Acorda Therapeutics, Inc. v. Roxane Laboratories, Inc. , 903 F.3d 1310 ( 2018 )


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  •   United States Court of Appeals
    for the Federal Circuit
    ______________________
    ACORDA THERAPEUTICS, INC.,
    Plaintiff-Appellant
    ALKERMES PHARMA IRELAND LIMITED,
    Plaintiff-Appellee
    v.
    ROXANE LABORATORIES, INC., MYLAN
    PHARMACEUTICALS INC., TEVA
    PHARMACEUTICALS USA, INC.,
    Defendants-Cross-Appellants
    ______________________
    2017-2078, 2017-2134
    ______________________
    Appeals from the United States District Court for the
    District of Delaware in Nos. 1:14-cv-00882-LPS, 1:14-cv-
    00922-LPS, 1:14-cv-00935-LPS, 1:14-cv-00941-LPS, Chief
    Judge Leonard P. Stark.
    ______________________
    Decided: September 10, 2018
    ______________________
    BRUCE M. WEXLER, Paul Hastings LLP, New York,
    NY, argued for plaintiff-appellant. Also represented by
    STEPHEN BLAKE KINNAIRD, IGOR VICTOR TIMOFEYEV,
    Washington, DC; GARRARD R. BEENEY, WENYING ANGELA
    CHANG, STEPHEN J. ELLIOTT, Sullivan & Cromwell LLP,
    2     ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.
    New York, NY; ANTHONY MICHAEL, JANE G. WASMAN,
    Acorda Therapeutics, Inc., Ardsley, NY.
    MARYELLEN NOREIKA, Morris, Nichols, Arsht & Tun-
    nell LLP, Wilmington, DE, for plaintiff-appellee. Also
    represented by JEREMY A. TIGAN.
    CHARLES B. KLEIN, Winston & Strawn LLP, Washing-
    ton, DC, argued for defendants-cross-appellants. Defend-
    ants-cross-appellants Roxane Laboratories, Inc., Teva
    Pharmaceuticals USA, Inc. also represented by ANDREW
    CURTIS NICHOLS; BRYCE COOPER, GEORGE C. LOMBARDI,
    REID SMITH, Chicago, IL.
    ROBERT FLORENCE, Parker Poe Adams & Bernstein
    LLP, Atlanta, GA, for defendant-cross-appellant Mylan
    Pharmaceuticals Inc. Also represented by MICHEAL L.
    BINNS, KAREN L. CARROLL.
    SARAH ANNE KAGAN, Banner and Witcoff, Ltd., Wash-
    ington, DC, for amicus curiae Biotechnology Innovation
    Organization. Also represented by MELISSA A. BRAND,
    LISA MEREDITH HEMMENDINGER; HANSJORG SAUER, Bio-
    technology Innovation Organization, Washington, DC.
    SCOTT E. KAMHOLZ, Covington & Burling LLP, Wash-
    ington, DC, for amicus curiae Pharmaceutical Research
    and Manufacturers of America. Also represented by
    BRIANNE BHARKHDA; DAVID EVAN KORN, Pharmaceutical
    Research and Manufacturers Association of America,
    Washington, DC.
    ______________________
    Before NEWMAN, DYK, and TARANTO, Circuit Judges.
    Opinion for the court filed by Circuit Judge TARANTO.
    Opinion dissenting filed by Circuit Judge NEWMAN.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   3
    TARANTO, Circuit Judge.
    Before us are patents that claim the administration of
    a medication containing the active ingredient 4-
    aminopyridine (4-AP) to improve walking in individuals
    with multiple sclerosis. Acorda Therapeutics, Inc., holds
    New Drug Application No. 022250, approved by the U.S.
    Food and Drug Administration (FDA). Pursuant to that
    approval, Acorda markets, under the name “Ampyra®,”
    10 milligram 4-AP sustained-release tablets for twice-
    daily oral administration. In the FDA’s Approved Drug
    Products with Therapeutic Equivalence Evaluations, or
    Orange Book, Acorda has listed, as claiming methods of
    using Ampyra, four patents that Acorda owns: U.S. Pa-
    tent No. 8,007,826; No. 8,663,685; No. 8,354,437; and
    No. 8,440,703. Those patents (“the Acorda patents”) are
    the main patents at issue on appeal.
    One additional patent is before us. Acorda holds an
    exclusive license to an earlier, broader patent, 
    U.S. Patent No. 5,540,938,
     referred to as “the Elan patent” because it
    was originally assigned to Elan Corporation, plc (whose
    successor in interest is Alkermes Pharma Ireland Ltd.).
    The Elan patent, listed in the Orange Book for Ampyra
    along with the Acorda patents, claims methods of treating
    patients having certain conditions, including multiple
    sclerosis, by administering a drug containing a sustained-
    release formulation of any of certain agents, one of them
    4-AP. The later Acorda patents claim species of the Elan
    patent’s genus claims by adding further, more specific
    requirements to the Elan patent’s claimed methods.
    While the Elan patent’s claims broadly cover administer-
    ing a sustained-release formulation of 4-AP to individuals
    with multiple sclerosis, the Acorda patents’ claims further
    specify that such a drug must be administered (1) in a
    10 mg dose twice a day (2) at that stable dose for the
    entire treatment period of at least two weeks (3) to
    achieve 4-AP serum levels of 15–35 ng/ml and (4) to
    improve walking.
    4   ACORDA THERAPEUTICS, INC.    v. ROXANE LABORATORIES, INC.
    Roxane Laboratories, Inc.; Mylan Pharmaceuticals,
    Inc.; and Teva Pharmaceuticals USA, Inc., have submit-
    ted Abbreviated New Drug Applications seeking FDA
    approval to market generic versions of Ampyra. In July
    2014, Acorda and Alkermes sued those entities (“defend-
    ants”) in the District of Delaware, alleging infringement
    of several claims in each of the Elan and Acorda patents.
    The defendants stipulated to infringement but challenged
    the validity of the asserted claims. The district court held
    that the asserted claims in the Acorda patents are invalid
    for obviousness. But the court upheld the asserted claims
    of the Elan patent against invalidity challenges and
    enjoined the defendants from activity infringing that
    patent until it expired on July 30, 2018.
    Acorda appealed the invalidity ruling regarding the
    Acorda patents.     The defendants cross-appealed the
    validity ruling regarding the Elan patent and the result-
    ing injunction. We now affirm the judgment that the
    asserted Acorda patent claims are invalid. We dismiss
    the cross-appeal as moot.
    I
    A
    In view of our decision that the issues concerning the
    Elan patent are moot, we focus on the background of the
    Acorda patents. Essential to understanding the obvious-
    ness issue is an understanding of the prior art.
    4-AP, also called “dalfampridine” and “fampridine,”
    was first identified in 1902. Acorda Therapeutics, Inc. v.
    Roxane Labs., Inc., No. 1:14-cv-00882-LPS, 
    2017 WL 1199767
    , at *3, *5 (Mar. 31, 2017) (Dist. Ct. Op.). Belong-
    ing to a class of compounds that function as potassium-
    channel blockers, 4-AP “has been found to slow the potas-
    sium flow in nerve impulse transmission” and, by doing
    so, help “restor[e] conduction in blocked and demyelinated
    nerves,” ’826 patent, col. 2, lines 5–11, i.e., nerves whose
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   5
    myelin insulation has been damaged. 4-AP was first used
    in human studies in the 1970s to investigate its effect on
    neurological diseases resulting in muscle weakness. Dist.
    Ct. Op. at *5. For several decades, 4-AP has been the
    focus of research regarding the treatment of multiple
    sclerosis in particular. See, e.g., 
    id.
     at *5–7 (reciting
    studies); J.A. 6697 (paper published in 1987 describing
    study of the effect of 4-AP on subjects with multiple
    sclerosis). Multiple sclerosis causes the demyelination, or
    loss of myelin, of nerves in the central nervous system
    and results in a wide variety of symptoms, including
    walking impairment, tingling or pain, brain scarring,
    cognitive changes, visual impairments, and fatigue. See
    ’826 patent, col. 1, lines 36–42; Dist. Ct. Op. at *2. Even-
    tually, 4-AP research led to the development, patenting,
    and FDA approval of Ampyra.
    1
    In the 1980s, researchers at the Rush Medical School
    conducted a study on 12 patients with multiple sclerosis,
    and 5 without, to determine whether intravenous admin-
    istration of 7 to 35 mg of 4-AP had any therapeutic effect
    on multiple sclerosis. J.A. 6697 (Dusan Stefoski et al., 4-
    Aminopyridine Improves Clinical Signs in Multiple Scle-
    rosis, 21 Annals of Neurology 71 (1987)). According to the
    published paper reporting that study (Stefoski), 10 of the
    12 patients with multiple sclerosis “showed mild to
    marked improvement”; “[v]ision improved in 7 patients,
    oculomotor function in 5, and motor function (power,
    coordination, gait) in 5.” J.A. 6697. Improvements were
    seen at doses as low as 2 mg: In one patient, gait im-
    provement occurred within 25 minutes of administration
    of a total dose of 2 mg. J.A. 6699. Stefoski also reported:
    [W]e observed no serious or bothersome side ef-
    fects at total doses below 30 to 35 mg injected not
    less than 20 minutes apart for aliquots up to
    3 mg. Moreover, the clinical improvements in
    6   ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.
    many of our patients were of sufficient magnitude
    to represent a functionally noteworthy therapeutic
    benefit. Studies are currently in progress to de-
    termine the clinical usefulness of oral 4-AP as a
    symptomatic treatment.
    J.A. 6701; accord J.A. 6697.
    In 1990, an overlapping group of researchers pub-
    lished a paper (Davis) reporting another study on 4-AP’s
    effect on symptoms of multiple sclerosis. J.A. 6327 (Floyd
    A. Davis et al., Orally Administered 4-Aminopyridine
    Improves Clinical Signs in Multiple Sclerosis, 27 Annals
    of Neurology 186 (1990)). In that study, 20 patients with
    multiple sclerosis were given either a single oral dose of 4-
    AP (15 patients) or a placebo (5 patients). J.A. 6327. Of
    those in the active treatment group, 4 patients were given
    a 10 mg dose of 4-AP, 2 were given 12.5 mg, 4 were given
    15 mg, 4 were given 20 mg, and 1 was given 25 mg. Davis
    at 187 tbl.1. Davis states that “[m]ild to marked im-
    provements occurred in all of the 15 [multiple sclerosis]
    patients given 4-AP.” J.A. 6329; accord J.A. 6327. “Im-
    provements developed gradually with doses as low as
    10 mg 4-AP, usually beginning within 60 minutes after
    drug administration.” J.A. 6329. Motor function im-
    proved in 9 of 13 patients in the active treatment group
    (motor function was not measured in 2). Davis at 187
    tbl.1; J.A. 6329. The improvements were “most striking[]
    with respect to power and coordination” and “were appar-
    ent with both simple function tests and the performance
    of complex motor tasks such as gait and repetitive move-
    ments.” J.A. 6329. Finally, Davis notes, no “serious or
    bothersome side effects,” including seizures, were ob-
    served at single oral doses up to 25 mg. J.A. 6332.
    A few years later, researchers at a university hospital
    in the Netherlands published a paper (Van Diemen)
    reporting a randomized, double-blind, placebo-controlled
    crossover study that “demonstrated efficacy of [4-AP] in
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   7
    improving disability of patients with multiple sclerosis.”
    J.A. 7037 (Harriët A. M. Van Diemen et al., 4-
    Aminopyridine in Patients with Multiple Sclerosis: Dosage
    and Serum Level Related to Efficacy and Safety, 16 Clini-
    cal Neuropharmacology 195 (1993)). In the second phase
    of the study lasting 12 weeks, 69 patients were orally
    administered 10–20 mg 4-AP per day, split into two or
    three doses. J.A. 7038, 7042. The doses were escalated
    during the second week, and again during the sixth week,
    by 5–15 mg. J.A. 7038–39. The paper reports improve-
    ments in certain measures of eye functioning. J.A. 7042.
    And it reports that “side effects were mild” for those
    patients given oral doses of 4-AP (versus intravenous 4-
    AP). J.A. 7045; see also Van Diemen at 200–01 (no sei-
    zures).
    Soon thereafter, some of the same researchers pub-
    lished a second paper (Polman) about the long-term
    efficacy and safety of 4-AP given to patients with multiple
    sclerosis.    J.A. 6654 (Chris H. Polman et al., 4-
    Aminopyridine in the Treatment of Patients with Multiple
    Sclerosis, 51 Archives of Neurology 292 (1994)). Polman
    reports a study of 31 patients with multiple sclerosis, 19
    of whom took a stable dose of 4-AP between 10–50 mg per
    day (the exact dose for each patient is unknown), and 12
    of whom initially took 10–15 mg per day and then took
    increasing doses in 4 to 8 weeks. J.A. 6655; see J.A. 7042.
    In the first group, 18 of the 19 patients “had a favorable
    response to the medication” and “reported a subjective
    improvement in the ability to perform the activities of
    normal daily life, which was mainly owing to improved
    ambulation and reduction in severity of fatigue.”
    J.A. 6655. In 3 patients, the subjective improvement was
    significant on the Expanded Disability Status Scale
    (EDSS), id.—a composite measure of function in multiple
    sclerosis patients, including a walking component, that is
    “widely accepted in the [multiple sclerosis] community,”
    Dist. Ct. Op. at *8; see 
    id. at *30
    ; J.A. 6681. In the second
    8   ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.
    group, 6 patients reported a “favorable response” to 4-AP
    treatment, “as defined by the ability to perform activities
    of normal daily life.” J.A. 6655–56. One patient demon-
    strated a significant improvement in EDSS score.
    J.A. 6656.
    Overall, 23 patients (17 in the first group; 6 in the
    second group) continued active treatment for 6 to 32
    months, with daily doses ranging from 15–40 mg.
    J.A. 6655–56. Those patients “indicated the drug to be
    beneficial because, by improving several neurologic func-
    tions, it increased their capability to perform the activi-
    ties of normal daily life,” including—for 13 of the 23
    patients—a reported improvement in ambulation and
    fatigue. J.A. 6656 & tbl.1; see J.A. 6654. 1 The paper
    states:
    Although a placebo effect cannot be excluded, the
    dynamics of the response in relation to the intake
    of the medication and the deterioration and sub-
    sequent improvement in functioning during a
    drug-free interval and subsequent restarting of
    the therapy are, in our view, highly suggestive of
    a real effect being induced by the 4-[AP]. Im-
    provements in fatigue and ambulation were men-
    tioned quite often by the patients as being
    responsible for the favorable overall effect . . . .
    J.A. 6657. The paper thus reports improvements in
    specific measures, while few patients experienced a
    significant change in EDSS, the overall composite meas-
    ure. 
    Id.
     As for adverse effects, two patients experienced a
    1   By comparison, only 5 reported an improvement
    in visual function; 4 in cognitive function/concentration;
    and 1 in diplopia (double vision), speech, spasticity, and
    urinary and fecal incontinence.      J.A. 6656 tbl.1; see
    J.A. 6654.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   9
    seizure—one on the second day of treatment and the other
    after 18 months of treatment. J.A. 6656–57. 2 Otherwise,
    the subjective side effects reported by the patients “never
    were reported to be very troublesome.” J.A. 6657.
    Polman states several conclusions and suggestions for
    further research. First, the study “demonstrates that 4-
    [AP] therapy, in the majority of patients who favorably
    respond to it, results in responses that can continue for
    periods of up to 32 months or more without interfering
    with the course of the disease.” Polman at 296. Second,
    the fact that “three major, though not life-threatening,
    side effects” occurred (including 2 seizures) “indicates that
    careful medical supervision is warranted during 4-[AP]
    therapy.” 
    Id.
     Third, based on the study data, the authors
    “suggest that approximately 30% of patients with [multi-
    ple sclerosis] will report a significant clinical response
    when they begin treatment with 4-[AP] and that 80% to
    90% of these responders will benefit from long-term
    administration. More studies are needed for further
    elaboration of the exact value of 4-[AP] in the long-term
    treatment of patients with [multiple sclerosis].” 
    Id.
    Around the same time, researchers at the University
    of Maryland, the Baltimore VA Medical Center, and Elan
    published a paper (Bever I) reporting the results of a
    randomized, placebo-controlled, double-blind, concentra-
    tion-controlled, crossover trial in 8 patients with multiple
    sclerosis. Christopher T. Bever, Jr., et al., The effects of
    4-aminopyridine in multiple sclerosis patients: Results of a
    randomized, placebo-controlled, double-blind, concentra-
    tion-controlled, crossover trial, 44 Neurology 1054 (1994);
    see J.A. 6180 (excerpt of Bever I). Noting that 4-AP has a
    “narrow toxic-to-therapeutic range[],” the study aimed to
    evaluate the toxicity and efficacy of 4-AP when the result-
    2   A third patient was presumptively diagnosed with
    a case of 4-AP-induced hepatitis. J.A. 6657.
    10 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    ing peak concentration in blood was low (30–59 ng/ml)
    versus when it was high (60–100 ng/ml). Bever I at 1055.
    Regarding toxicity, the report states that “[a]ll patients
    experienced side effects” when serum concentration was
    high, with two serious adverse events: a seizure when
    serum 4-AP peaked at 104 ng/ml, and an episode of en-
    cephalopathy when serum 4-AP peaked at 114 ng/ml. 
    Id. at 1054, 1056
    . Regarding efficacy, “[i]mprovements were
    seen in lower extremity strength,” including significant
    improvement in mean videotape scores of lower extremity
    strength (scoring muscle strength, reflexes, and ambula-
    tion) in both the low- and high-serum concentration
    ranges, although no significant changes were seen in
    EDSS scores or ambulation index (AI) scores. 3 
    Id.
     at
    1056–57 & tbl.4; but see 
    id. at 1058
     (commenting that the
    increased side effects from the short treatment duration
    “may have contributed to the lack of improvement in
    overall function (EDSS and AI scores)”).
