Sandoz has agreed to pay $450 million to resolve antitrust litigation brought by 43 US states and territories over alleged anti-competitive conduct in the American generic medicines market. The Swiss drugmaker's US subsidiary, Sandoz Inc., will pay $400 million over seven years starting in 2027, with a further $50 million going to states that reached earlier settlements. The states' claims sit within the broader multidistrict proceedings, In re Generic Pharmaceuticals Pricing Antitrust Litigation, before the US District Court for the Eastern District of Pennsylvania, which has also handled parallel direct-purchaser and end-payer class actions against Sandoz. For in-house counsel at pharmaceutical manufacturers, the settlement structure is instructive. State attorneys general have shown particular staying power in pharmaceutical pricing enforcement, continuing to pursue claims years after related federal matters closed.