record evidence that physicians would forego
    these alternatives and simply increase the dose of Mitiga-
    re when it failed to work as a prophylactic. Indeed, the
    ACR says that because colchicine can cause various
    adverse side effects, “[r]heumatologists rarely use colchi-
    cine for acute gout flares but utilize colchicine frequently
    for chronic gout prophylaxis.” J.A. 1505. Instead, non-
    steroidal anti-inflammatory drugs have become the
    “treatment choice for most acute attacks of gout.” Appel-
    lee’s Br. 32.
    was avoiding gout flare indication, and that Hikma needs
    to “believe[] Mitigare will be used for prophylaxis only.”
    Appellant’s Reply Br. 12. This turns the legal test on its
    head. Takeda needs to show that Hikma took affirmative
    steps to induce, not affirmative steps to make sure others
    avoid infringement.
    14   TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    Second, even with respect to physicians who would
    prescribe colchicine for the acute gout flares, there is
    insufficient evidence that doctors would inevitably pre-
    scribe Mitigare. Evidence that colchicine is prescribed for
    acute gout flares says nothing about whether Mitigare
    would be so prescribed. Takeda argues that, where the
    physician prescribes colchicine for an acute gout flare, it
    would be “impractical” for a patient already taking colchi-
    cine for prophylaxis not to “reach for the colchicine they
    have on hand” and follow Takeda’s patented methods.
    Appellant’s Reply Br. at 5. Takeda also suggested that it
    is “common sense” that doctors would prescribe Mitigare
    for an infringing use because it is already available on the
    shelf of the patient taking it for prophylaxis. But in
    Warner-Lambert, we already rejected the argument that
    it was “common knowledge” in the field that physicians
    routinely prescribe approved drugs for off-label uses, that
    information regarding the off-label prescriptions was
    “readily available” to the public, and that generic drugs
    are “commonly substitute[d]” for branded drugs. 
    316 F.3d at 1364
    ; see also ACCO Brands, Inc. v. ABA Locks Mfr.
    Co., 
    501 F.3d 1307
    , 1312–13 (Fed. Cir. 2007) (rejecting the
    argument that infringement can be found because a
    “natural and intuitive way to employ” the accused product
    was infringing).
    Attempting to bridge this evidentiary deficit, Takeda
    also submitted physicians’ declarations allegedly showing
    what physicians would do when patients consult them
    about acute gout flares.    One of Takeda’s physician
    declarations stated that “[e]ven though the [Mitigare]
    label states that the product has not been tested for use in
    treating gout flares, [he] believe[s] treating physicians
    would encourage patients to use Mitigare for this pur-
    pose” anyway because “in [his] experience, physicians will
    not recommend that a patient suffering a gout flare have
    two very similar colchicine products, i.e., Colcrys and
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   15
    Mitigare, on hand.” J.A. 2658–59 (emphasis added). The
    other declarant stated that he would “understand” that
    either Colcrys or Mitigare “could be used with equal
    effectiveness for the indications for which the other drug
    is approved,” and that “[b]ecause the Mitigare product
    label does not provide a low-dose regimen for treating
    acute flares . . . [he] expect[s] that some doctors would
    consult the Colcrys product label to inform a patient using
    Mitigare to take colchicine according to the low-dose
    regimen specified in the Colcrys label.” J.A. 99. Takeda
    contends that these declarations establish a “likelihood
    that some prescribers would practice the claimed method.”
    Appellant’s Br. 36.
    Speculation or even proof that some, or even many,
    doctors would prescribe Mitigare for acute flares is hardly
    evidence of inevitability. This evidence does not show
    anything more than that there may be some infringing
    uses of Mitigare. 5
    Finally, Takeda relies heavily on Astrazeneca LP v.
    Apotex, Inc., 
    633 F.3d 1042
     (Fed. Cir. 2010), to argue that
    the label induces infringement. The asserted method
    claims there covered treating respiratory diseases such as
    asthma by administering “a nebulized dose” of
    budesonide, i.e., an anti-inflammatory corticosteroid
    5    One declaration also stated that, “for a patient
    suffering a new or recurring acute gout attack, the patient
    will reach for his colchicine and follow the Colcrys low-
    dose regimen.” J.A. 2659. This evidence does not suggest
    physicians would prescribe Mitigare in accordance with
    Colcrys’ product label when consulted by patients. In fact,
    it seems to indicate something that undermines Takeda’s
    argument: that a physician believes that patients will
    simply ignore Mitigare’s label instructing them to consult
    their physician and use the drug off-label themselves.
    16   TAKEDA PHARMACEUTICALS U.S.A.    v. HIKMA AMERICAS INC.
    suspended in a liquid to be inhaled, at a frequency of “not
    more than once per day.” 
