By a 5-3 vote, the court in Federal Trade Commission v. Actavis held that such deals are not presumptively illegal under antitrust laws, but it said the government should be able to make a case that individual settlements are anticompetitive, under a "rule of reason" standard.

Justice Stephen Breyer, probably the court's prime antitrust expert, wrote for the majority that the "risk of significant anticompetitive effects" flowing from reverse payments outweigh the desirability of the settlements between drug makers.