delivered the opinion of the court:
The defendants, TAP Pharmaceutical Products, Inc., TAP Pharmaceuticals, Inc. (collectively referred to as TAP), and Abbott Laboratories, Inc., appeal the trial court’s order certifying a nationwide class of individuals and businesses under Illinois law. On appeal, the defendants seek the decertification of the class. We affirm the trial court’s decision.
FACTS
Plaintiff class representative Acie C. Clark filed a class action complaint in Williamson County. He alleged unjust enrichment and a violation of Illinois’s Consumer Fraud and Deceptive Business Practices Act (Consumer Fraud Act) (815 ILCS 505/1 et seq. (West 2000)). Acie alleged that, as a result of the defendants’ fraudulent marketing and sales scheme, he, along with thousands of individuals and entities who paid copayment or deductible amounts for beneficiaries under Medicare, overpaid for the prescription drug Lupron, which is used to treat prostate cancer.
Acie alleged that Medicare reimbursement has historically relied on the “average wholesale price” (AWP) published in Redbook, a pharmaceutical publication. Medicare reimbursed medical providers 80% of the allowable amount, and the Medicare beneficiary paid the remaining 20%, referred to as the copayment amount. Acie contended that the defendants wrongfully supplied Redbook with an inflated AWP, i.e., that the prices the defendants charged private-sector purchasers for Lupron were significantly less than the price published in Redbook and relied upon by Medicare and its beneficiaries. Acie claimed that the defendants’ fraudulent scheme induced medical providers to purchase, prescribe, and administer Lupron at a low cost, bill Medicare at the inflated cost, and earn a profit from the difference. Acie claimed that, therefore, in essence, the defendants created an improper kickback for their physician customers and increased their own profits and market share. Acie alleged that as a result of the defendants’ wrongful inflation scheme, he and those similarly situated substantially overpaid all or part of their 20% copayments for Lupron.
During his deposition on January 10, 2002, James Salanty, a former employee of TAR testified that the defendants calculated the AWP of Lupron, which was reported to Redbook, by multiplying the wholesale acquisition cost, a competitive price in the marketplace, by 1.25. Salanty testified that, in response to the lowest cost alternative (LCA) program, which some states implemented in 1997 to deal with such price-fixing and which decreased the physicians’ reimbursement for Lupron, TAP further discounted the price for doctors who were subject to the LCA reimbursement to maintain the spread.
The defendants submitted the affidavit of Christopher M. Gonzalez, M.D., who stated that his compensation is completely unaffected by the amount of Lupron he prescribes, that he generally was not aware of how patients pay for their services, i.e., whether they have Medicare, and that he uses Lupron because of patient preference and ease of administration, as opposed to profit incentives.
The defendants also submitted the affidavit of Stanley Weintraub, director of reimbursement for a health care consulting and advisory firm and a former senior policy advisor for the Health Care Financing Administration, who stated that to determine the relationship between the class member’s Medicare copayment and the AWP for Lupron, one must define the following groups: “(a) individuals who were prescribed Lupron by participating physicians; (b) individuals who were prescribed Lupron by non[ ]participating physicians; (c) individuals who reside in states where a ‘least costly alterative’ reimbursement policy has been applied to Lupron reimbursement; (d) individuals who are 65 years or older and still employed for whom Medicare is a secondary insurer; (e) insurers, both commercial (such as Medigap insurers) and non[ ] commercial (such as state Medicaid agencies, including Medicaid Managed Care agencies), who paid claims for part or all of the 20% Medicare part B co[ ]payment and/or deductible for Lupron; and (f) individuals who are members of Medicare HMOs [who do not pay copayments].”
At Rachel and Acie Clark’s depositions on December 27, 2001, Rachel testified that after reading information regarding the overcharge for Lupron, she contacted her husband’s attorneys. Acie testified that his responsibility as a plaintiff in this suit was to represent the best interests of the class. Acie stated that he, his wife, and his lawyer composed the class. Acie testified that he did not expect to receive funds from the lawsuit but expected to obtain Lupron at a lower cost. Acie testified that he did not understand the claims described in the complaint and did not recognize the responses to the defendants’ discovery requests that he had signed.
Acie’s class counsel also represent different named plaintiffs in a nationwide federal Racketeer Influenced and Corrupt Organizations (RICO) class action based on the same factual allegations. Goetting v. TAP Pharmaceutical Products, Inc., No. 01 — 0703 (filed S.D. Ill. October 24, 2001). The Judicial Panel on Multidistrict Litigation consolidated the Goetting action with other federal class actions related to Lupron pricing practices. The plaintiffs’ counsel’s multidistrict litigation complaint includes an action under Illinois’s Consumer Fraud Act and an action for unjust enrichment, in addition to five federal RICO causes of action and a common law fraud action against these defendants.
On November 15, 2001, the plaintiffs in the case sub judice moved for class certification, and on March 12, 2002, after hearing arguments, the trial court certified the following as a nationwide class: “All individuals or non-ERISA third-party payor entities in the United States who paid any portion of the 20% co[ jpayment or deductible amount for beneficiaries under the Medicare Part B for Lupron during the period 1993 through the present (the class period).”