    Bever I concludes that the therapeutic response was
    not concentration-related as between the two ranges
    tested and, therefore, that “[t]he lower serum concentra-
    tion range of 30 to 59 ng/ml may . . . be adequate for
    inducing improvement of some neurologic deficits.”
    Bever I at 1058; see 
    id.
     (“Because the high-serum-
    concentration arm produced much greater toxicity than
    the low without any obvious therapeutic advantage, it
    seems likely that clinically useful serum concentrations
    would be in the 30 to 59 ng/ml range.”). Bever I also
    states that the “rates of treatment-related improvements
    in visual and lower extremity motor function . . . were
    3    See Stephen L. Hauser et al., Intensive immuno-
    suppression in progressive multiple sclerosis, 
    308 New Eng. J. Med. 173
    , 174, 180 (1983) (ambulation index is a
    rating scale to assess mobility by measuring the time and
    degree of assistance needed to walk 25 feet).
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 11
    similar to those reported in similar short-term trials of [4-
    AP],” including Stefoski and Davis. Bever I at 1057–58.
    The article notes the limitations of the earlier trials’
    designs, including “questions about blinding, failure to
    randomize treatment, and failure to either use prospec-
    tively defined neurologic deficits or adjust significance
    levels to compensate for multiple comparisons.” 
    Id. at 1058
    . Bever I then observes that another study “ad-
    dressed some of the design weaknesses in earlier studies
    and suggested that not only can AP treatment improve
    specific residual deficits, but it can also improve overall
    function.” 
    Id.
    The same year as Bever I appeared, Dr. Bever, with
    the University of Maryland and the Baltimore VA Medical
    Center, published a review article on studies of the effect
    of 4-AP on multiple sclerosis (Bever II). Christopher T.
    Bever, Jr., The Current Status of Studies of Amino-
    pyridines in Patients with Multiple Sclerosis, 36 Annals of
    Neurology S118 (1994); see J.A. 6172 (excerpt of Bever II).
    The article states: “Recently completed randomized,
    double-blind, placebo-controlled trials show that treat-
    ment with the potassium channel blockers 4-
    aminopyridine (AP) or 3,4-diaminopyridine (DAP) can
    improve residual neurological deficits in some multiple
    sclerosis (MS) patients.” Bever II at S118; accord 
    id.
     at
    S120. As to efficacy, “[t]hese studies suggest that amino-
    pyridines may provide a new approach to the symptomat-
    ic treatment of [multiple sclerosis].” 
    Id.
     at S118. 4 As to
    4   Although criticizing a few 4-AP studies as involv-
    ing a small sample size or lacking a double-blinded or
    randomized design, Bever II also looked at “[l]arger
    randomized, double-blind, placebo-controlled crossover
    trials of” 4-AP with treatment periods as long as three
    months. J.A. 6172; accord Bever II at S118 (in the article
    abstract, stating that “[p]reliminary studies of [4-]AP
    12 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    toxicity, “seizures are common at higher doses,” but 4-AP
    “rarely cause[s] seizures at the doses used in [multiple
    sclerosis] trials.” 
    Id.
     at S120; see also 
    id.
     at S118 (“Both
    agents [4-AP and DAP] have rarely caused seizures.”).
    The paper notes that one 4-AP study “showed that side
    effects correlated with peak serum concentrations, while
    efficacy correlated with total drug exposure, suggesting
    that controlled release formulations may be useful in
    minimizing toxicity.” 
    Id.
     at S120.
    2
    The foregoing studies involved immediate-release, ra-
    ther than sustained-release, formulations of 4-AP. See
    Dist. Ct. Op. at *4; J.A. 761, 763, 767, 769, 774 (testimony
    of Acorda’s expert, Dr. Andrew Goodman). By 1990, Elan,
    which was known for its work on sustained-release formu-
    lations, entered into an agreement with the researchers at
    Rush Medical School to obtain their work on 4-AP phar-
    maceutical formulations. Dist. Ct. Op. at *4. According to
    Dr. Michael Myers, who worked at Elan at that time and
    is a named inventor on the Elan patent, Elan was inter-
    ested in developing a sustained-release formulation of 4-
    AP to “potentially reduce or eliminate some of th[e] side
    effects” associated with the immediate-release formula-
    tion. Sept. 19, 2016 Trial Tr. at 149, 155–56, Acorda
    Therapeutics, Inc. v. Alkem Labs. Ltd., No. 1:14-cv-00882-
    LPS (D. Del. Oct. 21, 2016), ECF No. 266.
    Elan developed a 4-AP sustained-release formulation
    in approximately a month’s time. Dist. Ct. Op. at *4. The
    inventors then filed for what became the Elan patent,
    demonstrated benefit in many temperature-sensitive
    patients with [multiple sclerosis], and improvement of
    function was found in a large randomized double-blind,
    placebo-controlled crossover trial of 3 months of oral
    treatment in 68 patients with [multiple sclerosis]”).
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 13
    which claims, among other things, administration of a
    sustained-release formulation of 4-AP once or twice daily
    for the treatment of neurological diseases, including
    multiple sclerosis. Elan patent, col. 22, lines 16–25, 29–
    30, 50–51 (independent claim 1 and dependent claims 3
    and 8). The Elan patent has a priority date of Novem-
    ber 1, 1991; issuance date of July 30, 1996; and expiration
    date of July 30, 2018.
    In 1994, Elan conducted a double-blind, randomized,
    placebo-controlled clinical trial involving 161 patients
    with multiple sclerosis to study the safety and efficacy of
    the sustained-release 4-AP formulation. Dist. Ct. Op. at
    *8. Patients were administered 12.5 mg 4-AP twice a day,
    which was later increased to 17.5 mg twice a day and
    finally to 22.5 mg twice a day. 
    Id.
     One of the primary
    endpoints measured was the EDSS composite measure of
    function. See 
    id.
     For the primary endpoints and most of
    the secondary endpoints, including ambulation, the trial
    revealed no statistically significant improvements for 4-
    AP versus placebo. 
    Id.
     But it did show a statistically
    significant improvement in the secondary outcome of
    lower extremity motor score, a measure of muscle
    strength in the legs. 
    Id.
     The 1994 Elan study was not
    published.
    Elan also sponsored a smaller, double-blind, placebo-
    controlled, crossover study in ten patients with multiple
    sclerosis. That study was reported in a paper published
    in 1997 (Schwid), on which Dr. Goodman, Acorda’s expert
    at trial, was the senior author. J.A. 6681–84 (Steven R.
    Schwid et al., Quantitative assessment of sustained-release
    4-aminopyridine for symptomatic treatment of multiple
    sclerosis, 48 Neurology 817 (1997)). In the background
    section, Schwid reports that an earlier, 161-patient study
    had been conducted to test improvement in EDSS for
    multiple sclerosis patients (the unpublished 1994 Elan
    study), but that it did not detect a significant improve-
    ment in that measure. J.A. 6681. Schwid notes, however,
    14 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    that the EDSS “may have been an inadequate outcome
    variable for [the 1994 Elan] trial.” 
    Id.
     The paper ex-
    plains:
    [The EDSS] is imprecise due to substantial intra-
    rater and inter-rater variability, and relatively in-
    sensitive to change due to its ordinal nature. For
    example, a patient who needed a cane to walk 100
    meters would need to improve enough to walk
    without the cane before the EDSS score would
    change. Lesser improvements in gait would not
    be reflected by the EDSS, and notable changes in
    strength or other deficits could also be overlooked.
    We planned the present pilot study to assess the
    effect of 4AP [sustained release] on more sensi-
    tive, quantitative measures of function in [multi-
    ple sclerosis].
    
    Id.
     (internal references omitted).
    In the Schwid study, ten patients were each given
    17.5 mg sustained-release 4-AP twice a day for a week and
    placebo for a week. 
    Id.
     The study measured (1) time to
    walk 8 meters (timed gait), (2) time to climb four stairs,
    (3) maximum voluntary isometric contraction measured
    quantitatively, (4) manual muscle testing, (5) grip
    strength, (6) EDSS, and (7) the patient’s global impres-
    sion. 
    Id.
     Schwid reports that the administered drug
    demonstrated a statistically significant improvement over
    placebo for timed gait in 9 of 10 patients, with p = 0.02.
    
    Id.
     5 In addition to that result, Schwid observes that
    “most of the other outcomes showed trends favoring 4AP
    5   Dr. Goodman testified at trial (for Acorda) that
    the p-value would be 0.14 (greater than the customary
    0.05 ceiling for “statistical significance”) if adjusted for
    the fact that there were multiple outcome measures (7
    total). J.A. 878; see Dist. Ct. Op. at *13 n.10.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 15
    [sustained-release].” J.A. 6684. Schwid concludes that, in
    the reported study, “4AP [sustained-release] improved
    motor function in [multiple sclerosis] patients.” J.A. 6681.
    The article notes that the results of the Schwid study are
    consistent with “[p]revious double-blind, placebo-
    controlled studies” using an immediate-release formula-
    tion of 4-AP, including another study reported by Stefoski
    (13 of 17 patients “showed ‘clinically important’ improve-
    ments”), Bever I (reporting that 4-AP “improved lower-
    extremity strength” and “a composite score of leg
    strength, spasticity, and ambulation”), and another study
    reported by Van Diemen (improvement in neurologic
    deficits, as measured by the EDSS). J.A. 6684.
    Schwid also states: “The quantitative outcomes used
    in this study permit more sensitive evaluation of the
    therapeutic effect and promise to be useful in future trials
    of symptomatic treatments for [multiple sclerosis].”
    J.A. 6681. It notes particularly that timed gait showed
    improvement where the EDSS did not. Id.; J.A. 6684.
    Schwid advises that future studies evaluate the more
    sensitive outcome measures, “establish[] efficacy in larger
    trials,” and “examine long-term efficacy and tolerability
    as well as further refine dosing regimens to optimize
    delivery despite a relatively narrow therapeutic window.”
    J.A. 6684.
    3
    While Elan was conducting those studies, Acorda was
    exploring the use of 4-AP in patients with spinal cord
    injuries. Dist. Ct. Op. at *8. In 1997, Elan granted Acor-
    da an exclusive license to the Elan patent for the use of
    Elan’s sustained-release formulation of 4-AP in patients
    with spinal cord injuries. 
    Id.
     Acorda conducted two
    studies to evaluate the pharmacokinetic and safety profile
    of the sustained-release formulation, and the results of
    both studies are reported in a paper published in 2003
    (Hayes). J.A. 6433–40 (Keith C. Hayes et al., Pharmaco-
    16 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    kinetic Studies of Single and Multiple Oral Doses of
    Fampridine-SR (Sustained-Release 4-Aminopyridine) in
    Patients With Chronic Spinal Cord Injury, 26 Clinical
    Neuropharmacology 185 (2003)). In the second study,
    Acorda tested doses of 10 mg, 15 mg, 20 mg, and 25 mg of
    the sustained-release formulation of 4-AP administered
    twice daily in patients with spinal cord injuries.
    J.A. 6434. The average serum concentration level (at
    steady state) for the 10 mg twice-daily dose was 20.8 ± 5.7
    ng/ml. J.A. 6439; accord ’826 patent, col. 25, lines 1–28
    (Table 7); ’685 patent, col. 25, lines 5–32 (Table 7). Acor-
    da also conducted clinical trials to evaluate the efficacy of
    that sustained-release formulation of 4-AP in patients
    with spinal cord injuries, but those studies failed.
    Soon after, Acorda learned that Elan was “no longer
    interested in pursuing or supporting” research into use of
    Elan’s sustained-release formulation of 4-AP for treat-
    ment of multiple sclerosis. J.A. 596 (testimony of Dr. Ron
    Cohen, Acorda founder). Acorda told Elan that it wished
    to take over that research. 
    Id.
     In 1998, Elan agreed to
    expand the earlier license to Acorda; it granted Acorda
    exclusive rights over the 4-AP sustained-release formula-
    tion for use in the treatment of multiple sclerosis. Dist.
    Ct. Op. at *8.
    Acorda reviewed Elan’s research, including Elan’s
    pharmacokinetic data and clinical study reports of the
    1994 Elan study. Acorda then conducted its own clinical
    trials. 
    Id. at *9
    .
    a
    In 2000 and 2001, Acorda ran a study—the MS-F201
    study—which involved 36 patients with multiple sclerosis
    and whose results were published only in part. 
    Id.
     6 After
    6 This was a Phase II study within the meaning of
    the FDA’s classification of certain studies as Phase I, II,
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 17
    one week of a placebo lead-in, a group of 25 patients
    received 10 mg 4-AP twice daily for a week, then higher
    dosages, which increased weekly in 5 mg increments up to
    40 mg twice daily at week 7. 
    Id.
     The rest of the patients
    consistently received a placebo. See 
    id.
     The outcome
    measures included fatigue, a lower extremity muscle test,
    a multiple sclerosis functional composite (timed 25-foot
    walk; nine-hole peg test; cognitive test), and subjective
    measures. 
    Id.
     Only the lower extremity muscle test
    showed a statistically significant difference—“when
    comparing the seven week range [4-AP] group against
    placebo.” J.A. 604–05. The results were not statistically
    significant for the timed 25-foot walk for any particular
    dose of 4-AP; and in 3 of the 7 weeks, the placebo group
    did better in the timed walk than the 4-AP group taking
    10 mg twice daily. Dist. Ct. Op. at *9. 7 After the study
    or III. See J.A. 870; U.S. Dep’t of Health & Human
    Servs., U.S. Food & Drug Admin., The FDA’s Drug Review
    Process: Ensuring Drugs Are Safe and Effective (2017),
    https://www.fda.gov/drugs/resourcesforyou/consumers/uc
    m143534.htm.
    7   During oral argument, counsel for Acorda repeat-
    edly noted the result that the placebo group actually
    outperformed the 10 mg twice-daily group in 3 of the
    7 weeks. E.g., Oral Arg. at 8:57–9:20; 
    id.
     at 10:05–20.
    But Acorda has not shown where that result was pub-
    lished in the prior art. See Sept. 23, 2016 Trial Tr. at 785,
    Acorda Therapeutics, Inc. v. Alkem Labs. Ltd., No. 1:14-
    cv-00882-LPS (D. Del. Oct. 21, 2016), ECF No. 269 (coun-
    sel for Acorda stating at trial that the MS-F201 data was
    not publicly available prior art, other than the data
    reported in the Goodman references). On this record, that
    result could not have informed the legally relevant person
    of skill in the art about whether to expect (or, as Acorda
    argues, not to expect) the 10 mg twice-daily dose to suc-
    ceed in improving walking.
    18 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    was completed, Acorda conducted a post-hoc analysis of
    the data on walking speed—which, unlike timed 25-foot
    walk, was not an endpoint the study was designed to
    test—and identified a statistically significant difference
    between the placebo and 4-AP groups considering all
    doses in the aggregate. 
    Id.
    Most but not all of the just-described results of the
    MS-F201 study were published. Dr. Goodman published
    two nearly identical abstracts in early 2003 (Goodman I,
    J.A. 6371–72, and Goodman II, J.A. 6370) and presented a
    poster in connection with those abstracts in late 2002
    (Goodman Poster, J.A. 6497–504). Goodman I explains
    that “[t]he primary aim” of the randomized, placebo-
    controlled, double-blinded Phase II dose-ranging study
    was to “determine the safety and tolerability of escalating
    doses of a sustained release (SR) formulation [of 4-AP],
    given orally to patients with [multiple sclerosis],” and
    that “[t]he secondary aim was to explore efficacy over a
    broad dose range using measures of fatigue and motor
    function.” J.A. 6371; see Dist. Ct. Op. at *14. The ab-
    stract discloses that the study involved 36 patients, 25 in
    the active-treatment and 11 in the placebo group, and
    that the active-treatment group received 20 mg/day 4-AP,
    with doses escalating 10 mg/day to reach a maximum of
    80 mg/day during week 8 of the study. J.A. 6371–72; see
    Dist. Ct. Op. at *14. In the “Results” section, Goodman I
    reports that five subjects withdrew as a result of adverse
    effects, including two seizures, and that adverse effects
    were “more severe at doses of 50 mg/day and higher,”
    including the two seizures that occurred at doses of 60
    and 70 mg/day. J.A. 6372; see Dist. Ct. Op. at *14. An-
    other reported result is that the 4-AP sustained-release
    treatment “group showed statistically significant im-
    provement from baseline compared to placebo in function-
    al measures of mobility (timed 25 walking speed; p=0.04)
    and lower extremity strength (manual muscle testing;
    p=0.01). Dose-response curves showed increasing benefit
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 19
    in both measures in the 20 to 50 mg/day range.”
    J.A. 6372; see Dist. Ct. Op. at *14. The abstract clarifies
    that “[n]o other measures showed significant treatment
    effects.” J.A. 6372; see Dist. Ct. Op. at *14. The “Conclu-
    sions” section reads:
    The safety profile of [4-AP sustained-release] was
    consistent with previous experience. Doses above
    50 mg [per day] added little benefit and increased
    adverse effects. There was significant improve-
    ment in measures of mobility and muscle
    strength.
    J.A. 6372.
    The Goodman Poster is similar. It reproduces almost
    all of the material in Goodman I in the “Abstract” section
    at the upper-left-hand corner of the poster. J.A. 6502
    (capitalization altered). The Poster contains more detail
    in the “Background” section, which notes that “[r]ecent
    clinical studies have indicated that [4-AP] promotes
    improvement in motor strength, walking, fatigue, and
    endurance in people with [multiple sclerosis]”; that ob-
    served adverse events, including seizures, were associated
    with higher peak plasma concentrations and rapid plasma
    concentration changes caused by immediate-release 4-AP;
    and that sustained-released formulations were developed
    to address those problems. 