    Id. at 1048
    . An accused infring-
    er’s label for a generic version of such an asthma inhaler
    instructed patients to take the drug “twice daily in divid-
    ed doses” for a total daily dose of 0.5 mg, and that pa-
    tients should “downward-titrate to the lowest effective
    dose.” 
    Id. at 1057
    . Because the label stated that the
    lowest available dose was a 0.25 mg vial, titrating down
    required going down from taking 0.25 mg twice a day to
    taking it once a day. 
    Id.
     Thus the patient did not have to
    consult anything outside of the label to infringe. The
    instruction would “necessarily lead” to infringement. 
    Id.
    This, we explained, was enough for “active steps” taken to
    “encourage” direct infringement. 
    Id. at 1059
    . Here, in
    contrast, Takeda asks us to look outside the label to
    understand the alleged implicit encouragement in the
    label, even while it admits that evidence of mere
    knowledge of infringing uses is not sufficient.
    The district court correctly concluded that Takeda did
    not establish a probability of success on the issue of
    infringement.
    B
    Takeda’s arguments with respect to the DDI patents
    are similarly insufficient to support a finding of induce-
    ment. The Mitigare label warns patients that co-
    administration of colchicine and certain inhibitors “have
    been reported to lead to colchicine toxicity,” that drug-
    drug interactions must thus “be considered prior to and
    during therapy,” and that concomitant use “should be
    avoided if possible.” J.A. 137. The label also warns that if
    co-administration “is necessary, the dose of Mitigare
    should be reduced and the patient should be monitored
    carefully for colchicine toxicity.” 
    Id.
     At one point the label
    also suggests that if co-administration is necessary, “the
    dose . . . should be adjusted by either reducing the daily
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   17
    dose or reducing the dose frequency.” J.A. 140. Takeda
    argues that this language constitutes inducement because
    a healthcare provider will have to determine whether co-
    administration is “necessary,” and the physician would
    then follow the patented methods. Takeda submitted
    declarations in which a physician hypothesized that he
    would “typically” follow Takeda’s patented methods if it
    was necessary to co-administer colchicine and medications
    “such as” the relevant inhibitors. J.A. 100.
    Noting that this label language failed to recommend
    or suggest to physicians that the patented DDI methods
    should be followed, the district court found that, in any
    case, there was insufficient evidence “that any healthcare
    provider has actually practiced the methods of the DDI
    patents,” J.A. 13. The district court concluded that
    Takeda did not even meet its burden to show likelihood of
    direct infringement, which is a prerequisite for indirect
    infringement. See Ricoh, 
    550 F.3d at 1341
    .
    With respect to the ’655 and ’648 patents requiring a
    0.3 mg dose of colchicine, the district court found that
    Mitigare would not likely be used to directly infringe
    because it comes in 0.6 mg capsules that cannot feasibly
    be split to reach a 0.3 mg dose of colchicine per day.
    Takeda argues that the capsules can be taken every other
    day to reach an average of 0.3 mg per day, citing in par-
    ticular the language in Mitigare’s label that warned
    patients to “either reduc[e] the daily dose or reduc[e] the
    dose frequency” if concomitant administration is neces-
    sary. But the district court found that, given that colchi-
    cine has a “narrow therapeutic index” whereby the
    margin between an effective dose and a toxic dose is
    narrow, this possibility was not likely. In any case, as
    Hikma argues, given that Mitigare’s label recites a 0.6 mg
    “once or twice daily” recommendation and a “maximum
    dose” recommendation, J.A. 137, it is natural to read
    “reducing the dose frequency” as just instructing reducing
    18       TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    0.6 mg from twice daily to once daily and not to achieve
    the 0.3 mg dose by administering 0.6 mg every other day.
    The district court’s findings on this issue were not clearly
    erroneous.
    With respect to the ’722 patent, which requires 0.6 mg
    of colchicine concomitantly administered with 240 ml of
    verapamil, the district court found that Takeda cited
    insufficient evidence this method would actually be prac-
    ticed. While Takeda points out that it submitted evidence
    that 240 ml was the “usual” dose of verapamil, we see no
    clear error in the district court’s finding that this was
    insufficient, especially since the issue is whether the
    concomitant administration occurs, and Hikma’s physi-
    cian experts declared that they try to and can easily avoid
    concomitant administration of the drugs. 6 Since there was
    insufficient proof of direct infringement here, we need not
    reach the question of whether there was evidence of
    inducement.
    CONCLUSION
    We conclude that the district court did not abuse its
    discretion in denying a preliminary injunction on the
    ground that Takeda had failed to meet its burden to show
    a likelihood of success on the merits. Because of our
    disposition, we need not reach Takeda’s other arguments.