On April 19, 2002, the trial court, pursuant to Supreme Court Rule 308 (155 Ill. 2d R. 308), certified the following questions to facilitate an immediate appellate review by this court:
“a. Whether common issues of fact and/or law predominate when each class member based his or its decision to use or purchase Lu-pron on factors unrelated to Lupron’s [AWP] and when each class member was subject to one of many different reimbursement methods depending on, inter alia: (a) the state in which the class member resides or whose regulations govern the class member’s reimbursement; (b) the Medicare carrier responsible for the individual class member’s reimbursement; (c) the nature of the individual class member’s medical care provider’s reimbursement request; (d) the type of entity from which the class member purchased Lupron; (e) the type of supplemental insurance program(s), if any, in which the individual class member is enrolled; and (f) the nature of the third party-payor class member entity and the services which it contracted to provide or purchase.
b. Whether, under the United States Constitution and Illinois choice[-]of[-]law principles, the Illinois Consumer Fraud Act can apply nationwide to claims of class members who are not Illinois residents and were not billed for Lupron in Illinois, especially in light of other similar class actions pending in various state and federal jurisdictions throughout the nation.
c. Whether, assuming the Illinois Consumer Fraud Act cannot apply nationwide to each class member’s claims, variations in the 50 [spates’ consumer protections laws create individual issues of law that predominate over common issues of law.
d. Whether a plaintiff who has a limited understanding of his own claims and the purpose of his own lawsuit can adequately represent a nationwide class of individuals and third party-payor entities and serve as its class representative.
e. Whether plaintiff’s counsel can simultaneously pursue this class action as well as a separate and potentially conflicting class action and still adequately protect the interests of the class in this case.
f. Whether a class action is an appropriate method for the fair and efficient adjudication of the controversy where: (a) mini[ jtrials will be necessary to determine whether each class member has a right to recover; (b) sub[ ]classification will be necessary to address critical variations in the consumer protection laws of the fifty states; and (c) multiple sets of instructions to the jury will be necessary to take into account the varying prima facie elements, standards of proof, and damages available depending on which state’s law applies.”
On October 28, 2002, this court granted the defendants’ petition for leave to appeal the national class-certification order.
ANALYSIS
To determine whether the proposed class should be certified, the court accepts the allegations of the complaint as true. Johns v. DeLeonardis,
To maintain a class action in Illinois, the court must find the following:
“(1) The class is so numerous that joinder of all members is impracticable.
(2) There are questions of fact or law common to the class, which common questions predominate over any questions affecting only individual members.
(3) The representative parties will fairly and adequately protect the interest of the class.
(4) The class action is an appropriate method for the fair and efficient adjudication of the controversy.” 735 ILCS 5/2 — 801 (West 2000).
Numerosity
The plaintiff’s complaint alleges thousands of plaintiffs nationwide, and the defendants do not dispute that the class is so numerous that the joinder of all members would be impractical. Accordingly, the first prerequisite of section 2 — 801 of the Code of Civil Procedure (735 ILCS 5/2 — 801(1) (West 2000)) is met.
Common Questions of Fact or Law
The defendants assert that the application of Illinois law to non-Illinois class members, whose transactions with non-Illinois medical care providers occurred in states other than Illinois, violates the due process and commerce clauses of the United States Constitution, principles of state sovereignty, and Illinois choice-of-law rules.
In Avery,
The substantive law of Illinois, the forum state, may be applied, consistent with the requirements of procedural due process, where Illinois has significant contact or aggregation of contacts to the claims asserted by each member of the plaintiff class, contacts creating state interests ensuring that the choice of its law is not arbitrary or unfair. Martin v. Heinold Commodities, Inc.,
The defendants’ deceptive practices involving the fraudulent inflation of the cost of Lupron were designed, established, and initiated from the defendants’ marketing and sales agents located at the defendants’ corporate headquarters in Illinois and were designed to be uniformly relied upon by Medicare and its beneficiaries nationwide when they overpaid for Lupron. See Avery,
Additionally, “[t]he resolution of this case under Illinois law does not violate another state’s sovereignty, nor is interstate commerce adversely impacted” (Avery,
Furthermore, applying Illinois’s Consumer Fraud Act to the present case does not violate Illinois’s choice-of-law principles. To determine which law applies, we look to the conflicts law of Illinois, the forum state. Esser v. McIntyre,
The injury to the plaintiffs, in paying the inflated cost of Lu-pron, occurred throughout the country, including Illinois. The conduct leading to the injury occurred in Illinois, i.e., the defendants’ marketing and sales agents, located in the defendants’ principal places of business in Illinois, concocted the fraudulent scheme to inflate the price of Lupron. Although the plaintiffs are domiciled throughout the country, the defendants’ principal places of business are in Illinois. The relationship of the parties, if any, is centered in Illinois, where the fraudulently inflated price of Lupron originated. Illinois may apply its law to the out-of-state occurrences because Illinois has the most significant relationship to the activity in question. See Ingersoll,
The defendants further contend that the class does not meet the predominance prerequisite to class certification because individual issues of law, required by the need to apply all 50 states’ laws to the nationwide class claims, along with individual issues of fact required by the materiality, proximate cause, and injury elements of a Consumer Fraud Act claim, are present. Specifically, the defendants assert that individual issues of fact, such as how class members made copayments for Lupron, whether the copayments were based on the published AWP for Lupron, and why their medical care providers administered Lupron, defeat class certification.