    Id.
     (capitalization altered).
    The study objectives were defined as: (1) “[d]etermine
    safety of multiple doses of [sustained-release 4-AP] (one
    week each of 20 mg/day, 30 mg/day, 40 mg/day, 50
    mg/day, 60 mg/day, 70 mg/day, and 80mg/day)”; and
    (2) “[o]btain evidence of efficacy and dose-response using
    several outcome measures.” Id.; accord 
    id.
     (Methods
    section). The Goodman Poster notes that, because indi-
    viduals taking 4-AP “frequently report” improvements in
    activity and fatigue levels, the study focused on outcomes
    associated with such effects—namely, timed ambulation,
    manual muscle testing, and patients’ self-reports of
    20 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    fatigue—rather than the EDSS, because “it was not clear
    whether” the EDSS “would adequately reflect this type of
    improvement.” 
    Id.
     (Methods section).
    As to the study’s results concerning safety, the Good-
    man Poster provides, in the “Results Summary,” that
    “more severe adverse events,” including seizures, occurred
    “[a]t doses above 40 mg/day.” J.A. 6504 (capitalization
    altered). The Poster states that “the risk of seizure re-
    quires further study and characterization[,] particularly
    in the anticipated dose range.” 
    Id.
    As to the results concerning efficacy, the Goodman
    Poster includes a graph of a dose-response curve for the
    25-foot walk:
    J.A. 6503. The graph shows that the total time for the
    walk decreased significantly between the placebo dose
    (run-in) and the 20 mg/day dose. 
    Id.
     The total time
    seems to have plateaued at higher doses. 
    Id.
     (total time
    remained between approximately 12.5 and 14 seconds as
    doses increased from 20 mg/day to 80 mg/day); see also
    Sept. 19, 2016 Trial Tr. at 102–03, 137 (testimony of
    defendants’ expert Dr. Peroutka, observing a walk time
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 21
    between 12 and 14 seconds for a “stable clinical effect at
    20 to 40” mg/day in the “flat part of the dose response
    curve”).
    The results section also provides bar graphs showing
    changes in individual patients’ speed on the 25-foot walk.
    J.A. 6503. The upper bar graph shows, on average, im-
    provements in speed for patients in the active-treatment
    group, aggregated for doses ranging from 20–50 mg/day.
    Id.; see J.A. 416. It appears that a few of those patients’
    speed decreased by approximately 0–10%, while more
    than a dozen patients’ speed increased by more than
    10%—nine by more than 20%, four by more than 40%,
    and one by more than 60%. J.A. 6503. The lower bar
    graph shows, on average, zero or slight improvement in
    speed for patients in the placebo group, with no patient’s
    speed having improved by more than 20% and one pa-
    tient’s speed having decreased by more than 20%. 
    Id.
    22 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    The results for improvements in leg strength between
    the active-treatment group (aggregating the doses of 20–
    50 mg/day) and placebo group showed a similar trend:
    
    Id.
    In the “Results Summary,” the Goodman Poster states
    that “[s]ignificant improvement in walking speed was
    observed in the [4-AP sustained-release] treated group
    (p=0.04*),” where the p-value reflects a “*repeated meas-
    ure ANOVA (weeks 1–7)”—i.e., the walking speed for the
    active-treatment group, aggregating the dose levels.
    J.A. 6504; see Dist. Ct. Op. at *14 n.11 (noting that Dr.
    Goodman explained that the p-value reflects “the aggre-
    gated value for the treatment group as a whole, including
    all dosages, and did not reflect the results associated with
    any single dosage” (emphasis omitted)). More specifical-
    ly, the Goodman Poster reports that (1) “[t]he average
    improvement in walking speed [in the 25-foot walk]
    during the low dose period (20–50 mg/day) included > 20%
    increase for 9 of the 25 subjects” and (2) “[c]hanges in the
    placebo-treated group were equally distributed between
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 23
    increases and decreases in walking speed and none of the
    11 subjects showed increases > 18% during the low dose
    period.” J.A. 6504. The Poster also reports, for the lower
    extremity manual muscle test (LEMMT), a “[s]tatistically
    significant improvement in the [4-AP sustained-release]
    treated group (p=0.01*).” 
    Id.
    The Conclusions section contains six bullet points.
    The first states that the “[s]afety profile [is] consistent
    with previous experience.” J.A. 6503. The next few bullet
    points report a “[s]ignificant benefit on timed walking,”
    “[s]ignificant benefit on lower extremity strength,” “[n]o
    evidence of benefit on overall fatigue—susceptibility of
    fatigue to placebo effect,” and “[e]vidence of dose-response
    in 20–40 mg/day range.” 
    Id.
     Finally, there was “[l]ittle
    added benefit, and increased [adverse events,] at doses
    above 50 mg/day.” 
    Id.
    This Goodman prior art—which post-dates Elan’s
    transfer of the research project to Acorda and which
    added significantly to the teachings of the earlier prior
    art—became the most important prior art in the obvious-
    ness analysis in this case.
    b
    In 2003, after completion of the MS-F201 study, Acor-
    da conducted another placebo-controlled Phase II study
    (MS-F202 study) to test 4-AP’s effect on walking speed.
    Dist. Ct. Op. at *9. After a two-week up-titration period
    beginning with a 10 mg dose, patients were administered
    a stable dose of 10 mg, 15 mg, or 20 mg sustained-release
    4-AP twice daily for twelve weeks. 
    Id.
     Although none of
    the 4-AP groups demonstrated a statistically significant
    improvement in walking speed relative to placebo, anoth-
    er post-hoc analysis showed that responders were in the
    4-AP group (p < 0.0001) and that there was no meaningful
    difference in efficacy among the tested 4-AP doses. Id.;
    see also J.A. 612–14 (Acorda founder Dr. Cohen explain-
    ing that isolating responders in the study—those patients
    24 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    with improved walking—showed that responders were
    overwhelmingly in the active treatment groups and that
    there was no meaningful difference in efficacy among the
    responders in those treatment groups taking 10 mg, 15
    mg, or 20 mg twice daily).
    Acorda then conducted two Phase III studies to evalu-
    ate the effect of 10 mg sustained-release 4-AP twice daily,
    with walking improvement responder analysis as the
    primary outcome measure. 
    Id.
     Both studies were suc-
    cessful, with p < 0.0001. 
    Id.
    Neither the results of the MS-F202 study nor the re-
    sults of the Phase III studies constitute publicly available
    prior art to the Acorda patents in this case.
    4
    On April 9, 2004, Acorda employees filed a provisional
    patent application; that date is undisputedly the priority
    date of the Acorda patents. 
    Id.
     at *9 n.8. The Acorda
    patents issued between August 2011 and March 2014.
    The parties treat the Acorda patents’ claims, for pur-
    poses of the invalidity issue on appeal, as involving meth-
    ods of administering to a patient with multiple sclerosis a
    sustained-release 4-AP formulation (1) in a 10 mg dose
    twice daily, (2) at that stable dose for the entire treatment
    period of at least two weeks, (3) maintaining 4-AP serum
    levels of 15–35 ng/ml, (4) with walking improved. The
    parties treat claim 7 of the ’826 patent and claim 22 of the
    ’437 patent as representative. Claim 7 of the ’826 patent
    depends on claim 6, which reads:
    6. A dosing regimen method for providing a 4-
    aminopyridine at a therapeutically effective con-
    centration in order to improve walking in a hu-
    man with multiple sclerosis in need thereof, said
    method comprising:
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 25
    initiating administration of 4-aminopyridine
    by orally administering to said human a sustained
    release composition of 10 milligrams of 4-
    aminopyridine twice daily for a day without a pri-
    or period of 4-aminopyridine titration, and then,
    maintaining      administration      of     4-
    aminopyridine by orally administering to said
    human a sustained release composition of 10 mil-
    ligrams of 4-aminopyridine twice daily; without a
    subsequent period of 4-aminopyridine titration,
    whereby an in vivo CmaxSS:CminSS ratio of 1.0 to
    3.5 and a CavSS of 15 ng/ml to 35 ng/ml are main-
    tained in the human.
    ’826 patent, col. 27, lines 41–57. Claim 7 covers “[t]he
    method of claim 6, whereby an increase in walking speed
    is obtained in said human.” 
    Id.,
     col. 27, lines 58–59.
    Claim 22 of the ’437 patent depends on claim 18,
    which depends on claim 1. Claim 1 of the ’437 patent
    reads:
    1. A method of increasing walking speed in a
    human multiple sclerosis patient in need thereof
    comprising orally administering to said patient a
    sustained release composition of 10 milligrams of
    4-aminopyridine twice daily for a time period of at
    least two weeks, wherein said 10 milligrams of 4-
    aminopyridine twice daily are the only doses of 4-
    aminopyridine administered to said patient dur-
    ing said time period.
    ’437 patent, col. 27, lines 55–61. Claim 18 requires that
    the sustained release composition in claim 1 be “a tablet,”
    
    id.,
     col. 28, lines 47–48; and claim 22 requires that the
    tablet of claim 18 “exhibit[] a release profile to obtain a
    CavSS of about 15 ng/ml to about 35 ng/ml,” 
    id.,
     col. 28,
    26 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    lines 55–57. The parties have not distinguished the
    claims for purposes of the invalidity issue before us. 8
    5
    Acorda submitted New Drug Application No. 022250
    to the FDA for the use of 10 mg 4-AP extended-release
    tablets (Ampyra). The FDA granted priority review to
    that application and approved it on January 22, 2010.
    According to the approved FDA label, Ampyra “‘is in-
    dicated as a treatment to improve walking in patients
    with multiple sclerosis (MS). This was demonstrated by
    an increase in walking speed.’” Dist. Ct. Op. at *4 (cita-
    tion omitted). “Improvement in walking in MS patients is
    [the] only approved use” of Ampyra. 
    Id.
     The “Descrip-
    tion” section of the label states that “‘Ampyra (dal-
    fampridine) is a potassium channel blocker, available in a
    10 mg tablet strength . . . , formulated as an extended
    release tablet for twice-daily oral administration.’” 
    Id.
    (capitalization altered). The “Dosage and Administration”
    section explains that “‘[t]he maximum recommended dose
    of Ampyra is one 10 mg tablet twice daily, taken with or
    without food, and should not be exceeded. . . . No addi-
    tional benefit was demonstrated at doses greater than 10
    mg twice daily and adverse reactions and discontinua-
    tions because of adverse reactions were more frequent at
    higher doses.’” 
    Id.
     (capitalization altered).
    Between the time of FDA approval in 2010 and the
    end of 2015, total sales of Ampyra were $1.7 billion and
    net income was $998.7 million. 
    Id. at *16
    . Net sales of
    8    Although the ’826 patent’s claim 7 does not re-
    quire a regimen of at least two weeks, asserted claim 39
    does (claim 39 requires 12 weeks), as do the ’437 patent’s
    asserted claims 1, 2, 5, 22, 32, 36, and 37; the ’685 pa-
    tent’s asserted claims 3 and 5; and the ’703 patent’s
    asserted claims 36, 38, and 45.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 27
    Ampyra, in dollars, increased at an average rate of 20%
    per year, and the volume of tablets sold increased at an
    average rate of 8% per year, despite an increasing price
    per tablet over that period (2010 to 2015). 
    Id.
     Acorda
    also receives royalty payments from licenses to sell Ampy-
    ra outside the United States; it has collected at least $135
    million from those licenses. 
    Id.
    Commercial opportunity, however, is constrained be-
    cause Ampyra is indicated only for improvement of walk-
    ing.     
    Id.
     at *16–17.      Ampyra sales revenue is
    approximately 2–3% of the total sales revenue from the
    top ten multiple sclerosis drugs. 
    Id. at *17
    . Not all
    multiple sclerosis patients respond to Ampyra. Among
    multiple sclerosis patients who experience walking diffi-
    culties, 15–20% of those patients are prescribed Ampyra.
    
    Id.
    On the other hand, Ampyra is the first and only drug
    approved for improving walking in multiple sclerosis
    patients. 
    Id.
     When Sanofi-Aventis in 2008 conducted a
    Phase III study to test whether a different potassium-
    channel blocker, nerispirdine, would improve walking in
    patients with multiple sclerosis, it did not find evidence of
    a “specific significant difference between the responders
    [and] non-responders that received nerispirdine or place-
    bo” in a timed 25-foot walk. J.A. 726–28 (testimony of
    Acorda’s expert Dr. Fred Lublin); see Dist. Ct. Op. at *17.
    B
    In 2014, the defendants notified Acorda and Alkermes
    of the defendants’ submission of Abbreviated New Drug
    Applications seeking FDA approval to market generic
    versions of Ampyra. In mid-July 2014, Acorda and Alk-
    ermes filed suits against Roxane, Mylan, and Teva,
    among others, in the District of Delaware for the alleged
    infringement of several claims in each of the Elan and
    Acorda patents under 
    35 U.S.C. § 271
    (e). The cases were
    consolidated in 2015.
    28 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    The defendants stipulated to infringement of the as-
    serted claims—claims 3 and 8 of the Elan patent; claims
    1, 7, 38, and 39 of the ’826 patent; claims 3 and 5 of the
    ’685 patent; claims 1, 2, 5, 22, 32, 36, and 37 of the ’437
    patent; and claims 36, 38, and 45 of the ’703 patent. Dist.
    Ct. Op. at *9–12, *18. The defendants, however, chal-
    lenged the validity of the asserted claims of all five pa-
    tents for obviousness under 
    35 U.S.C. § 103
    . 9          The
    defendants also challenged the validity of the asserted
    claims of the Elan patent for insufficient written descrip-
    tion and enablement under 
    35 U.S.C. § 112
    , ¶ 1.
    After a bench trial held in September 2016, the district
    court determined that the defendants had not proven
    invalidity of the Elan patent. Dist. Ct. Op. at *20–29.
    But the court held that the defendants had proven that
    the asserted claims of the Acorda patents are invalid for
    obviousness. 
    Id.
     at *29–41. As to the Acorda patents:
    Based on the publications discussed above, as well as
    expert testimony, the court found that, as of 2004 (the
    priority date), a relevant skilled artisan would have been
    motivated to administer a stable dose of 10 mg of 4-AP
    twice daily and had a reasonable expectation of success in
    the objective of improving the walking ability of multiple
    sclerosis patients. 
    Id.
     at *30–35. The court also found
    that the Acorda patents’ claim limitations regarding
    serum levels (the pharmacokinetic limitations) were
    inherent in the dosing claimed. 
    Id.
     at *35–36. Finally,
    the court, while finding certain facts in Acorda’s favor
    regarding objective indicia of obviousness, ultimately
    discounted such indicia, relying on the fact that the Elan
    9    Because the effective filing date of the claims of
    the Acorda patents are before March 16, 2013, the version
    of § 103 preceding the enactment of the Leahy-Smith
    America Invents Act, Pub. L. No. 112-29, 
    125 Stat. 284
    (2011), governs this case.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 29
    patent was a “blocking patent” for the claimed methods of
    the Acorda patents: any marketer of a drug for uses
    practicing those methods would need a license to the Elan
    patent—to which Acorda, for years preceding the 2004
    priority date, had an exclusive license from Elan. 
    Id.
     at
    *36–40. 10
    On April 25, 2017, the court entered final judgment in
    favor of the defendants as to the Acorda patents and in
    favor of Acorda as to the Elan patent. The court set the
    effective date of any final FDA approval of the defendants’
    Abbreviated New Drug Applications no earlier than the
    expiration date of the Elan patent—July 30, 2018—and
    enjoined the defendants from any infringing activity
    before that date.
    Acorda and the defendants timely appealed and cross-
    appealed, respectively. We have jurisdiction under 
    28 U.S.C. § 1295
    (a)(1).
    II
    Acorda makes essentially three arguments on appeal
    regarding the district court’s ruling that the Acorda
    patent claims are invalid for obviousness. First, Acorda
    contends, on a number of grounds, that the district court
    10   In inter partes reviews initiated by a petitioner
    not included among the defendants here, the Patent Trial
    and Appeal Board considered challenges to the Acorda
    patents that did not involve Schwid or the Goodman
    references but, instead, depended on whether a particular
    filing with the Securities and Exchange Commission was
    prior art to the patents. The Board concluded that it was
    not. Coalition for Affordable Drugs (ADROCA) LLC v.
    Acorda Therapeutics, Inc., Nos. IPR2015-01850, -01853, -
    01857, -01858, 
    2017 WL 950736
    , at *9–20 (P.T.A.B. Mar.
    9, 2017). That ruling does not change the analysis in this
    case.
    30 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    erred in finding that a person of skill would have had a
    motivation to combine the prior art to arrive at the Acor-
    da invention and a reasonable expectation of success in
    doing so. Second, Acorda challenges the court’s determi-
    nation that the claim limitations relating to pharmacoki-
    netics—i.e., achieving 4-AP serum levels of 15–35 ng/ml—
    are inherent in the claimed invention and therefore
    obvious. Third, Acorda argues that the court improperly
    applied a categorical rule that a blocking patent (the Elan
    patent) negates any findings in favor of Acorda on the
    objective indicia of commercial success, failure of others,
    and long felt but unmet need. 11
    Under 
    35 U.S.C. § 103
    (a), obviousness is a question of
    law based on underlying questions of fact, including the
    level of ordinary skill in the art, the scope and content of
    the prior art, the differences between the claims and the
    prior art, motivation to modify or combine with a reason-
    able expectation of success, and objective indicia of non-
    obviousness. See KSR Int’l Co. v. Teleflex Inc., 
    550 U.S. 398
    , 406 (2007); In re Stepan, 
    868 F.3d 1342
    , 1345–46
    (Fed. Cir. 2017); PAR Pharm., Inc. v. TWI Pharm., Inc.,
    
    773 F.3d 1186
    , 1193–94, 1196–97 (Fed. Cir. 2014). We
    review the district court’s determination of obviousness de
    11   Acorda also argues that the district court failed to
    analyze the claimed inventions as a whole. We see no
    methodological error. The court did nothing other than
    follow the parties’ own breakdown of what aspects of the
    claimed inventions, alone or together, a skilled artisan at
    the priority date would have been motivated to adopt with
    a reasonable expectation of success and, more generally,
    would have found obvious. The court did not overlook any
    meaningful argument by Acorda that certain aggregations
    of claim elements, including the whole, required analysis
    beyond the analysis of the walking-benefit, dosage, stabil-
    ity, and serum-level aspects of the claims.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 31
    novo and its underlying factual findings for clear error.