    The main appeal is:
    AFFIRMED
    The cross-appeal is:
    6  The fact that one doctor said that he has pre-
    scribed colchicine concomitantly with the inhibitors is not
    evidence that other doctors would do the same, nor is it
    evidence of direct infringement since he did not speak of
    using Mitigare.
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   19
    DISMISSED AS MOOT
    COSTS
    Costs to Hikma.
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    TAKEDA PHARMACEUTICALS U.S.A., INC.,
    Plaintiff-Appellant
    v.
    WEST-WARD PHARMACEUTICAL CORPORATION,
    HIKMA AMERICAS INC., HIKMA
    PHARMACEUTICALS PLC,
    Defendants-Cross-Appellants
    ______________________
    2015-1139, 2015-1142
    ______________________
    Appeals from the United States District Court for the
    District of Delaware in No. 1:14-cv-01268-SLR, Judge Sue
    L. Robinson.
    ______________________
    NEWMAN, Circuit Judge, dissenting.
    This is not a simple question of the legal status of pa-
    tented uses of unpatented drugs. This is a legal policy
    issue, for the patent law implements a complex balance
    between the incentive to develop new medicinal treat-
    ments in the public interest, while facilitating competition
    after patent expiration.
    The product colchicine has been used to treat gout for
    centuries, but was known to have highly toxic side effects.
    Takeda discovered and developed modes of treatment at
    reduced toxicity. Takeda took these methods and prod-
    ucts through clinical trials and FDA approval, and ob-
    2    TAKEDA PHARMACEUTICALS U.S.A.    v. HIKMA AMERICAS INC.
    tained patents on the treatment methods. My colleagues
    hold that none of these patents is enforceable against
    Hikma, a new provider of colchicine.
    It is agreed that Hikma is not a direct infringer of the
    Takeda patents, and my colleagues hold that Hikma does
    not induce infringement because the official Hikma “la-
    bel” does not contain directions to use colchicine in ac-
    cordance with the Takeda patented uses. Takeda argued
    that it suffices that the Hikma label directs patients to
    tell a health care provider if the affliction of acute gout
    flares arises, because the health care provider will pre-
    scribe the Takeda method of use. My colleagues hold that
    such circumstance cannot produce induced infringement.
    In my view, these events do not produce a simple,
    bright line rule of law. In this preliminary injunction
    proceeding, the parties produced conflicting evidence as to
    the prevalence of gout flares and the likelihood that a
    doctor would prescribe the patented Takeda treatments.
    Precedent is also conflicting if generalized to all circum-
    stances. In Toshiba Corp. v. Imation Corp., 
    681 F.3d 1358
    , 1364 (Fed, Cir. 2012), this court held that “[t]he
    existence of a substantial non-infringing use does not
    preclude a finding of inducement.” But in Warner-
    Lambert Co. v. Apotex Corp., 
    316 F.3d 1348
    , 1366 (Fed.
    Cir 2002) this court said that “[w]here a product has
    substantial noninfringing uses, intent to induce infringe-
    ment cannot be inferred even when [the accused infring-
    er] has actual knowledge that some users of its product
    may be infringing the patent.”
    The panel majority today adopts a rule that induce-
    ment cannot be found, whatever the facts of the particular
    medicament and use. That is seriously flawed, for the
    variety of medicinal situations is unlimited. In turn, the
    public interest in new uses, new methods, and new com-
    bination treatments is disserved by a rule that is a disin-
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   3
    centive to the development of new uses of unpatented
    medicinal products.
    Thus I dissent from the court’s ruling that the provid-
    er of a known drug product, with knowledge that it is
    likely to be used in direct infringement, can never be
    liable for induced infringement. These are fact-specific
    circumstances, and are not amenable to final disposition
    at a preliminary injunction hearing. The question re-
    quires trial on the facts of this case.
    DISCUSSION
    The panel majority presents an incomplete picture of
    the facts and the law and ignores the public interest in
    the development of improved methods of treatment.
    Although colchicine is a known gout treatment,
    Takeda, through its predecessor Mutual, developed new
    treatment protocols for acute gout flares, conducted
    clinical trials, including treatment for patients concomi-
    tantly taking other drugs, and secured FDA approval for
    safety and efficacy of specified dosages and combinations
    and schedule of administration. This information is
    included on the FDA-approved Takeda label, and omitted
    from the Hikma label.
    Hikma provides colchicine capsules in the same 0.6
    mg dosage as the Takeda approved product, but the FDA
    permitted Hikma to omit from its label the combinations
    and acute flare treatment method patented by Takeda.
