The state of play before the UPC
Before the UPC there are no statutory provisions regarding infringement of second medical use claims. Thus, it is a judicial task to define the limits of infringement of these claims and there is no harmonized approach yet, let alone one endorsed by the UPC Court of Appeal.
The nature of the second medical use claim is a purpose-limited product claim. Thus, these claims can be infringed like product claims, i.e. directly and indirectly (cf. Art. 25(a) UPCA, Art. 26 UPCA resp.). As of today, the UPC Court of First Instance has dealt with second medical use claims in a number of cases (UPC_CFI_552/2025, Gilead Sciences v Academy of Military Medical Sciences, 4 May 2026; UPC_CFI_146/2024, Sanofi v STADAPHARM GmbH, 12 December 2025; APL_24205/2025, ORD_33516/2025, BOEHRINGER v ZENTIVA, 13 August 2025). However, the question of the relevant infringement test for second medical use claims was only comprehensively dealt with in the landmark decision of the Local Division Düsseldorf delivered on May 13, 2025 (UPC_CFI_505/2024, Sanofi v Amgen). Here, the Court held that direct infringement of such claims is not limited to scenarios where the product is already or actually being used for the claimed therapeutic purposes. In the Court’s view this would unduly limit the protection of the patent proprietor.
For a finding of direct infringement of a second medical use claim, the alleged infringer must offer or place the medical product on the market in such way that it (i) either leads or (ii) at least may lead to the claimed therapeutic use of which the alleged infringer (i) either knows or (ii) at least reasonably should have known that it does. Thus, this test comprises an objective element, i.e. a governing prescription practice or at least circumstances which allow concluding that such a practice may be expected to occur. In addition, this test includes a subjective element, i.e. the infringer must (i) either know about the objective element or (ii) at least reasonably should have known.
Reducing this two-pronged test to practice requires a case-by-case analysis taking into account all the relevant facts of the case at hand. Pursuant to the Local Division Düsseldorf, the relevant facts may include:
- the extent or significance of the allegedly infringing use,
- the relevant market, including what is customary on that market,
- the market share of the claimed use compared to other uses,
- what actions the alleged infringer has taken to influence the respective market,
- either “positively”, de facto encouraging the patented use,
- or “negatively” by taking measures to prevent the product from being used for the patented use.
For both the objective and the subjective element, the burden of pleading and proof rests with the plaintiff (cf. Art. 54 UPCA). In the absence of a proven prescription practice occurring to a relevant extent, as means of evidence, the manufacturing and putting on the market of the accused product as well the package insert and the Summary of Product Characteristics (SmPC) are of utmost relevance. The same holds true for marketing statements, press releases, and websites provided that information is presented in a way of a recommendation for using the accused product for the patented use. With respect to the SmPC, the section about the therapeutic indications plays a crucial role. In most cases, the accused product is marketed with a label explicitly carving out the claimed therapeutic use. For prescription medicines, this means that physicians prescribing the accused product for the claimed therapeutic use engage in “off-label” prescriptions. However, depending on the circumstances, e.g. the country where the accused product is prescribed, there may be different hurdles for the physician for an “off-label” prescription, such as a need for medical justification, or the risk of a refusal of reimbursement or recourse by the health insurance funds. Against this background, it is by no means an easy task to successfully assert second medical use claims before the UPC.