    In re Cyclobenzaprine Hydrochloride Extended-Release
    Capsule Patent Litig., 
    676 F.3d 1063
    , 1069 (Fed. Cir.
    2012).
    A
    Acorda challenges the district court’s findings about
    the relevant skilled artisan’s motivations and expecta-
    tions regarding the administration of a stable 10 mg 4-AP
    dose twice daily to improve walking. It presents two
    relatively focused arguments: that Schwid teaches away
    from the claimed invention; and that the prior art teaches
    the administration of sustained-release 4-AP in a titrated-
    dosing regimen rather than a stable-dosing regimen.
    More broadly, Acorda argues that neither the Goodman
    Poster nor the prior art collectively teaches the efficacy of
    a stable 10 mg twice-daily dose or indicates that such a
    dose is among the small number of options that a skilled
    artisan would have been motivated to test with a reason-
    able expectation of success to improve walking. We reject
    these challenges.
    1
    Acorda contends that Schwid “affirmatively teaches
    away from Acorda’s invention.” Acorda Br. 36. The
    district court considered Schwid, as Acorda urged, among
    the teachings of the overall art available at the 2004
    priority date, and it made findings as to the motivation
    and expectations of a relevant skilled artisan at that date
    regarding a stable 10 mg dosage of 4-AP to improve
    walking. Dist. Ct. Op. at *30–31. Acorda has not shown
    that Schwid renders the court’s findings on those issues
    clearly erroneous.
    Schwid supports a motivation to test, with a reasona-
    ble expectation of success, a 10 mg twice-daily dose of
    sustained-release 4-AP to improve walking in multiple
    sclerosis patients. Schwid itself used a 17.5 mg twice-
    32 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    daily dose, but it found success with that dosage: as stated
    in Schwid, “[t]he results of this double-blind crossover
    study provide evidence that 4AP [sustained release] had a
    therapeutic effect on neurologic deficits from [multiple
    sclerosis].” J.A. 6684. In particular, there was a statisti-
    cally significant improvement for the 17.5 mg 4-AP versus
    placebo in timed gait (i.e., in walking ability); and the
    improvements in other outcomes, while not statistically
    significant, “showed trends favoring 4AP [sustained
    release].” J.A. 6681, 6684. Schwid expressly concludes
    that the study shows “4AP [sustained release] improved
    motor function in [multiple sclerosis] patients.” J.A. 6681.
    And, stressing toxicity concerns with high doses, Schwid
    provides affirmative reason to investigate low doses. See
    J.A. 6681 (“4AP can provoke seizures and acute encepha-
    lopathy”—episodes that “tend to occur when serum 4AP
    levels peak, suggesting that lower peak levels may in-
    crease safety.”); J.A. 6684 (“[F]uture studies of 4AP [sus-
    tained release] will need to examine long-term efficacy
    and tolerability as well as further refine dosing regimens
    to optimize delivery despite a relatively narrow therapeu-
    tic window.”).
    Schwid makes certain observations that its study
    showed favorable results in some outcome measures at
    high serum levels of 4-AP (60 ng/ml)—levels that, accord-
    ing to evidence emphasized by Acorda, may require the
    administration of 4-AP doses higher than 10 mg twice a
    day. See J.A. 445–48 (defendant’s expert’s testimony that
    17.5 mg twice-daily or 25 mg twice-daily could result in
    serum levels at or above 60 ng/ml); J.A. 823 (Acorda’s
    expert’s testimony: similar). But Acorda overstates the
    significance of this serum-level observation to the issue of
    a reasonable expectation of success for walking improve-
    ment.
    Schwid found no statistically significant difference be-
    tween the 4-AP and placebo groups as to patients’ subjec-
    tive global impression of their condition, one of seven
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 33
    outcome measures in the Schwid study. J.A. 6683. As to
    that outcome measure, Schwid states that “[n]one of the
    patients with a serum level less than 60 ng/mL felt better
    (according to their global impressions) on 4AP [sustained
    release] than placebo.” 
    Id.
     But efficacy in patients’ global
    impression is not the issue—efficacy in timed gait is.
    Schwid made no such finding as to timed gait. Schwid
    also observes, as a general matter, that “[t]reatment [with
    4AP sustained release] appeared particularly efficacious
    in subjects who achieved serum 4AP levels above 60
    ng/mL, with everyone improving in timed-gait testing and
    grip strength, and five of six improving by MVICT [maxi-
    mum voluntary isometric contraction, measured quantita-
    tively] and their own subjective assessment [global
    impression].” J.A. 6684. But Schwid’s measured im-
    provement in timed gait was not limited to patients with
    high serum levels. See J.A. 6683 (9 of 10 patients im-
    proved in timed gait, and only 6 patients achieved serum
    levels greater than 60 ng/ml).
    In short, high serum levels were not required, and a
    dose of 17.5 mg sustained-release 4-AP twice-daily was
    sufficient, for improvement in timed gait in Schwid.
    Meanwhile, Acorda has pointed to nothing in Schwid
    declaring that doses lower than 17.5 mg twice-daily would
    not be effective in improving walking. Schwid therefore
    supports a finding that a person of skill would have had a
    reasonable expectation of success regarding the admin-
    istration of 17.5 mg of 4-AP twice-daily—or perhaps even
    a lower dose since 17.5 mg was sufficient—to improve
    walking in multiple sclerosis patients. And in light of
    Schwid’s warning that seizures may occur at higher doses,
    the district court did not clearly err in finding that a
    person of skill would look to lower doses rather than
    higher ones. See Dist. Ct. Op. at *32 (“While the prior art
    may have generally suggested that 4-AP would be more
    effective in higher doses, the art also reduced the set of
    34 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    plausible doses because it suggested that higher doses of
    4-AP were more likely to cause adverse events.”).
    2
    Acorda’s second argument is that the prior art teaches
    administering sustained-release 4-AP only in a titrated-
    dosing regimen to avoid the risk of seizure, and therefore
    that the district court could not properly find that a
    person of skill would have been motivated to pursue, or
    had a reasonable expectation of success concerning, a
    stable-dosing regimen. We reject this argument.
    The prior art is not limited to titrated dosing (where
    doses start low and move higher) but rather contains
    evidence of stable dosing (where the dose starts and stays
    at the claimed level). As the district court noted, Polman
    is evidence of safe and effective long-term oral admin-
    istration of a stable dose of immediate-release 4-AP. Dist.
    Ct. Op. at *34; see J.A. 6655. Schwid also provides evi-
    dence of a stable-dosing regimen of 4-AP, if only for a
    week. As for the studies that used escalating doses, some
    of those studies began with 10 mg as the lowest dose
    before titrating upwards to doses that may increase the
    risk of seizure. E.g., Davis at 187 tbl.1; see also Dist. Ct.
    Op. at *8 (1994 Elan study began with 12.5 mg 4-AP twice
    daily); 
    id. at *9
     (10 mg twice daily was the lowest dose
    used in the Acorda MS-F202 study); cf. J.A. 6647 (trial in
    patients with other conditions began with dose of 10 mg 4-
    AP twice daily and titrated up to 200 mg daily); J.A. 6434
    (Acorda’s trial in patients with spinal cord injury began
    with 10 mg twice daily as the lowest dose). Significantly,
    the most important prior art, the Goodman references,
    report a start dose of 10 mg twice daily. J.A. 6370, 6372,
    6502.
    Even if many earlier studies used a titrated-dosing
    scheme to avoid adverse effects caused by starting at
    higher doses, those studies do not, as the district court
    found, undermine the other evidence in the prior art that
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 35
    a person of skill would have a reasonable expectation of
    success for a stable-dosing scheme at low doses. Dist. Ct.
    Op. at *34. The Bever II prior-art review article reports
    that while “seizures are common at higher doses,” 4-AP
    “rarely cause[s] seizures at the doses used in [multiple
    sclerosis] trials.” Bever II at S120. Other published
    studies say the same: seizures were seen at higher doses,
    but not lower ones like 10 mg. E.g., J.A. 6651 (trial in
    patients with Eaton-Lambert syndrome, congenital myas-
    thenia, and myasthenia gravis starting at dose of 10 mg
    4-AP twice daily and escalating to 200 mg daily found
    that all of the patients who experienced seizures during
    the study “were receiving 80 mg or more of 4-AP daily”);
    J.A. 6504 (Goodman Poster “Results Summary”: “At doses
    above 40 mg/day, more severe adverse events were re-
    ported, including two cases of seizure (at 60 and 70
    mg/day)”). And in Schwid, the authors advise that future
    studies pursue lower doses for long-term tolerability. See
    J.A. 6681 (“4AP can provoke seizures and acute encepha-
    lopathy,” but those episodes “tend to occur when serum
    4AP levels peak, suggesting that lower peak levels may
    increase safety.”); J.A. 6684 (“[F]uture studies of 4AP
    [sustained release] will need to examine long-term effica-
    cy and tolerability as well as further refine dosing regi-
    mens to optimize delivery despite a relatively narrow
    therapeutic window.”).
    Expert testimony supports the district court’s finding
    that a person of ordinary skill in the art would have been
    motivated to pursue, and had a reasonable expectation of
    success in pursuing, a stable-dosing regimen of 10 mg 4-
    AP twice daily. According to Dr. Peroutka, “the general
    goal of drug development [is] to provide a stable dosing
    regimen.” J.A. 414. He testified that stable dosing was
    particularly desirable for treating multiple sclerosis
    because, as a chronic disease that requires long-term
    treatment, a stable oral dose is much easier to administer.
    See Sept. 19, 2016 Trial Tr. 110 (“Obviously, it’s a lot
    36 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    easier simply to take one pill, the same pill twice a day
    than to have to figure out, well, this morning I need this
    much, that much. But with pills, it is almost impossible
    to titrate easily.”). Even Dr. Goodman conceded that “it
    would be desirable” to have a stable-dosing regimen
    where “the patient would be prescribed [some dose] to
    take on a regular basis.” J.A. 868. And titration was not
    required given such a low starting dose: Acorda founder
    Dr. Cohen testified that, upon recognizing the efficacy of
    the 10 mg twice-daily dose, “we realized we didn’t have to
    titrate anymore.” J.A. 614. Finally, Dr. Peroutka ex-
    plained that nothing in the prior art suggested that 4-AP
    could not be used for long-term treatment for a chronic
    condition. Sept. 19, 2016 Trial Tr. 104.
    3
    Acorda’s most general argument is that the district
    court improperly found that a relevant skilled artisan
    “would have formed a reasonable expectation of success
    based on Schwid and Goodman [in particular, the Good-
    man Poster], in light of the totality of the prior art,”
    regarding a 10 mg twice-daily dose of 4-AP to improve
    walking. Dist. Ct. Op. at *31. We reject Acorda’s argu-
    ment.
    As described above, Schwid reports a statistically sig-
    nificant improvement in timed gait for patients given
    17.5 mg 4-AP twice-daily versus placebo. Also as de-
    scribed above, the Goodman Poster reports a statistically
    significant improvement in walking speed and in lower
    extremity strength for patients given 10–40 mg 4-AP
    twice daily versus placebo; an average improvement in
    walking speed during the low-dose period (10–25 mg 4-AP
    twice daily) of more than 20% for 9 of 25 subjects; and
    “more severe adverse events,” including seizures, at doses
    above 20 mg 4-AP twice daily. J.A. 6504. The Goodman
    Poster also reports a dose response in the timed walk at
    doses in the range of 10–20 mg 4-AP twice daily. See Dist.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 37
    Ct. Op. at *33 (“Goodman states that the results showed
    ‘evidence of a dose response in the 20 to 40 milligram per
    day range,’ indicating that patients taking these dosages
    of 4-AP demonstrated a greater response to treatment
    than did patients receiving placebo.”).
    The district court did not clearly err in finding that a
    person of skill would have looked to both of those refer-
    ences, considered their limits, and had a reasonable
    expectation of success as to the efficacy of 10–20 mg 4-AP
    twice daily to improve walking. Despite certain identified
    “shortcomings” in the principal references, “the combined
    message a [person of skill in the art] would have dis-
    cerned from Schwid together with the Goodman refer-
    ences was a reasonable expectation of success in treating
    walking with 4-AP.” 
    Id. at *31
    . Other prior art was
    consistent with that message. 
    Id.
     As to dosages, the
    disclosures of Schwid and the Goodman Poster regarding
    relevant benefits at doses including or near to the Acorda-
    claimed range (recounted above), together with the re-
    ported concerns about high doses, support the further
    finding that a relevant skilled artisan would have “con-
    sider[ed] 10 mg/twice daily to be among the finite group of
    doses of sustained-release 4-AP that could reasonably be
    expected to improve walking in MS patients.” 
    Id. at *33
    (footnote attached citing further partial support from
    testimony of Acorda’s Dr. Goodman). In a finding reflect-
    ing both motivation and reasonable expectation of suc-
    cess, the district court stated: “As the lowest of the range
    of encouraging doses, 10mg/twice daily would have been
    an attractive starting point for a [person of skill in the
    art].” 
    Id.
     These findings not only have adequate eviden-
    tiary support but comport with the guidance of KSR to
    “take account of the inferences and creative steps that a
    38 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    person of ordinary skill in the art would employ.” 
    550 U.S. at 418
    . 12
    Expert testimony further supports the district court’s
    findings. The defendants’ expert Dr. Peroutka explained
    that Schwid showed that the claimed formulation was
    effective at a 17.5 mg twice-daily dose and that the result
    was statistically significant.      J.A. 406–07, 410.   Dr.
    Peroutka also stated that the Goodman abstracts “said
    that dose response curves showed an increasing benefit in
    both measures in the 20 to 50 milligram a day range [10–
    25 mg twice-daily range], meaning timed walking or lower
    extremity strength.” J.A. 414. According to Dr. Peroutka,
    the study presented in the Goodman abstracts was a dose-
    ranging study where “the goal” is “to find the most effica-
    cious dose without adverse events.” Id.; accord J.A. 869
    (Acorda’s expert Dr. Goodman: “[W]hat we really want to
    find is the most effective dose that can be given safely.”).
    The additional information provided in the bar graph in
    the Goodman Poster showed that people taking 10–25 mg
    twice daily did better in walking speed than placebo, and
    the dose-response curve showed improvement in walking
    speed at the 10 mg twice-daily dose—a level of improve-
    ment that was maintained at higher doses. See J.A. 416;
    Sept. 19, 2016 Trial Tr. 102 (“They got the 10 milligrams
    to work at this level and that level of efficacy was main-
    tained through the dose ranges.”); id. at 103 (“[I]t’s cer-
    tain stable clinical effect at 20 to 40” milligrams per day
    12   In its formulation describing the narrow set of
    choices facing the relevant artisan in 2004 in this case,
    the district court quoted KSR’s discussion of obviousness
    where the claimed invention was “obvious to try.” Dist.
    Ct. Op. at *32 (quoting 
    550 U.S. at 421
    ). But the court
    fully applied the familiar standards focused on the rele-
    vant artisan’s motivation to make the claim-required
    combinations with a reasonable expectation of success.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 39
    (doses of 10 mg, 15 mg, and 20 mg twice-daily).). Dr.
    Peroutka testified that he would have included the 10 mg
    dose in a Phase III study because there are “very serious”
    side effects at higher doses so “you would take the lowest
    effective dose that was safe.” Id. at 104. He also testified
    that a person of skill might even want to try a lower dose,
    but “based on the [Goodman] data, 10 is the lowest effec-
    tive dose.” Id. Acorda’s expert Dr. Goodman himself
    stated that the Goodman Poster “suggest[s]” “that the
    range for further testing would be the 20 to 40 milligrams
    per day [10 to 20 mg twice-daily] range.” J.A. 844–45; see
    also J.A. 874 (Dr. Goodman stating during his deposition
    that “a person of ordinary skill in the art in December
    2003 would have been motivated based on the 201 study
    to design a study along the lines of what became the 202
    study,” which tested the 10 mg twice-daily dose). Ulti-
    mately, the court found, based on the prior art and expert
    testimony, that a person of skill before the 2004 priority
    date would have looked (1) to the 10–20 mg twice-daily
    dose range for effective doses that would be reasonably
    expected to improve walking in multiple sclerosis patients
    and (2) to the low end of that range to avoid adverse
    effects. Dist. Ct. Op. at *32–33.
    Acorda’s core argument appears not to be that the ev-
    idence fails to support the finding of a motivation to
    combine. Rather, it appears to be that the evidence
    cannot support a finding of a reasonable expectation of
    success (in 2004) in the absence of publications showing a
    statistically significant difference in walking tests be-
    tween the specific dose of 10 mg 4-AP taken twice daily
    versus placebo. See Acorda Br. 41–42; Acorda Reply Br.
    20–21; Oral Arg. at 6:10–30. We reject this contention.