The plaintiffs assert that, at the trial, they will prove the following common questions of fact and law: that because the defendants lied about the AWP for Lupron, class members were injured by paying a price for Lupron that exceeded the amount they should have paid had the defendants properly disclosed the AWP; that Medicare and its patients were overcharged for Lupron by a specified percentage above the AWP; and that although damage calculations may be different based, for example, on whether the Medicare beneficiary was in an LCA state, the overpayment may reasonably be applied on a subclass-wide basis.
We have previously determined that Illinois’s Consumer Fraud Act may apply to the present case (see Avery,
So long as questions of fact or law common to the class predominate over questions affecting only individual members of the class, the statutory requisite is met. Steinberg v. Chicago Medical School,
“ ‘[A] class action will not be defeated solely because of some factual variations among class members’ grievances.’ ” Heastie v. Community Bank of Greater Peoria,
Individual questions of injury and damages do not defeat class certification. Heastie,
The record reveals the question common to the class that predominates over questions affecting individual class members: whether the defendants engaged in a fraudulent and deceptive scheme to charge Medicare, its beneficiaries, and third-party payors an inflated cost for the prescription drug Lupron. See 815 ILCS 505/2 (West 2000); Thacker v. Menard, Inc.,
The fact that some class members were billed based on the provider’s actual cost, the provider’s “estimated acquisition cost,” or the AWP for the “least costly alternative” to Lupron involves questions of complexity or uncertainty regarding the amount of damages and does not present individual issues to bar class certification. See In re Folding Carton Antitrust Litigation,
The defendants assert that the plaintiffs’ unjust enrichment claim is also swamped with individual issues of fact that overwhelm the common issues because, the defendants contend, to show that the defendants benefited from the increased sales and market share of Lu-pron that flowed from the deceptive conduct, a physician-by-physician evaluation must be conducted to determine why each physician decided to administer Lupron. The plaintiffs counter that to establish their unjust enrichment claim, they will address the common question of whether the defendants fraudulently inflated the cost of Lupron and determine the defendants’ profit from their illegal conduct, which would be unrelated to individual class members but divided among the class members based upon their out-of-pocket losses.
To prove a claim of unjust enrichment, a plaintiff must show that the defendant has unjustly retained a benefit to the plaintiffs detriment and that the defendant’s retention of that benefit violates fundamental principles of justice, equity, and good conscience. HPI Health Care Services, Inc. v. Mt. Vernon Hospital, Inc.,
Representative Party
The defendants next assert that Acie and his counsel will not adequately represent the proposed class because Acie does not have a basic understanding of his claims or the class he represents and because counsel are simultaneously pursuing an overlapping class action in the federal multidistrict litigation proceedings, thereby creating a possible conflict of interest.
“The purpose of the adequate representation requirement is merely to ensure that all class members will receive proper, efficient, and appropriate protection of their interests in the presentation of the claim.” Gordon,
Class certification is not defeated even though Acie’s wife, as opposed to Acie, initiated contact with counsel, Acie may not understand the complexities of his complaint, and Acie has little knowledge of the intricacies of his lawsuit. See Surowitz,
Due process requires that the plaintiffs’ attorney be qualified, experienced, and able to conduct the proposed litigation. Steinberg,
Class Action Is Appropriate Method
The defendants assert that the class action is not the appropriate method for the fair and efficient adjudication of the controversy, given the need for extensive subclasses to address variations in state law, the need for minitrials to resolve individual issues of fact attendant to each class member’s claims, and the pendency of other actions around the nation that will address the claims of the absent class members in this case.
To satisfy the “appropriate method” requirement, the plaintiff must demonstrate that the class action (1) can best secure the economies of time, effort, and expense and promote a uniformity of decision or (2) can accomplish the other ends of equity and justice that class actions seek to obtain. McCabe,
Applying these principles to the record before us, we conclude that a class action is appropriate in the case at bar. Initially, our holding that the first three prerequisites of section 2 — 801 of the Code of Civil Procedure have been established makes it evident that the fourth requirement has been fulfilled. See Steinberg,
In conclusion, the record supports the trial court’s decision. We caution the trial court, however, that in the future it should make findings to support its legal conclusions. See Besinga v. United States,
Having addressed the defendants’ contentions and the trial court’s questions, we affirm the trial court’s decision certifying the suit as a class action.
CONCLUSION
For the foregoing reasons, we affirm the order of the circuit court of Williamson County.
Affirmed.