    Instead, the Hikma label instructs users that if acute gout
    flares arise, “tell your healthcare provider.” 1
    1     The FDA initially objected to this omission from
    the Hikma label, stating that “If Mitigare is being used
    for prophylaxis, it may be natural for the provider to use
    it for acute treatment as well.” Hikma then added to its
    label that Mitigare was not “studied” for “safety and
    4    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    Takeda argues that the Hikma label statement is an
    inducement to infringe, providing testimony from physi-
    cians that they would tell the patient to use the Takeda
    protocol. Hikma provided contrary testimony. My col-
    leagues on this panel hold that it is “not sufficient for
    inducement” that physicians and patients would directly
    infringe the Takeda patents. Maj. Op. at 11. To the
    contrary, it is highly relevant, for this situation does not
    lend itself to a rigid, all-purpose rule of law. This should
    be a fact-dependent, case-by-case determination based on
    evidence of likelihood and intent for the particular unpat-
    ented drug and patented new use.
    The panel majority goes too far, and states a general
    rule that provides easy avoidance of patents on new uses
    and improvements. The Hatch-Waxman Act is intended
    to encourage drug research and development, not to
    provide a disincentive by negating enforcement of im-
    provement patents by the simple expedient of omitting
    the improvement from the label. With the removal of the
    patent incentive for improvements, the loser is the afflict-
    ed public.
    The panel majority is incorrect in stating that “in the
    Hatch-Waxman Act context . . . . [t]he label must encour-
    age, recommend, or promote infringement.” Maj. Op. at
    11 (citing Metro-Goldwyn-Mayer Studios Inc. v. Grokster,
    Ltd., 
    545 U.S. 913
    , 936 (2005). The FDA label is not a
    vehicle of promotion of any use; it is a record of approved
    safety and efficacy of the product as used in accordance
    with the label. Nor does the FDA “aid and abet” in-
    fringement by including approved uses on the label.
    Grokster is a copyright case, and although there is com-
    mon law commonality in the word “inducement,” ques-
    tions of intent and scienter are as fact-specific in the
    effectiveness” of treatment of acute gout flares. On this
    statement, the FDA withdrew its objection.
    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.   5
    copyright field as in connection with patents. An over-
    simplified analogy between copyright and patent causes
    does not aid understanding of these complex issues.
    The panel majority also appears to misunderstand the
    Hatch-Waxman Act. The majority says “the statute was
    designed to enable the sale of drugs for non-patented uses
    even though this would result in some off-label infringing
    uses,” Maj. Op. at 11, citing purported authority in Cara-
    co Pharm. Labs., Ltd. v. Novo Nordisk A/S, 
    132 S. Ct. 1670
    , 1681-82 (2012); Warner-Lambert, 
    316 F.3d at 1359
    .
    That is a misreading of statute and precedent. The
    Hatch-Waxman Act is not designed to enable off-label
    uses, whether or not they are infringing.
    The cited cases do not hold otherwise. To the contra-
    ry, Warner-Lambert states that “‘[I]f there are indications
    which are claimed by any use patent and for which the
    [ANDA] applicant is not seeking approval, then an ANDA
    must state that the applicant is not seeking approval for
    those indications which are claimed by such use patent.’”
    
    316 F.3d at 1359
     (quoting House Report No. 98-857).
    Takeda argues that the Hikma label, which mentions
    acute gout flares but advises afflicted persons to see a
    physician instead of reciting the FDA-approved protocol,
    suffices to induce infringement. Unlike the facts of Warn-
    er-Lambert, Takeda is not “asserting patents on unap-
    proved uses,” 
    316 F.3d at 1359
    . It is infringement of the
    approved patented uses that Takeda states is induced by
    instructing the patient to tell a doctor in the event of
    acute flares. Takeda offered evidence that the physician
    is likely to prescribe the Takeda protocol and dosage for
    treatment of acute flares. Resolution of the question of
    inducement depends on the facts of the case. However,
    the panel majority rejects even the need for such resolu-
    tion, stating that “we need not decide whether evidence as
    to the invariable response of physicians could ever trans-
    6    TAKEDA PHARMACEUTICALS U.S.A.   v. HIKMA AMERICAS INC.
    form a vague label into active encouragement.” Maj. Op.
    13. To the contrary: that is the issue of this case.
    The trier of fact must have the opportunity to consider
    the evidence of how particular uses are made known and
    implemented for the Hikma product. The panel majority
    misstates my argument, for I do not propose that liability
    for inducement is automatic. Here, Hikma instructs that
    if acute flares arise, “tell your healthcare provider”; and
    Takeda presented evidence that the doctor is likely to
    prescribe the Takeda protocol, for that protocol is ap-
    proved by the FDA and is known to physicians who treat
    gout. The panel majority errs in discarding all this as
    irrelevant, for the knowledge and extent and likelihood of
    infringement are highly relevant to whether infringement
    is deemed induced.
    These aspects warrant full development of fact and
    law, and thoughtful application to this case.