    To the extent that Acorda’s contention is a legal one,
    asserting a law-required minimum for what can support a
    “reasonable” expectation of success, Acorda has offered no
    support for the contention. This court has long rejected a
    requirement of “[c]onclusive proof of efficacy” for obvious-
    40 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    ness. See, e.g., Hoffman-La Roche Inc. v. Apotex Inc., 
    748 F.3d 1326
    , 1331 (Fed. Cir. 2014); PharmaStem Therapeu-
    tics, Inc. v. ViaCell, Inc., 
    491 F.3d 1342
    , 1364 (Fed. Cir.
    2007); Pfizer, Inc. v. Apotex, Inc., 
    480 F.3d 1348
    , 1364,
    1367–68 (Fed. Cir. 2007) (reasoning that “the expectation
    of success need only be reasonable, not absolute”). And
    Acorda has cited no authority from the Supreme Court or
    this court requiring as a matter of law, for reasonableness
    of an expectation of success, testing of specific doses
    versus placebo that shows the relevant result with statis-
    tical significance. Acorda has furnished no basis for
    treating the question in this case as anything but one of
    context-specific fact based on evidence.
    In some cases, of course, the evidentiary basis for an
    inference of reasonable expectation of success may be
    inadequate. See, e.g., In re Cyclobenzaprine, 676 F.3d at
    1070–71. Here, though, as we have discussed, expert and
    other evidence indicates that a person of skill in the
    present context can draw reasonable inferences about the
    likelihood of success even without a perfectly designed
    clinical trial showing a statistically significant difference
    in efficacy between a specific dose and placebo. See also
    J.A. 6657 (Polman: “Although a placebo effect cannot be
    excluded, the dynamics of the response in relation to the
    intake of the medication and the deterioration and subse-
    quent improvement in functioning during a drug-free
    interval and subsequent restarting of the therapy are, in
    our view, highly suggestive of a real effect being induced
    by the 4-[AP]. Improvements in fatigue and ambulation
    were mentioned quite often by the patients as being
    responsible for the favorable overall effect.”). We see no
    clear error in the district court’s finding to that effect.
    We are not persuaded by Acorda’s reasons for a con-
    trary finding. To begin with, “Elan’s failure in the only
    large-scale and properly statistically powered trial of
    sustained-release 4-AP that deflated expectations for the
    drug,” Acorda Reply Br. 28, is not particularly relevant to
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 41
    the expectations of success for the Acorda invention. The
    record shows that the Elan trial was unpublished and is
    only cursorily discussed in the introduction in Schwid,
    limiting any “deflat[ing]” effect on expectations in the
    field. Sept. 19, 2016 Trial Tr. 143–44 (Dr. Peroutka
    noting that, even in the short discussion of the 1994 Elan
    study in Schwid, there is very little detail and no mention
    of the dose of 4-AP that was used). Moreover, the abbre-
    viated discussion of that trial in Schwid distinguishes the
    aggregate outcome measure (EDSS) and results in the
    Elan study from the Schwid study’s measure of particular
    functionalities (e.g., timed gait). J.A. 6681 (noting the
    failure of the Elan study but stating that “[t]he EDSS . . .
    may have been an inadequate outcome variable for this
    trial,” as EDSS measures several outcomes and could
    “overlook” significant but lesser improvements in walk-
    ing). And the 1994 Elan study preceded the successes
    reported later in Schwid and the Goodman references,
    which were a sound basis for altering earlier expectations.
    Similarly, the “inconclusiveness of the exploratory
    studies of 4-AP, a 102-year old drug,” Acorda Reply
    Br. 28, does not speak to the more recent research relied
    on by the district court—namely, Schwid and the Good-
    man references. And “the rigorous 2003 Solari review of
    the field dispelling any confidence in using
    am[ino]pyridines to treat [multiple sclerosis],” id. at 29,
    does not dispel confidence in a walking improvement;
    rather, Solari, a prior-art literature review, reports a
    statistically significant improvement in walking,
    J.A. 7208 (reviewing three studies that “assessed the
    efficacy of aminopyridines on ambulation” and reporting
    that patients who received 4-AP showed a statistically
    significant improvement in ambulation compared to
    42 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    placebo (p<0.0001)). 13 When Acorda asserts that the
    “prior art’s [Schwid’s] teaching that 4-AP had a narrow
    therapeutic window where high doses and high blood
    serum levels were necessary for any meaningful thera-
    peutic effect,” Acorda Reply Br. 29, Acorda is incorrect, as
    discussed previously: Schwid reports that a relatively low
    (17.5 mg twice a day) dose showed a statistically signifi-
    cant improvement in walking and that high serum levels
    were not required for improvements in timed gait.
    Schwid, which reports success and no seizure events with
    a stable dose of 17.5 mg twice daily, also undermines
    Acorda’s argument that “the prior art’s consistent use of
    titration to achieve a therapeutic dose because of seizure
    risk” conclusively precludes a reasonable expectation of
    success even for a low dose like 10 mg twice daily that
    avoids high peak serum levels. Id. In the end, Schwid,
    Goodman as a whole, and expert testimony supply a
    sufficient basis for the district court’s finding of a reason-
    able expectation of success in this case.
    In light of the record evidence, the district court did
    not clearly err in finding that a person of skill at the time
    of the invention would have had a motivation to combine,
    and a reasonable expectation of success in combining, the
    teachings of the prior art to arrive at the Acorda invention
    of a stable regimen of 10 mg twice-daily sustained-release
    4-AP to improve walking in multiple sclerosis patients.
    B
    Acorda nevertheless contends that a skilled artisan
    would not have a reasonable expectation of success re-
    garding the invention of the Acorda patents because the
    prior art did not teach or suggest a final limitation of the
    13  Alessandra Solari et al., Aminopyridines for symp-
    tomatic treatment in multiple sclerosis (Review), Cochrane
    Database of Systematic Reviews, Issue 4 (2002).
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 43
    asserted claims—the pharmacokinetic limitation, which
    requires 4-AP serum levels in the 15–35 ng/ml range.
    E.g., ’826 patent, col. 27, line 29. We disagree.
    The district court found that the prior art taught that
    a dose of 10 mg sustained-release 4-AP twice daily would
    result in serum levels within the range claimed in the
    Acorda patents. Dist. Ct. Op. at *35. Hayes discloses that
    when a sustained-release formulation of 4-AP is adminis-
    tered in a 10 mg dose twice daily, and steady-state condi-
    tions are reached, the result is a 4-AP average serum
    level of 20.8 ± 5.7 ng/ml (15.1–26.5 ng/ml, which is within,
    and in fact covers most of, the Acorda patents’ claimed
    range). J.A. 6436, 6439 tbl.3. The Hayes study is sum-
    marized—and Hayes’s table listing the pharmacokinetic
    results is replicated—in the specifications of two of the
    Acorda patents. ’826 patent, col. 24, line 25 through
    col. 25, line 50 (Example 7 and Table 7); ’685 patent,
    col. 24, line 30 through col. 25, line 54 (Example 7 and
    Table 7). The district court noted that the parties did not
    dispute either of two propositions: the Hayes researchers
    used the Elan formulation that is claimed in the Acorda
    patents and is now marketed as Ampyra; and the phar-
    macokinetic results reported in Hayes are inherent prop-
    erties of that formulation. Dist. Ct. Op. at *35. As
    discussed in the previous subsections, the district court
    also found that a person of skill would have been motivat-
    ed, with a reasonable expectation of success, to administer
    a dose of 10 mg sustained-release 4-AP twice daily to
    improve walking in multiple sclerosis patients. Id. at
    *35–36. Based on those findings, the court invoked the
    principle that “an obvious formulation cannot become
    nonobvious simply by administering it to a patient and
    claiming the resulting serum concentrations,” Santarus,
    Inc. v. Par Pharm., Inc., 
    694 F.3d 1344
    , 1354 (Fed. Cir.
    2012), and concluded that the pharmacokinetic limitation
    could not alter the obviousness analysis.
    44 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    On appeal, Acorda does not directly object to the dis-
    trict court’s inherency finding about Hayes, but Acorda
    suggests that a person of skill would expect that the
    inherent pharmacokinetic profiles would differ between
    patients with spinal cord injury (as in Hayes) and pa-
    tients with multiple sclerosis (as in the Acorda patents).
    But Acorda cites no support for that assumption, and
    Acorda appears to have made the opposite assumption by
    including the Hayes pharmacokinetic data in its own
    patents on using 4-AP to treat multiple sclerosis. Acor-
    da’s expert also admitted at trial that Hayes “may cer-
    tainly show the pharmacokinetic profile that’s analogous
    to what would be found in MS [multiple sclerosis] pa-
    tients. I don’t have any dispute with that.” J.A. 825. The
    defendants’ expert agreed, testifying that a person of skill
    would expect the same pharmacokinetic profile in pa-
    tients with either condition. J.A. 539–40. And while
    Acorda argues that a person of skill in the art “would
    have no basis to connect Hayes with [multiple sclerosis]
    prior art,” Acorda Br. 54, Hayes’s introduction explicitly
    makes that connection, stating that “[4-AP] is the first
    compound shown to restore some neurologic function in
    patients with chronic [spinal cord injury] or other demye-
    linating conditions such as multiple sclerosis.” J.A. 6433
    (internal references omitted). 14
    Even if the pharmacokinetic profile is inherent in the
    10 mg twice-daily administration of sustained-release 4-
    AP in Hayes, Acorda complains that a person of skill may
    not have known the details of the formulation used in
    14   Hayes also discloses that the reported study on
    the pharmacokinetics of sustained-release 4-AP was
    sponsored by Acorda. J.A. 6433. That disclosure links
    Hayes to the Goodman references, which also disclose an
    association with Acorda in a sustained-release 4-AP
    study. J.A. 6370, 6372, 6498.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 45
    Hayes (Ampyra) and therefore would not have known
    whether the formulation claimed in the Acorda patents
    would produce the same pharmacokinetic profile. Cf. In
    re Cyclobenzaprine, 676 F.3d at 1069–71 (obviousness
    analysis of patent claims to a “therapeutically effective
    plasma concentration” and to particular pharmacokinetic
    parameters required a factual finding regarding what a
    skilled artisan would know about the serum levels needed
    to produce a therapeutic effect). But Acorda, in response
    to the district court’s question as to whether the pharma-
    cokinetic limitation would have been obvious, conceded at
    trial that a skilled artisan in 2003 would know the phar-
    macokinetic data for a 10 mg twice-daily dose of sus-
    tained-release 4-AP. J.A. 1108–09 (counsel for Acorda: “It
    was known in the art that a sustained-release formulation
    of 10 [mg] [twice daily] could achieve that PK [pharmaco-
    kinetic result], not that that PK would yield any efficacy
    for walking.”). Acorda itself therefore assumed that a
    person of skill would know that a regimen of 10 mg twice-
    daily dosing of sustained-release 4-AP—regardless of the
    specifics of the rest of the formulation—would achieve
    that pharmacokinetic profile. And, again, Acorda has not
    pointed to any evidence to contradict that assumption,
    such as evidence showing that a person of skill would
    expect another sustained-release formulation containing
    the same dose of 4-AP to produce a different pharmacoki-
    netic profile, how that formulation would differ, or how
    the associated profile would differ.
    C
    Acorda’s remaining argument on appeal concerns the
    proper analysis of objective indicia of nonobviousness in
    this case. Acorda focuses on the district court’s reliance
    on the Elan patent as a blocking patent for the Acorda
    patents’ claimed inventions, in determining that commer-
    cial success, failure of others, and long-felt but unmet
    need did not “support” or “militate in favor of” nonobvi-
    ousness. Dist. Ct. Op. at *39, *40. Acorda characterizes
    46 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    the district court as having applied a categorical rule that
    a blocking patent defeats the significance of such objective
    indicia to the obviousness determination. We think,
    however, that the district court’s opinion is best read not
    as invoking a categorical rule, but as drawing conclusions
    on the limited factual record created in this case bearing
    on the effect of a blocking patent. In any event, the court
    did not err in concluding that the defendants proved
    obviousness, considering the evidence on objective indicia.
    1
    A patent has been called a “blocking patent” where
    practice of a later invention would infringe the earlier
    patent. The existence of such a blocking patent may deter
    non-owners and non-licensees from investing the re-
    sources needed to make, develop, and market such a later,
    “blocked” invention, because of the risk of infringement
    liability and associated monetary or injunctive remedies.
    If the later invention is eventually patented by an owner
    or licensee of the blocking patent, that potential deterrent
    effect is relevant to understanding why others had not
    made, developed, or marketed that “blocked” invention
    and, hence, to evaluating objective indicia of the obvious-
    ness of the later patent. See Note, Subtests of “Nonobvi-
    ousness”: A Nontechnical Approach to Patent Validity, 
    112 U. Pa. L. Rev. 1169
    , 1177 (1964) (Regarding commercial
    success, “a court must be assured that the patentee’s
    market domination is not attributable to monopoly power
    or other economic coercion, or to other factors unrelated to
    patent validity.”) (cited in Graham v. John Deere Co. of
    Kansas City, 
    383 U.S. 1
    , 18, 36 (1966)).
    We briefly discussed blocking patents in Merck & Co.
    v. Teva Pharmaceuticals USA, Inc., 
    395 F.3d 1364
     (Fed.
    Cir. 2005) (Merck I). The Merck patent at issue, applied
    for in 1998, was for the weekly administration of alendro-
    nate monosodium trihydrate (Fosamax). 
    Id.
     at 1366–67.
    That patent was preceded by Merck’s earlier patent
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 47
    (issued in 1986) covering a method of administering an
    effective amount of Fosamax to treat osteoporosis, as well
    as Merck’s statutory right, since obtaining FDA approval
    in 1995, to the exclusive marketing of any dosage strength
    of Fosamax for the next five years. 
    395 F.3d at 1367, 1377
    ; Br. for Def.-Appellant Teva Pharm. USA, Inc.,
    Merck I, No. 04-1005, 
    2003 WL 24307848
    , at *62–63 (Fed.
    Cir. Dec. 17, 2003). We ruled that the district court had
    erred in its analysis of commercial success because the
    earlier patent and FDA regulatory approval depressed
    incentives for others to invent the weekly-dosing scheme.
    
    395 F.3d at 1377
     (“Because market entry by others was
    precluded on those bases, the inference of non-
    obviousness of weekly-dosing, from evidence of commer-
    cial success, is weak.”). In that context, we said, the
    evidence of commercial success was “not enough to show
    the claims at bar are patentably distinct from the weekly-
    dosing ideas in the [invalidating prior art].” 
    Id.
    In Galderma Laboratories, L.P. v. Tolmar, Inc., 
    737 F.3d 731
     (Fed. Cir. 2013), we considered the district
    court’s finding, in support of commercial success, that the
    FDA-approved product “quickly gained and maintained
    market share.” 
    Id. at 740
    . Because earlier patents owned
    by Galderma may have “blocked” competition to market
    the FDA-approved product by any entity other than
    Galderma, we reasoned that the commercial success of the
    product was “of ‘minimal probative value’” and not suffi-
    cient to justify a conclusion of nonobviousness in light of
    the other evidence supporting obviousness. 
    Id. at 741
    (quoting Merck I, 
    395 F.3d at 1376
    ).
    Recently, in Merck Sharp & Dohme Corp. v. Hospira,
    Inc., 
    874 F.3d 724
     (Fed. Cir. 2017) (Merck II), we conclud-
    ed that Merck’s exclusive license to a blocking patent did
    not, all by itself, justify discounting evidence of commer-
    cial success. 
    Id.
     at 730–31. We explained that commer-
    cial success is “a fact-specific inquiry” that may involve
    considering the operation of specific blocking patents on
    48 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    possible competition. 
    Id. at 731
    . But the mere existence
    or sheer number of blocking patents does not, without
    more, “necessarily detract from evidence of commercial
    success of a product or process.” 
    Id.
     Nevertheless, “even
    giving the evidence of commercial success its full and
    proper weight,” we affirmed the judgment invalidating
    the claims at issue for obviousness in light of “the evi-
    dence that the claimed process was substantially de-
    scribed in the prior art” and that “merely ordinary
    experimentation was required to arrive at the [patent at
    issue].” 
    Id.
    Merck II’s reasoning reflects a common-sense recogni-
    tion that, as a theoretical matter, a blocking patent may
    or may not deter innovation in the blocked space by
    commercially motivated potential innovators other than
    the owners or licensees of the blocking patent. 15 Where
    the owner of the blocking patent or exclusive licensee is
    different from the owner of the patent in suit, the grant-
    ing of a license may be a realistic possibility. Even where,
    as here, the owner of the patent in suit and the exclusive
    licensee of the blocking patent are the same, such a
    potential innovator might or might not think it could
    successfully challenge the blocking patent. And such a
    potential innovator might or might not be willing to
    research in the blocked space without a license to a block-
    ing patent—even if the research itself is within the safe
    harbor provided by 
    35 U.S.C. § 271
    (e)(1)—and wait until
    it has already developed and patented its aimed-at im-
    15   We use the term “blocked space” to refer to what
    would infringe given the “boundaries,” Festo Corp. v.
    Shoketsu Kinzoku Kogyo Kabushiki Co., 
    535 U.S. 722
    , 730
    (2002), or “metes and bounds,” Brenner v. Manson, 
    383 U.S. 519
    , 534 (1966), set by the blocking patent’s claims.
    See Andrew Corp. v. Gabriel Electronics, Inc., 
    847 F.2d 819
    , 823 (Fed. Cir. 1988).
