Lidoderm Antitrust Litigation

Consumer Claim Form

Section A: Claimant Identification

*By providing your e-mail address, you authorize the Claims Administrator to use it in providing you with information relevant to this claim.

Section B: Should I File a Claim Form

You must meet the following criteria to be eligible for a payment from the Proposed Settlements:

  • Paid for some or all of the purchase price of (i) branded Lidoderm during the time period from August 23, 2012 through September 14, 2013, and/or (ii) AB-rated generic Lidoderm (Lidocaine 5% patch) during the time period from September 15, 2013 to August 1, 2014;
  • For consumption by you or your family member (i.e. not for resale);
  • In one or more of the following states: Arizona, California, Florida, Kansas, Maine, Massachusetts, Minnesota, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, South Dakota, Tennessee, West Virginia, or Wisconsin (the Class States); and
  • If submitting a claim based on purchases of branded Lidoderm, you would have bought the generic had it been available.

Excluded from the Class and from the Proposed Settlements are:

  • Any consumer who, after September 15, 2013, paid for branded Lidoderm and did not purchase generic Lidoderm;
  • Any consumer who purchased Lidoderm or generic Lidoderm only via a “single flat copay,” meaning that your insurance copayment was the same regardless of whether you purchased brand or generic Lidoderm (for example, if you paid a $20 co-pay for both branded and generic drugs);
  • Any consumer who purchased Lidoderm and/or generic Lidoderm (Lidocaine patch 5%) only through a Medicaid program;
  • Officers, directors, managers, or employees of defendants Endo Pharmaceuticals Inc. ("Endo"); Teikoku Pharma USA, Inc. or Teikoku Seiyaku Co., Ltd. (together, "Teikoku"); or Actavis, Inc. (f/k/a Watson Pharmaceuticals, Inc.), Watson Laboratories, Inc., Actavis plc, Anda Inc., Anda Pharmaceuticals, Inc., or Valmed Pharmaceuticals, Inc. (together, "Watson"); and
  • Any judge or justice assigned to hear any aspect of this lawsuit or their immediate family.

Required