Health plan plaintiffs scored big in a trio of appellate rulings in multidistrict litigation over Pfizer Inc.’s off-label marketing of Neurontin. The U.S. Court of Appeals for the First Circuit affirmed a $142 million verdict against the company and revived class certification plus racketeering and state law claims.

The MDL, which dates to November 2004, followed Pfizer division Warner-Lambert’s May 2004 deal with the government to settle off-label marketing charges. The company pleaded guilty to two mislabeling charges and agreed to pay a $240 million criminal fine and $190 million in civil fines.