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 49
    provement to negotiate for a cross-license with the block-
    ing patent’s owner to share the profits from the improve-
    ment. Besides the assessment of whether the blocking
    patent can be successfully challenged, a number of varia-
    bles appear generally relevant to the calculus, including:
    the costliness of the project; the risk of research failure;
    the nature of improvements that might arise from the
    project, and whether such improvements will be entirely
    covered by the blocking patent; the size of the market
    opportunities anticipated for such improvements; the
    costs of arriving at the improvements and getting them to
    market; the risk of losing the invention race to a blocking-
    patent owner or licensee; the risk that the blocking-patent
    owner (making its own economic calculations, perhaps in
    light of its own other products or research activities) will
    altogether refuse to grant a license to the improvement or
    will demand so large a share of profits that the whole
    project is not worthwhile for the potential innovator—all
    evaluated in light of other investment opportunities.
    For such reasons, it is clear that, if all other variables
    are held constant, a blocking patent diminishes possible
    rewards from a non-owner’s or non-licensee’s investment
    activity aimed at an invention whose commercial exploita-
    tion would be infringing, therefore reducing incentives for
    innovations in the blocked space by non-owners and non-
    licensees of the blocking patent. Such a blocking patent
    therefore can be evidence that can discount the signifi-
    cance of evidence that nobody but the blocking patent’s
    owners or licensees arrived at, developed, and marketed
    the invention covered by the later patent at issue in
    litigation. But the magnitude of the diminution in incen-
    tive in any context—in particular, whether it was great
    enough to have actually deterred activity that otherwise
    would have occurred—is “a fact-specific inquiry.” Merck
    II, 874 F.3d at 731. That inquiry, conducted within the
    framework under which the challengers always retain the
    burden of persuasion on obviousness, may be a difficult
    50 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    one as a practical matter. In a particular case, a court
    may ultimately be left, for its evaluation, with the solid
    premise of diminished incentives, plus some evidence
    (possibly weak or ambiguous) about the significance of the
    deterrence, together with a background sense of the
    general realities in the area at issue that can affect the
    weight to be given to the evidence in the specific case.
    2
    Against this background, we review the district
    court’s consideration of objective indicia of nonobvious-
    ness in light of the Elan patent. Acorda licensed the Elan
    patent in the late 1990s, before the period of commercial
    success alleged by Acorda and found by the district court.
    Here, Acorda bore the burden of producing evidence of
    objective indicia, but the “ultimate burden of proving
    obviousness” at all times remained with the defendants.
    Galderma, 737 F.3d at 736–38. We conclude that the
    district court did not err in viewing the Elan patent,
    among other evidence, as evidence that discounted the
    weight of Acorda’s evidence of commercial success, failure
    of others, and long-felt but unmet need so that “the evi-
    dence as a whole” in the case “prove[d] clearly and con-
    vincingly that the Acorda Patents are invalid due to
    obviousness.” Dist. Ct. Op. at *41.
    The parties presented evidence on the objective indi-
    cia of commercial success, failure of others, and long-felt
    but unmet need. 16 In particular, the defendants present-
    ed evidence of blocking by the Elan patent. See Dist. Ct.
    Op. at *38 & n.43 (undisputed that invention of Acorda
    patents practice the Elan patent).
    16   Acorda also presented evidence of unexpected re-
    sults, but the district court found the evidence unpersua-
    sive. See Dist. Ct. Op. at *39. Acorda does not appeal
    that finding.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 51
    As to commercial success, the district court found that
    “no one other than the Elan patentees and their licensees
    could have practiced the invention of the Acorda patents
    without facing liability for patent infringement. The risk
    of such liability would have provided an independent
    incentive for a patentee not to develop the invention of the
    Acorda patents, even if those inventions were obvious.”
    Id. at *38. The district court therefore found that the
    evidence of commercial success did not support the con-
    clusion that the Acorda patent claims were non-obvious.
    Id. at *39.
    We will interpret the district court’s statements to-
    gether as referring to domestic marketing of a product.
    As discussed below, the Elan patent would not preclude
    practice of the Elan invention outside the United States
    or under the safe harbor provision of 
    35 U.S.C. § 271
    (e)(1)
    for specified FDA-related activities. The district court’s
    key finding, therefore, is that “[t]he risk of [infringement]
    liability” for marketing in the United States “would have
    provided an independent incentive for a patentee not to
    develop the invention of the Acorda patents, even if those
    inventions were obvious.” Dist. Ct. Op. at *38.
    That finding is supported by the record. The defend-
    ants offered unrebutted testimony from an expert in
    economics and pharmaceuticals that the Elan patent
    acted as a blocking patent for entities other than Acorda
    (the exclusive licensee to the Elan patent) that wanted to
    pursue commercial opportunities like Ampyra. J.A. 965–
    66 (“[O]ther entities that might want to pursue commer-
    cial opportunity like Ampyra . . . would not have access to
    [the sustained-release 4-AP formulation claimed in the
    Elan patent] because Acorda has that exclusive license.”).
    The Elan patent issued in 1996 and was licensed exclu-
    sively to Acorda in 1997 for spinal cord injury and in 1998
    for multiple sclerosis treatment. J.A. 965. After that, the
    exclusive license blocked others from domestic marketing
    without risk of infringement.
    52 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    Other evidence supports a finding that the Elan pa-
    tent would have deterred entities other than Elan (holder
    of the Elan patent) and Acorda (exclusive licensee) from
    investing in research whose reward depended on market-
    ing a drug like Ampyra. After more than a decade of
    research by different groups and then issuance of the
    Elan patent in 1996, clinical trial research into sustained-
    release 4-AP treatment for multiple sclerosis appears,
    based on the prior art introduced at trial, to have been
    limited to Elan and Acorda. When seeking to use 4-AP for
    multiple sclerosis, Acorda itself sought and obtained a
    license to the Elan patent. There is no evidence that Elan
    sought to license the Elan patent to any entity other than
    Acorda, or that Acorda sought to sublicense the Elan
    patent, either of which would dilute the power of the
    blocking patent. J.A. 966. And what Elan granted Acor-
    da was an exclusive license, suggesting the significance of
    the Elan patent’s blocking power.
    Acorda notes that U.S. patents do not block sales out-
    side the United States. That observation is relevant, but
    it is not shown to be weighty in this case by any concrete
    evidence about the particular inventions at issue. Indeed,
    the two international studies that Acorda highlights were
    both conducted before issuance of the Elan patent in 1996.
    See J.A. 6654 (1994 Polman study); J.A. 7037 (1993 Van
    Diemen study).
    Acorda also notes that potential innovators would not
    have been blocked from practicing the Elan patent in the
    ways covered by the safe harbor provision of 
    35 U.S.C. § 271
    (e)(1), which declares specified activities to be non-
    infringing if undertaken “solely for uses reasonably relat-
    ed to the development and submission of information” to
    the FDA. See Merck KGaA v. Integra Lifesciences I, Ltd.,
    
    545 U.S. 193
    , 205–08 (2005). That safe harbor is certainly
    relevant, but it does not eliminate infringement liability
    for the eventual reward-collecting activity of generally
    marketing the product. We have no basis for finding clear
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 53
    error in the district court’s finding about the explanatory
    significance of the risk of such liability. Acorda did not
    supply evidence to make unreasonable the implicit find-
    ing that securing freedom from blocking patents in ad-
    vance is likely important to pharmaceutical research
    investments. 17 And amici appearing in this court on
    appeal have not supplied such evidence either. 18
    17    Without contrary evidence, we see nothing inher-
    ently unreasonable about the implicit finding to that
    effect. See Stoyan A. Radkov, Freedom to Operate (FTO)
    from a large company’s perspective 3, 5, Royal Society of
    Chemistry (Oct. 11, 2010), http://www.rsc.org/images/
    StoyanRadkov_tcm18-192425.pdf (in a presentation by an
    attorney for Novartis Pharma AG an FTO analysis of
    “[t]he ability to perform a particular commercial activity
    (e.g. commercialize a product, provide a service, perform a
    manufacturing process or use a product) without ‘infring-
    ing’ 3rd party’s valid IP [intellectual property] rights,”
    explaining that “[i]dentifying possible 3rd party IP rights
    posing risks as soon as possible is essential”); Saharsh
    Davuluri, Generic Drugs – The Freedom to Operate,
    Neutland Labs. Ltd. (Aug. 2, 2014), https://www.neuland
    labs.com/blog/2014/08/02/generic-drugs-the-freedom-to-op
    erate/ (“A Freedom to Operate analysis is crucial – and is
    best performed before embarking down the product devel-
    opment path.”). In so stating, we do not prejudge what
    evidence in another case might demonstrate.
    18  Amici point out that pharmaceutical improve-
    ments (new formulations, new combinations, and new
    indications of previously marketed drugs) are not un-
    common: 23 were approved by the FDA and launched in
    2016. Biotech. Innovation Org. Br. at 20 (citing A.I. Graul
    et al., The year’s new drugs & biologics 2016: Part I, 53
    Drugs of Today 27, 28 (2017)). But amici do not specify
    whether the approved applications for those improve-
    54 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    Acorda offers no more persuasive basis for challenging
    the district court’s findings of the weakness of Acorda’s
    evidence of the failure of others and long-felt but unmet
    ments are held by the owners (or licensees) of any original
    blocking patents or by competing entities. See Chie Hoon
    Song & Jeung-Whan Han, Patent cliff and strategic
    switch: exploring strategic design possibilities in the
    pharmaceutical industry, 5 SpringerPlus 692, 698–99
    (2016) (noting that some of the best ways for a pharma-
    ceutical company to avoid the “patent cliff” of losing the
    monopoly on its brand-name drug from patent expiration
    is through a product-line extension (new formulations,
    new combinations), new indications, or a follow-on prod-
    uct). For example, among the examples from 2016 listed
    in the Graul article are Ilaris, Ezetrol, and Inegy, see
    Graul, The year’s new drugs & biologics, 53 Drugs of
    Today at 56, 57, which involve improvements (new indica-
    tions) on drugs previously approved for other indications
    for marketing by the same company that submitted the
    application for the new indication. See Product Update:
    New indication for Inegy, The Pharmaceutical Journal
    (Mar. 1, 2016), https://www.pharmaceutical-journal.com/
    news-and-analysis/notice-board/new-indication-for-inegy/
    20200796.article?firstPass=false (Merck sells the drug
    Inegy (ezetimibe/simvastatin) for both old and new indica-
    tions); U.S. Food & Drug Admin., U.S. Dep’t of Health &
    Human Servs., FDA News Release: FDA approves expand-
    ed indications for Ilaris for three rare diseases (Sept. 23,
    2016),    https://www.fda.gov/newsevents/newsroom/press
    announcements/ucm522283.htm (Ilaris (canakinumab)
    sold by Novartis for old and new indications); Joel Levy,
    MHRA approves new indication for MSD’s Ezetrol, Phar-
    mafile (Feb. 26, 2016), http://www.pharmafile.com/news/
    503098/mhra-approves-new-indication-msd-s-ezetrol
    (Merck (MSD) sells Ezetrol (ezetimibe) for both old and
    new indications).
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 55
    need as evidence of non-obviousness. Dist. Ct. Op. at *39–
    40. As to the former, the district court found that Sanofi-
    Aventis experimented with another potassium-channel
    blocker and was unsuccessful, and “Sanofi-Avenits likely
    did not use 4-AP because” of the blocking effect of the
    Elan patent. Id. at *39. Acorda has not shown clear error
    in that finding. Acorda also points to the failure of Elan’s
    1994 study. But the district court reasonably found that
    “Elan’s failure is not particularly probative” because the
    Elan study preceded publications that would render the
    invention obvious to those of skill in the art (Schwid and
    Goodman) as of the 2004 priority date. Dist. Ct. Op. at
    *40; see Graham, 
    383 U.S. at 36
     (“The [1956] Scoggin
    invention . . . rests upon exceedingly small and quite non-
    technical mechanical differences in a device which was old
    in the art. At the latest, those differences were rendered
    apparent in 1953 by the appearance of the Livingstone
    patent [invalidating prior art], and unsuccessful attempts
    to reach a solution to the problems confronting Scoggin
    made before that time became wholly irrelevant.”); see
    also Note, Subtests of “Nonobviousness,” 112 U. Pa. L.
    Rev. at 1174 (“In receiving evidence of unsuccessful
    research, courts must take care that such research was
    conducted under the same state of the art as that which
    confronted the patentee. It may be that an intervening
    innovation made that which the patentee accomplished
    obvious even though it was not obvious to prior unsuccess-
    ful researchers.” (internal reference omitted)). By 1997,
    the art expressly explained why improvement of multiple
    sclerosis symptoms with 4-AP was promising despite the
    failed 1994 Elan study. See, e.g., J.A. 6681 (1997 Schwid
    article states that the EDSS score was “an inadequate
    outcome variable” for the Elan study, reports a significant
    improvement in timed gait, and concludes that “4AP
    [sustained-release] improved motor function in [multiple
    sclerosis] patients.”).
    56 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    As to long-felt but unmet need, the district court
    discounted its finding of such need in light of the evidence
    of blocking by the Elan patent. Dist. Ct. Op. at *40. We
    see no clear error. While not dispositive, the evidence of
    blocking we have discussed is pertinent, in this case, to
    the factual question of long-felt but unmet need—at least
    as to the period after the issuance of the Elan patent in
    1996.
    III
    The defendants cross-appealed the district court’s
    ruling that the Elan patent is not invalid and the result-
    ing injunction. Because the injunction terminated by its
    terms on the date of expiration of the Elan patent (July
    30, 2018), and no retrospective liability is at issue, the
    cross-appeal is dismissed as moot. See Fed. R. App. P.
    41(b), (c); 16AA Charles A. Wright & Arthur R. Miller,
    Federal Practice and Procedure § 3987 (4th ed. 2018); cf.
    Defs.’ Br. 61 (“the Court need not reach the cross-appeal
    unless the Court intends to issue a decision before August
    2018”).
    IV
    We affirm the district court’s ruling that the asserted
    claims of the Acorda patents are invalid and dismiss the
    defendants’ cross-appeal as moot.
    AFFIRMED
    United States Court of Appeals
    for the Federal Circuit
    ______________________
    ACORDA THERAPEUTICS, INC.,
    Plaintiff-Appellant
    ALKERMES PHARMA IRELAND LIMITED,
    Plaintiff-Appellee
    v.
    ROXANE LABORATORIES, INC., MYLAN
    PHARMACEUTICALS INC., TEVA
    PHARMACEUTICALS USA, INC.,
    Defendants-Cross-Appellants
    ______________________
    2017-2078, 2017-2134
    ______________________
    Appeals from the United States District Court for the
    District of Delaware in Nos. 1:14-cv-00882-LPS, 1:14-cv-
    00922-LPS, 1:14-cv-00935-LPS, 1:14-cv-00941-LPS, Chief
    Judge Leonard P. Stark.
    ______________________
    NEWMAN, Circuit Judge, dissenting.
    The court today holds that the new Acorda treatment
    for multiple sclerosis, Ampyra®, achieved after decades of
    failed research, was obvious. For this discovery, where a
    relatively small pharmacological difference produced long-
    sought medical benefits, it is essential that the correct
    law and analysis of obviousness are applied.
    2   ACORDA THERAPEUTICS, INC.    v. ROXANE LABORATORIES, INC.
    The district court observed that the objective indicia,
    viz. commercial success, long-felt but unmet need, failure
    of others, and copying, could change the result, yet dis-
    counted its weight on the theory that the patentee had a
    “blocking” patent. Adopting this flawed reasoning, my
    colleagues hold that this new treatment for multiple
    sclerosis was obvious. However, it is apparent that there
    is not clear and convincing evidence of obviousness.
    The consequences of this new legal theory are large,
    as the amici curiae advise. Had the court’s approach to
    the law of obviousness been in effect when Acorda took up
    the study of 4-aminopyridine after decades of failures by
    others, it is questionable whether this new treatment for
    multiple sclerosis would have been discovered and pur-
    sued. The loser is the afflicted public. 1
    From my colleagues’ continuation of this error, and
    their erroneous conclusions, I respectfully dissent.
    I
    The Decades of Failures
    As the court reports, 4-AP has “for several decades”
    been the “focus of research regarding the treatment of
    multiple sclerosis.” Maj. Op. at 5. Starting in the 1980s
    or earlier, scientists in several countries tried and failed
    to provide safe and effective application of 4-AP. My
    colleagues agree, as do the Defendants who initiated
    these Hatch-Waxman proceedings, that the Acorda Pa-
    tents describe novel technology, and that a safe and
    effective formulation for 4-AP was not previously known.
    The Acorda inventors succeeded where many others had
    1   The FDA gave the Acorda product expedited ap-
    proval, in view of the public need for relief of multiple
    sclerosis. Appellant’s Br. at 23.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   3
    failed. The panel majority treats these past failures
    simply as invalidating prior art.
    The court recognizes that the Acorda Patents are di-
    rected to a new, effective treatment to relieve the “walk-
    ing impairment” of multiple sclerosis. 2 However, the
    court holds that Acorda merely “add[ed] further, more
    specific requirements to the Elan Patent’s claimed meth-
    ods.” Maj. Op. at 3. The court does not mention that
    Elan, after years of failures, abandoned its attempts to
    use 4-AP to treat multiple sclerosis and licensed the
    sustained-release patent to Acorda.
    The record shows that many scientists in many insti-
    tutions studied and eventually abandoned 4-AP as a
    treatment prospect for multiple sclerosis. These aban-
    doned studies constitute the prior art on which the dis-
    trict court and my colleagues rely for obviousness of the
    Acorda Patents. However, the experimentation with 4-AP
    shows just the opposite – it shows that work with 4-AP
    was abandoned due to the inability to balance the com-
    pound’s potential effectiveness with its toxicity.
    To review obviousness of the Acorda Patents, I start
    with the cited references, whose chronology illustrates the
    initial encouragement followed by failed attempts to apply
    the neurological properties of 4-aminopyridine, and the
    2    The symptoms of multiple sclerosis include “walk-
    ing impairment, visual difficulty, fatigue, bladder dys-
    function, tingling or pain, sexual dysfunctions, balance
    problems, and cognitive changes,” with “weakness in the
    legs and/or alterations in walking among the most com-
    mon symptoms.” Acorda Therapeutics, Inc. v. Roxane
    Labs., Inc., No. 1:14-cv-00882-LPS, 
    2017 WL 1199767
     (D.
    Del. Mar. 31, 2017) (Dist. Ct. Op.) at *2.
    4   ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.
    eventual abandonment of this product despite some
    positive observations.
    A. The Stefoski Study
    In 1987, Stefoski et al. reported a one-day test of the
    effects of 4-AP on vision and gait in twelve multiple
    sclerosis patients. 3 They reported that, following intrave-
    nous injection of 7 to 35 mg of 4-AP, in 1 to 5 mg doses
    every ten to sixty minutes, “[v]ision improved in 7 pa-
    tients, oculomotor function in 5, and motor function
    (power, coordination, gait) in 5,” stating that there were
    “no serious side effects,” and “transient therapeutic bene-
    fit in selected patients.” Stefoski et al. at 71. My col-
    leagues rely on this publication for rendering obvious
    Acorda’s improvement in walking, while downplaying the
    “serious side effects” including seizures reported by Bev-
    er 4 and others, and the criticism of the small sample size
    and the brief duration of these one-day tests.
    B. The Davis Study
    In 1990, Davis and Stefoski reported a study of fifteen
    patients using an orally-administered formulation of 4-
    AP. 5 They concluded that the results “suggest a safe and
    effective therapeutic window for orally administered 4-
    AP,” but they cautioned that similar studies had found
    3    Dusan Stefoski et al., 4-Aminopyridine Improves
    Clinical Signs in Multiple Sclerosis, 21 Annals of Neurol-
    ogy 71 (1987), J.A. 6697.
    4    Christopher T. Bever, Jr., The Current Status of
    Studies of Aminopyridines in Patients with Multiple
    Sclerosis, 36 Annals of Neurology S118 (1994) (“Bever II”),
    J.A. 6172.
    5    Floyd A. Davis et al., Orally Administered 4-
    Aminopyridine Improves Clinical Signs in Multiple Scle-
    rosis, 27 Annals of Neurology 186 (1990), J.A. 6327.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   5
    that side effects of 4-AP “precluded its clinical use,” and
    that “MS patients have an increased risk of seizures.”
    Davis et al. at 191.
    These studies were criticized by Bever as “limited be-
    cause they did not use a randomized treatment design,
    were not double blinded, and relied on outcome measures
    that were not widely accepted.” Bever II at S119. Alt-
    hough my colleagues cite Davis’ reports of “mild to
    marked improvements,” Maj. Op. at 5, they do not men-
    tion the risk of seizures as warned by Davis, or Bever’s
    criticisms.
    While the panel majority states that Davis reported
    “no serious or bothersome side effects, including seizures”
    at doses up to 25 mg, 
    id.,
     Elan, which relied on Davis’
    research team, Dist. Ct. Op. at *4, terminated its devel-
    opment of 4-AP based on toxicity and seizures, and li-
    censed its sustained release patent to Acorda.
    Nonetheless, my colleagues hold that the Davis studies
    contributed to the obviousness of the Acorda Patents,
    ignoring the problems that were reported, and the aban-
    donment of 4-AP by these researchers.
    C. The Van Diemen study
    The panel majority also relies on a study conducted in
    the Netherlands and published in 1993 by Van Diemen. 6
    The publication reports the effect of escalating doses of 4-
    AP, measured by the Kurtzke expanded disability status
    scale (EDSS) that is frequently used as a benchmark to
    measure symptoms in multiple sclerosis patients. The
    6   Harriët A. M. Van Diemen et al., 4-Aminopyridine
    in Patients with Multiple Sclerosis: Dosage and Serum
    Level Related to Efficacy and Safety, 16 Clinical Neuro-
    pharmacology 195 (1993), J.A. 7037.
    6   ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.
    study examined the effect on eye function of intravenous
    and oral administration of 4-AP for up to 12 weeks.
    My colleagues report that eye functioning was bene-
    fited, but ignore the report of side effects, including nau-
    sea and dizziness, at the “escalated” dosages needed to
    produce improvement in eye function. Van Diemen et al.
    at 200, 203.
    D. The Polman study
    Polman7 describes an unblinded study of the treat-
    ment with 4-AP of thirty-one multiple sclerosis patients,
    some of whom had been involved in an earlier study.
    Twenty-three patients were treated with 4-AP for longer
    than six months. The new patients were given an upward
    titration dosing plan in accordance with the tolerability
    by the patient, up to a maximum dose (based on patient
    weight) over four to eight weeks. Polman measured
    efficacy based on subjective reports from the patients
    during clinic visits.
    The Van Diemen and Polman references were relied
    on by the district court as teaching “stable dosing,” but
    they involve stable dosing only after titration to the
    highest tolerable dose for each individual patient. Both
    Van Diemen and Polman describe using a titration
    scheme up to the maximum amount based on the patient’s
    weight. Dist. Ct. Op. at *12–13. These references only
    teach stable dosing after the maximum tolerable dose has
    been determined for each patient, after upward titration.
    Goodman, post, also reports an “increasing benefit” for
    doses up to 50 mg/day if such doses can be tolerated.
    These sources all show the understood need to target
    7  Chris H. Polman et al., 4-Aminopyridine in the
    Treatment of Patients with Multiple Sclerosis, 51 Archives
    of Neurology 292 (1994), J.A. 6654.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   7
    higher doses to the extent they can be tolerated. See
    Goodman Poster (reporting increasing benefit as dosage
    was increased from 20mg to 50mg). 8
    Polman reported that “[i]mprovements in fatigue and
    ambulation were mentioned quite often by the patients.”
    Polman et al. at 295. However, two patients in the Pol-
    man study experienced seizures and discontinued partici-
    pation. 
    Id.
     at 294–5. My colleagues cite Polman’s report
    of “favorable response to the medication,” Maj. Op. at 7
    (citing 
    id. at 293
    ), but downplay Polman’s conclusion that
    there was little quantifiable benefit of the therapy using
    the primary EDSS benchmark, my colleagues stating that
    the side effects were not troublesome, despite the reports
    of seizures. Maj. Op. at 8–9.
    E. Additional studies reported by Bever
    The Bever II reference reports additional studies, as
    follows:
    Two double-blind, placebo-controlled crossover
    trials of DAP have recently been completed.
    Carter and associates, using 3-week treatment pe-
    riods and doses up to 80 mg/day, found subjective
    improvement in 48% of patients on DAP but only
    24% on placebo. Although this difference was not
    statistically significant, treatment-related differ-
    ences were found in sensitivity to thermal chal-
    lenge.
    8    Dist. Ct. Op. at *14 (“The Goodman Poster is a
    poster presented at the September 2002 annual meeting
    of the America Committee for Treatment and Research in
    Multiple Sclerosis, held in Baltimore, Maryland.”), J.A.
    6497–504.
    8   ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.
    Bever II at S120 (citing JL Carter et al., A double-blind,
    placebo-controlled crossover trial of 3,4-diaminopyridine
    in the symptomatic treatment of multiple sclerosis, 34
    Annals of Neurology 272 (1993)).
    These studies further illustrate the uncertain state of
    the art at that time, and the “differences” and “sensitivi-
    ty” that led to abandonment of development of 4-AP.
    These studies did not lead to any proposed treatment of
    multiple sclerosis, despite the accumulating knowledge
    concerning 4-AP. My colleagues mention the toxic effects
    including seizures, encephalopathy, and hepatitis, but
    skip over their importance. However, it is apparent that
    others did not ignore their importance, for no proposed
    product, no proposed treatment, resulted from these
    studies.
    F. The abandoned Elan studies
    The manifestations and miseries of multiple sclerosis
    are powerful, and Elan Corporation entered the field to
    pursue the idea that sustained-release formulations of 4-
    AP might relieve the toxic effects and provide “therapeu-
    tically effective blood levels throughout a given treatment
    period.” 
    U.S. Patent No. 5,540,938
     (the “Elan Patent”) at
    col.2, l.15. In 1991 Elan filed the patent application
    leading to the Elan Patent, which described and claimed
    sustained-release formulations of 4-AP. Elan undertook
    major efforts to develop a treatment for multiple sclerosis
    using sustained-release formulations. Reports of these
    unsuccessful efforts were published.
    Schwid 9 reports a failed clinical trial in 1994, de-
    scribed as a six-week, 161-patient placebo-controlled
    9  Steven R. Schwid et al., Quantitative assessment
    of sustained-release 4-aminopyridine for symptomatic
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC.   9
    study of the administration of sustained-release 4-AP to
    multiple sclerosis patients. The results were measured
    using the EDSS benchmark, and included measures of
    walking disability including gait and speed. The conclu-
    sion was that there was no improvement over the placebo.
    Schwid et al. at 817.
    Another Elan study of ten patients, also reported by
    Schwid, stated that nine of these patients showed an
    improvement in speed of walking. Schwid discussed that
    the mean serum level of 4-AP during the study was
    “65±25 ng/ml (range, 34-99)” and that the treatment
    “appeared particularly efficacious in subjects who
    achieved serum 4AP levels above 60 ng/ml.” 
    Id.
     at 819–
    20. The study reported that “[n]one of the patients with a
    serum level less than 60 ng/ml felt better (according to
    their global impressions) on 4AP SR [sustained-release]
    than placebo,” while all patients with serum levels above
    60 ng/ml demonstrated improvement in timed gait, grip
    strength, and five of six improving by their own subjective
    impression. 
    Id.
     at 819–20. In contrast, the Acorda Pa-
    tents are directed to a serum range of about 15-35 ng/ml,
    which Schwid described as unlikely to produce therapeu-
    tic effect.
    The 17.5 mg dose used by Schwid was stated to be in-
    effective in a number of respects, including the EDSS
    benchmark. Schwid et al. at 817. Schwid suggested that
    further research should be conducted, but this does not
    convert Schwid’s reported failures into a teaching of the
    path to success. My colleagues state that Schwid reported
    “promising” results, Maj. Op. at 55, but do not mention
    Schwid’s conclusion that 4-AP was not effective at the
    doses that were necessary to limit toxicity, or the lack of
    treatment of multiple sclerosis, 48 Neurology 817 (1997),
    J.A. 6681-84.
    10 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    improvement over placebo. Instead, my colleagues sug-
    gest that Schwid contributed to obviousness because
    Schwid suggested that, since the EDSS benchmark had
    failed, it might be useful to look at “more sensitive, quan-
    titative measures.” Maj. Op. at 13–14 (quoting Schwid,
    J.A. 6681). Thus the panel majority concludes that these
    studies rendered obvious the Acorda success that had
    eluded Schwid.
    Elan also sponsored studies at the University of Mar-
    yland, published by Bever et al. 10 Bever summarized that
    the “lower serum concentration range of 30 to 59 ng/ml
    may . . . be adequate for inducing improvement of some
    neurologic deficits,” Bever I at 1058, quoted at Maj. Op.
    at 10; but the panel majority ignores that the study did
    not show any improvement on the EDSS benchmark or on
    an ambulation benchmark, 
    id.
     at 1056–57, and treats the
    Bever report of “increased side effects,” including a grand
    mal seizure, as a throwaway, Maj. Op. at 10.
    These studies surely added to the body of knowledge,
    but they did not produce a usable product. Although
    these studies used Elan’s sustained-release formulations,
    the effort was eventually abandoned. The record is con-
    sistent in showing that Elan, like the others who had
    studied 4-AP, had been unable to achieve an effective
    product free of toxicity and serious side effects.
    10   Christopher T. Bever, Jr. et al., The effects of 4-
    aminopyridine in multiple sclerosis patients: Results of a
    randomized, placebo-controlled, double-blind, concentra-
    tion-controlled, crossover trial, 44 Neurology 1054 (1994)
    (“Bever I”), J.A. 6180.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 11
    G. The Hayes report of early Acorda studies
    Hayes 11 reports Acorda’s activity, starting in 1993 and
    investigating use of 4-AP for treatment of spinal cord
    injury. The first of these studies evaluated single doses of
    sustained-release 4-AP in fourteen patients with spinal
    cord injury, and the second study examined multiple
    doses of sustained-release 4-AP in sixteen patients with
    spinal cord injury. Dist. Ct. Op. at *15 (citing Hayes et al.
    at 186). The Hayes publication stated that all patients in
    both studies experienced at least one adverse event, such
    as dizziness, hypotension, or nausea. Hayes et al. at 188,
    191.
    H. The Solari review article
    Solari 12 is a review of medical knowledge related to 4-
    AP, including reports on clinical trials conducted with MS
    patients. From the studies in its analysis, Solari tabulat-
    ed that 54% of the multiple sclerosis patients taking 4-AP
    or diaminopyridine experienced improved motor func-
    tions, compared to 7% of placebo. Solari et al., J.A. 7204.
    Solari concluded that its “review of trials found there is
    not enough evidence about the safety of these drugs or
    whether benefits are certain.” Solari et al., J.A. 7218.
    11  Keith C. Hayes et al., Pharmacokinetic Studies of
    Single and Multiple Oral Doses of Fampridine-SR (Sus-
    tained-Release 4-Aminopyridine) in Patients With Chronic
    Spinal Cord Injury, 26 Clinical Neuropharmacology 185
    (2003), J.A. 6433.
    12  Alessandra Solari et al., Aminopyridines for symp-
    tomatic treatment in multiple sclerosis (Review), Cochrane
    Database of Systematic Reviews, Issue 4 (2002), J.A.
    7204.
    12 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    II
    The Acorda Studies
    As outlined supra, Acorda began research with 4-AP
    in 1993 for treatment of spinal cord injury. As reported
    by Hayes, successful results were not obtained. Dr. Ron
    Cohen, the founder of Acorda, turned to study of multiple
    sclerosis. Dr. Cohen testified that he took on the “daunt-
    ing challenges” of seeking an effective treatment for
    multiple sclerosis, with knowledge of the failures of Elan
    and others. Appellant’s Br. at 13 (citing J.A. 596–97).
    Acorda scientists conducted research over the ensuing
    six years, and published their results as experience accu-
    mulated and knowledge evolved. These publications are
    treated as prior art to the Acorda Patents.
    A. Acorda’s initial failures
    Acorda’s initial publications reported that the multi-
    ple sclerosis population receiving various experimental 4-
    AP treatments showed some improvement in walking
    speed and lower extremity muscle strength, but “did not
    show that any individual dosage had a statistically signif-
    icant effect versus placebo.” Appellant’s Br. at 15; see
    Goodman Poster, n.9 ante. Dr. Goodman was the lead
    clinical investigator for Acorda, and the lead author for
    the published results of Acorda’s MS-F201 study, 13 a
    randomized double-blind placebo-controlled study with
    the aim of “determin[ing] the safety and tolerability of
    escalating doses of a sustained-release (‘SR’) formulation
    given orally to patients with MS.” Goodman I at S116.
    13   Andrew Goodman et. al., Placebo-Controlled Dou-
    ble-blinded Dose Ranging Study of Fampridine-SR in
    Multiple Sclerosis, 8 Multiple Sclerosis S116 (P308) (July
    2002), (“Goodman I”) J.A. 6370.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 13
    Goodman I states that the MS-F201 data “showed sta-
    tistically significant improvement from baseline compared
    to placebo in functional measures of mobility (timed 25
    walking speed; p=0.04) and lower extremity strength
    (manual muscle testing; p=0.01).” Id. at S117. It further
    states that “[d]ose response curves showed increasing
    benefit in both measures in the 20 to 50 mg/day range.”
    Id. However, two participants withdrew due to seizures.
    Id.
    The Goodman Poster reported that the MS-F201
    study demonstrated “statistically significant improve-
    ments in the timed 25-foot walk and manual muscle test
    relative to placebo.” Dist. Ct. Op. at *15. However, the
    Poster also stated that a greater improvement in fatigue
    was reported by the placebo group as compared to the 4-
    AP treated group, and referred to the withdrawal of two
    subjects due to seizure. Goodman Poster, J.A. 6502. Dr.
    Goodman testified at trial that “[a]ll of the prespecified
    analyses failed except for the lower extremity manual
    muscle test.” J.A. 604 (289:24–5). He stated that the
    result of the timed walk “was not at all significant,” and
    was consistent with the failed Elan study. J.A. 605
    (290:5).
    The district court found that the Goodman Poster es-
    tablished that “the use of a 10 mg sustained-release dose
    of 4-AP twice per day to treat walking in MS patients
    would have been obvious to a POSA at the priority date of
    the Acorda Patents.” Dist. Ct. Op. at *33. Acorda states
    that “the district court’s conception that the Goodman
    Poster teaches anything about a 10 mg BID dose of 4-AP
    as the sole individual dose of an MS treatment protocol—
    as opposed to merely the starting point of an escalating
    dosing scheme—is impermissible hindsight.” Appellant’s
    Br. at 38. Acorda is correct that the Goodman Poster does
    not suggest this low-dose formulation with a reasonable
    expectation of success, but reports increasing benefit as
    dosage was increased from 20 to 50 mg.
    14 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    Acorda correctly states that the Elan work and these
    initial Acorda studies show, if anything, that 4-AP treat-
    ment requires upward titration to determine the maxi-
    mum tolerable dose for individual patients since efficacy
    can only be achieved at higher doses, and that these
    studies do not provide any reason to believe that a low
    dose would be effective. Goodman I reported an “increas-
    ing benefit in both measures in the 20-50 mg/day range,”
    referring to mobility and lower extremity strength.
    Goodman I at S117.
    In 2003, Acorda conducted a 206-patient clinical
    study, designated MS-F202. The study employed upward
    titration to successively higher doses, starting at dosages
    of 10 mg of sustained-release 4-AP twice-daily. The
    highest tolerable dose was then continued for 12 weeks.
    It was concluded that no treatment group showed im-
    provement over placebo, over the 12-week testing period.
    Dist. Ct. Op. at *9.
    The low dose protocol developed by Acorda is not sug-
    gested in the prior art. Although the goal was a stable
    dose without individual titration, no study, no reference
    reported successful results using the low dose of the
    Acorda Patents, or even suggested that it should be tried.
    The panel majority’s contrary theory is devoid of support.
    B. Acorda’s analytical breakthrough
    Acorda analyzed the MS-F202 results, focusing on
    “patients in the study who, after treatment, showed a
    ‘meaningful difference’ from their before-treatment base-
    line—i.e. the ‘responders,’” and learned that the therapeu-
    tic effect of 4-AP did not increase with increase in dosage,
    as prior reports and Acorda’s own research had suggested.
    Appellant’s Br. at 19. Dr. Cohen testified that they “were
    extremely surprised” because “[e]verything that we had
    come to expect throughout the program told us that we
    should be seeing more and more efficacy the higher the
    dose went as long as the patients were tolerating it and
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 15
    that turned out not to be the case.” J.A. 614 (299:5–9).
    This contradicted the teachings of all of the earlier stud-
    ies. Only the courts find it obvious.
    Acorda then conducted additional clinical studies at
    the lower dosages, and established that a twice-daily
    sustained-release 10 mg dose produced improvement in
    walking gait and speed, while avoiding the toxicity and
    seizures of higher dosages. Acorda filed a provisional
    patent application on April 9, 2004, directed to this
    treatment. Acorda continued its studies, and after a total
    of twelve years of investigation and development, Acorda
    in 2010 obtained FDA approval for a product for improv-
    ing the walking impairment in multiple sclerosis patients.
    This product has the brand name Ampyra®. The Acorda
    Patents are directed to and limited to the twice-daily
    administration of 10 mg doses of sustained-release 4-AP
    formulation.
    The district court, affirmed by my colleagues, held the
    Acorda Patents invalid on the ground of obviousness. The
    district court ruled that the evidence of long-felt need,
    failure of others, unexpected results, and commercial
    success are irrelevant because the Elan Patent was a
    “blocking” patent. However, the Elan Patent did not
    block research on 4-AP, did not block other possible
    treatments for multiple sclerosis, and did not affect the
    Defendants’ development and copying and Hatch-
    Waxman challenge to the Elan and Acorda patents. The
    court’s theory of “blocking” is unrelated to whether the
    Acorda product meets a long-felt need in treating multiple
    sclerosis, for the Elan and Acorda patents do not block the
    Defendants from developing a competitive treatment for
    multiple sclerosis. The patents that support Acorda’s
    eventual success do not block others from using and
    learning from Acorda’s teachings, experimenting with and
    comparing with Acorda’s product, and engaging in com-
    petitive activity.
    16 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    III
    The District Court’s Analysis
    The Defendants conceded infringement, and the dis-
    trict court found the Acorda Patents invalid on the ground
    of obviousness. The district court determined that four
    claim elements were common to the Acorda Patents, then
    found that each of these elements is present in a separate
    reference, and held that a person of ordinary skill in this
    field would obviously have selected and combined these
    elements to produce the Acorda product and method.
    The district court did not find any motivation or sug-
    gestion in the prior art as to which elements to select and
    combine, and did not find any teaching or suggestion that
    such selection and combination would be likely to succeed
    in treating the walking impairment of multiple sclerosis.
    Acorda attributes the district court’s rulings to “hindsight
    bias” and incorrect statements of law by the Defendants.
    Indeed, without the hindsight knowledge of Acorda’s
    success, there is no teaching or suggestion of this selection
    and combination or its likelihood of success.
    A. The selected claim elements
    The district court selected four aspects of the Acorda
    claims, as follows: (1) the use of 4-AP to improve walking
    in multiple sclerosis patients; (2) the use of a 10 mg twice-
    daily sustained release dose; (3) the use of stable dosing
    without upward titration; and (4) the specific pharmaco-
    kinetic parameters achieved. The court concluded that “a
    POSA would have been motivated to combine these limi-
    tations with a reasonable expectation of success.” Dist.
    Ct. Op. at *29.
    However, the question is not whether these four ele-
    ments, if combined, would produce a successful treatment.
    The question is whether the prior art contains a sugges-
    tion or motivation to select these four elements from the
    decades of inconclusive prior art, with a reasonable expec-
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 17
    tation that the selection would eliminate the failures of
    the prior art. See, e.g., In re Cyclobenzaprine Hydrochlo-
    ride Extended-Release Capsule Patent Litig., 
    676 F.3d 1063
    , 1068–69 (Fed. Cir. 2012) (“a party seeking to invali-
    date a patent as obvious must ‘demonstrate “by clear and
    convincing evidence that a skilled artisan would have had
    reason to combine the teaching of the prior art references
    to achieve the claimed invention, and that the skilled
    artisan would have had a reasonable expectation of suc-
    cess from doing so.”’” (quoting Procter & Gamble Co. v.
    Teva Pharms. USA, Inc., 
    566 F.3d 989
    , 994 (Fed. Cir.
    2009))); In re Kubin, 
    561 F.3d 1351
    , 1359 (Fed. Cir. 2009)
    (prior art does not provide a reasonable expectation of
    success where the art may suggest “vary[ing] all parame-
    ters or try[ing] each of numerous possible choices until
    one possibly arrived at a successful result, where the prior
    art gives either no indication of which parameters were
    critical or no direction as to which of many possible choic-
    es is likely to be successful.” (quoting In re O'Farrell, 
    853 F.2d 894
    , 903 (Fed. Cir. 1988)). The years of studies and
    failures weigh heavily against the simplistic post hoc
    predictability accepted by the court.
    The district court analyzed the purported obviousness
    of each of the four limitations, as follows.
    1. Improvement in walking
    The district court found that several references
    showed improved walking upon treatment with 4-AP.
    The court framed the question as whether a POSA would
    have “a reasonable expectation that 4-AP could be suc-
    cessfully used as claimed to treat (i.e., achieve therapeuti-
    cally-effective blood levels in) even a single patient.” Dist.
    Ct. Op. at *30. The court referred to Schwid’s analysis of
    the early Acorda studies as showing “a statistically signif-
    icant improvement in . . . timed gait, which was found to
    be improved in nine out of 10 patients, in comparison to
    the placebo group.” 
    Id.
    18 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    However, the early Acorda studies all stated concern
    about toxicity, particularly seizures, at the dosages that
    these studies showed were needed to obtain relief. No
    witness suggested that these early studies taught or
    suggested that a low dosage formulation would be effec-
    tive.
    2. The dosage of 10 mg twice daily
    The district court concluded that this dosage was an
    obvious choice, because the prior art evaluated doses
    ranging from 10 mg to 80 mg. Dist. Ct. Op. at *32. How-
    ever, the prior art contains no suggestion, indeed no hint,
    that a 10 mg twice-daily sustained-release formulation
    would be effective. All of the early references demon-
    strated the need for upward titration, showing that high-
    er doses are needed for efficacy, with individual titration
    to determine the highest tolerable dose before seizures
    occurred. The district court cited the Goodman Poster as
    showing that toxicity increased at higher dosages, and as
    providing “[e]vidence of dose-response in [the] 20-40
    mg/day range.” Dist. Ct. Op. at *32. However, the stud-
    ies reported by Goodman did not provide a safe and
    efficacious product, but depended on individual titration
    to establish individual dosages at the highest tolerable
    level.
    The district court held that it was obvious to use the
    10 mg dose, despite the general showing of ineffectiveness
    of the 10 mg dose. Dist. Ct. Op. at *33. It is not disputed
    that the general teaching was that doses higher than 10
    mg were needed for therapeutic effect. It cannot reasona-
    bly be viewed as obvious that a dosage that was described
    in the prior art as ineffective, is in fact the optimum
    dosage.
    3. Stable dosing without upward titration
    The district court found that the prior art, particular-
    ly the Van Diemen and Polman references, taught the use
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 19
    of uniform dosing of 4-AP, and “included reports of safe
    and effective long-term use of stable dosing of immediate-
    release 4-AP.” Dist. Ct. Op. at *34. The district court
    further found that the prior art’s “consistent use of titra-
    tion . . . did not undermine the other evidence in the prior
    art that supports finding that a POSA would have had a
    reasonable expectation of success with stable dosing.” 
    Id.
    Only hindsight can construct the Acorda formulation from
    these inapt teachings, for the references cited by the
    district court require upward titration to select the high-
    est tolerable dose, for low stable doses were ineffective.
    The panel majority, seeking to fill this gap, asserts
    that “[t]he prior art is not limited to titrated dosing,” Maj.
    Op. at 34, citing Polman and Schwid. However, Polman
    involved titration, and reported that therapeutic doses
    required in excess of 40 mg for minimal quantifiable
    benefit. See Polman et al. at 295 (stating that the report-
    ed improvements generally did not result in significant
    changes to the EDSS benchmark). In addition, Schwid
    suggested the need for a far higher dose, only maintained
    stable dosing for a week, and did not report meaningful
    success in treating multiple sclerosis. Schwid et al. at
    817.
    4. Pharmacokinetic limitations
    For the fourth limitation, the district court found that
    the claimed pharmacokinetic serum levels were disclosed
    by Hayes, for “[i]t is undisputed that the Hayes research-
    ers used the Ampyra® formulation in their study.” Dist.
    Ct. Op. at *35. The district court considered Acorda’s
    argument that “there is nothing in the prior art identify-
    ing the pharmacokinetic values recited in the claims as
    being effective to improve walking or increase walking
    speed in MS patients,” 
    id.,
     and found that “a POSA would
    have been aware that a sustained-release dosage form
    achieving the pharmacokinetic parameters disclosed in
    20 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    Hayes III would have been associated with an improve-
    ment in walking in MS patients.” Dist. Ct. Op. at *36.
    The Defendants argue that even if the serum level in
    the Acorda Patents is not obvious based on the Hayes
    reference, the claimed range is inherent in the dosage of
    4-AP, citing Santarus, Inc. v. Par Pharm., Inc., 
    694 F.3d 1344
    , 1354 (Fed. Cir. 2012), where the court held that
    reciting the blood serum concentration resulting from a
    dosage form did not impart patentability to known dosage
    forms. Acorda responds that the prior art did not teach or
    suggest that any specific blood serum levels would im-
    prove walking in multiple sclerosis patients. No such
    teaching or suggestion appears anywhere in the record.
    Hayes does not relate its serum analysis to efficacy in
    improving gait or walking speed in persons afflicted with
    multiple sclerosis.
    The district court referred to Acorda’s statement at
    trial, that “[i]t was known in the art that a sustained
    release formulation of 10 megs BID could achieve” the
    claimed pharmacokinetic values. Dist. Ct. Op. at *35 n.39
    (citing J.A. 1108–1109). The district court found that
    there was a reasonable expectation of success with regard
    to the pharmacokinetic parameters because these param-
    eters are inherent in the claimed dosing. 
    Id.
     The court
    did not find, and the prior art does not establish, that this
    pharmacokinetic range was known to have a beneficial
    effect on walking speed and gait in persons afflicted with
    multiple sclerosis.
    B. The combination of elements
    The district court found a reasonable expectation of
    success on combination of the four claim elements, stating
    that “a POSA would consider 10 mg/twice daily to be
    among the finite group of doses of sustained-release 4-AP
    that could reasonably be expected to improve walking in
    MS patients,” Dist. Ct. Op. at *33. The court concluded
    that:
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 21
    Defendants have adduced clear and convincing ev-
    idence that a POSA at the priority date would
    have been motivated and would have had a rea-
    sonable expectation of success to practice and
    combine each of the limitations of the asserted
    claims of the Acorda Patents.
    Dist. Ct. Op. at *40.
    Acorda is correct that there was no suggestion in the
    prior art that the claimed combination should be tried,
    and there is no hint of a reasonable expectation of success.
    Acorda points to the decades of failure of others to develop
    a safe and effective treatment for multiple sclerosis using
    4-AP, despite its known toxicity. The district court’s
    selection of separate limitations from separate sources,
    and retrospectively fitting them into the Acorda template,
    is achieved only with the hindsight knowledge of Acorda’s
    eventual success. See Sanofi-Synthelabo v. Apotex, Inc.,
    
    550 F.3d 1075
    , 1086 (Fed. Cir. 2008) (“The determination
    of obviousness is made with respect to the subject matter
    as a whole, not separate pieces of the claim.”). Here, only
    the Acorda Patents teach the combination that successful-
    ly treats this multiple sclerosis impairment while avoid-
    ing toxicity and seizures.
    Acorda’s path to successfully harness the neurological
    benefits of 4-AP eluded the many scientists studying
    multiple sclerosis. Although the district court acknowl-
    edged the known adverse effects of 4-AP including sei-
    zures, Dist. Ct. Op. at *41 (stating that “the Court agrees
    with Plaintiffs that, at the priority date of the Acorda
    Patents, the risk of seizures loomed over the work of
    exploring the use of 4-AP in MS”), nonetheless the court
    found that a person of ordinary skill would have had a
    reasonable expectation of success with the Acorda prod-
    uct. The recognized need for a stable, non-toxic dosage
    protocol does not render the solution obvious if it is even-
    tually discovered. The record does not show any teaching
    22 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    or suggestion of success of the formulation in the Acorda
    Patents.
    Nor does the record support a finding of “obvious to
    try.” Such a finding requires that a person of ordinary
    skill would not only have selected these specific elements
    from various discarded experiments, but also “would have
    had a reasonable expectation of success in doing so.”
    Pfizer, Inc. v. Apotex, Inc., 
    480 F.3d 1348
    , 1361 (Fed. Cir.
    2007). It is clear that the prior art does not provide a
    reasonable expectation of success of the Acorda Patents’
    specific dosage and protocol.
    IV
    The Objective Indicia of Unobviousness
    The objective indicia “may often be the most probative
    and cogent evidence in the record . . . . It is to be consid-
    ered as part of all the evidence, not just when the deci-
    sionmaker remains in doubt after reviewing the art.”
    Stratoflex, Inc. v. Aeroquip Corp., 
    713 F.2d 1530
    , 1538–39
    (Fed. Cir. 1983). The district court, affirmed by the panel
    majority, err in discounting the undisputed evidence of
    commercial success, long-felt need, failure of others,
    unexpected results, and copying.
    The district court discussed the objective indicia, and
    concluded that they did not “outweigh” the conclusion of
    obviousness. The district court found that Ampyra® could
    be considered a commercial success “[g]iven the strength
    of Ampyra®’s sales, and the absence of any evidence that
    its sales are disappointing given its limited indication and
    patient population.” Dist. Ct. Op. at *38. However, the
    court concluded that this commercial success did not
    weigh heavily because “no one other than the Elan pa-
    tentees and their licensees could have practiced the
    invention of the Acorda Patents without facing liability
    for patent infringement.” 
    Id.
    ACORDA THERAPEUTICS, INC.   v. ROXANE LABORATORIES, INC. 23
    Commercial success is measured against the products
    available for the same purpose, not against infringing
    copies of the patented product. Defendants do not con-
    tend that they are precluded from providing or developing
    other treatments for multiple sclerosis. The Acorda
    product met a long-felt need, for which the failure of
    others, despite decades of experimenting with the neuro-
    logical properties of 4-AP, is evidence of the unobvious-
    ness of the Acorda achievement. Such evidence is an
    important aid to a court that is attempting to divine
    whether the patentee’s discovery was obvious in accord-
    ance with law.
    Concerning failure of others, the panel majority states
    that Elan’s failure “is not particularly relevant to the
    expectation of success.” Maj. Op. at 40–41. This is a
    peculiar conclusion, for Elan had undertaken an immense
    investment, including clinical trials, in the hope that its
    extended-release concept would solve the problems en-
    countered by others. Elan eventually gave up. Nonethe-
    less, my colleagues find that Acorda’s success was obvious
    to them.
    The district court and my colleagues also misapply the
    concept of “blocking patent,” and hold that because a
    patent provides the right to exclude infringers, the indicia
    of commercial success, long-felt need, failure of others,
    and copying are diminished. However, as the Pharmaceu-
    tical Research and Manufacturers of America, as amicus
    curiae, reminds us, “a prior patent would not have cate-
    gorically precluded others from further developing the
    technology,” pointing to the statutory safe harbor of §
    271(e)(1), the knowledge provided in the patents, and the
    right to conduct research on patented subject matter. Br.
    of Amicus Curiae at 4.
    The objective indicia of unobviousness are measured
    against the state of the science and in the commercial
    context. Here the unexpected success and its human
    24 ACORDA THERAPEUTICS, INC. v. ROXANE LABORATORIES, INC.
    benefits are not disputed. The district court was advised
    that the Patent Trial and Appeal Board sustained the
    validity of the Acorda Patents in inter partes review, at
    Coalition for Affordable Drugs (ADROCA), LLC v. Acorda
    Therapeutics, Inc., 
    2017 WL 950736
     (P.T.A.B. Mar. 9,
    2017). Although the majority reports this event, as did
    the district court, its consequences are not explored,
    including issues of privity, estoppel, and finality.
    CONCLUSION
    Obviousness of the Acorda Patents was not estab-
    lished by clear and convincing evidence. The prior art did
    not provide a suggestion to select the specific elements
    and limitations of the Acorda formulation, and did not
    suggest that such selection and combination would have a
    reasonable expectation of success in relieving the walking
    impairment of multiple sclerosis. From my colleagues’
    contrary holding, I respectfully dissent.