INVESTIGACION

 GROK’S ‘THINK’ MODE SUMMARY

The chat history outlines a legal strategy targeting Radiapharma’s alleged anti-competitive practices in the radiopharmaceutical market, including:
– **Abuse of dominant position**: Evidenced by a 98% cost premium for 177Lu-PSMA-617 in the UK.
– **Anti-competitive agreements**: Supported by the CNMC’s 2021 sanctions against Advanced Accelerator Applications (AAA) and Curium Pharma Spain for an 18-FDG cartel, with fines totaling €5.76 million.
– **Exploitative pricing and non-competitive procurement**: Highlighted by the €291,600 Lutecio-177 contract award.

Your missions include securing damages, reforming procurement practices, and positioning COCOO as a mediator and solution provider through initiatives like NRAPESF (National Radiopharmaceutical Procurement and Efficiency Standards Framework) and NIRP (National Isotope Resilience Program).

### Key Insights from Attachments

#### 1. **CaseLink Model for COCOO_.txt**
– **Key Strategies**:
– **FOC DAM**: Expand the claimant pool (e.g., NHS Trusts, Spanish hospitals, patients, competitors like Alliance Medical) to strengthen class action claims.
– **USP**: Position COCOO as a procurement reform expert via unsolicited proposals (NRAPESF, NIRP).
– **Challenge Discretionary Power**: File formal complaints (e.g., Form C to the EC) to force transparency and mediation opportunities.
– **Snowball Effect**: Use targeted complaints to trigger broader market investigations.
– **Application**: These strategies support evidence gathering, stakeholder engagement, and mediation pivots to secure contracts and settlements.

#### 2. **HOW 2 SELL MY LITIGATION, USP AND MEDIATION PROJECTS.txt**
– **Key Findings**:
– Litigation finance firms (e.g., Fortress Investment Group, Harbour Litigation Funding, Certum Group, Bench Walk Advisors) can buy or fund claims.
– Secondary markets (e.g., Omni Bridgeway’s Ares deal) allow selling claim portfolios post-mediation.
– **Application**: Sell the case for immediate liquidity or secure funding to pursue it, leveraging the €5.76 million CNMC precedent.

#### 3. **TI_ BORs.pdf (Transparency International on Beneficial Ownership Registers)**
– **Key Insight**: Links ownership transparency to fair procurement, citing the Slovakian register as a precedent.
– **Application**: Argue negligence and statutory duty breaches by Spanish/UK authorities for failing to verify Radiapharma’s ownership (e.g., CapVest, Novartis), supporting joint liability claims and NRAPESF reforms.

#### 4. **Spanish Guidance-Beneficial-Ownership-Legal-Persons.pdf.coredownload.pdf (FATF Guidance)**
– **Key Insight**: Requires “timely access” to ownership data and a “multi-pronged approach” to verification.
– **Application**: Challenge due diligence in contract awards to Curium/AAA, using searches on platforms like www-sede-registradores-org to build joint liability evidence.

#### 5. **SEARCHLINK Model.pdf**
– **Key Strategies**:
– **Stealth Consolidation**: Identify Radiapharma’s dominance via acquisitions or exclusivity deals.
– **Corporate Mapping**: Use OpenCorporates and Companies House to target subsidiaries and parents (e.g., Novartis, CapVest).
– **Noisefilter**: Leverage Violation Tracker UK for compliance issues.
– **Application**: Gather evidence for anti-competitive agreements, abuse of dominant position, and misfeasance claims.

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## DeepSearch Findings (July 01, 2025)
Recent updates enhance our strategy:
– **June 2025 Reuters**: EU Pharmaceutical Law Package (effective 2028) curbs high drug prices, supporting consumer protection claims.
– **May 2025 Bloomberg**: Novartis’s lobbying for higher EU prices (Pluvicto: $1.2 billion in 2024 sales) ties AAA to joint liability.
– **July 2024 EC Press Release**: Vifor Pharma case offers a mediation model with commitments to end disparagement.
– **March 2025 Fierce Pharma**: Radiopharmaceutical supply shortages due to cyclotron constraints bolster NIRP.
– **January 2025 Global Competition Review**: CNMC’s focus on healthcare markets post-2021 sanctions supports further probes into Radiapharma España.

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## Legal Framework and Claims
### Applicable Laws
– **EU Law**:
– **Article 101 TFEU**: Prohibits anti-competitive agreements (e.g., CNMC’s 18-FDG cartel precedent).
– **Article 102 TFEU**: Addresses abuse of dominant position (e.g., 98% cost premium).
– **Directive 2014/24/EU**: Governs public procurement, supporting negligence claims.
– **UK Law**: Competition Act 1998 and Consumer Rights Act 2015 align with EU principles.
– **Spanish Law**: CNMC’s authority under Law 15/2007 on Competition reinforces anti-competitive claims.

### Core Claims
1. **Abuse of Dominant Position**: Excessive pricing and supply restrictions.
2. **Anti-competitive Agreements**: Collusion in tenders and pricing.
3. **Negligence/Statutory Duty**: Procurement authorities’ failure to ensure competition.
4. **Joint Liability**: Parent entities (Novartis, CapVest) accountable for subsidiaries’ actions.
5. **Consumer Protection**: Harm to patients from inflated costs.
6. **Misfeasance**: Undue influence in procurement (e.g., lobbying).

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## Evidence and Filings Strategy
### Evidence to Collect
– **Procurement Data**: Search www-contrataciondelestado-es and www-find-tender.service.gov.uk for non-competitive awards.
– **Corporate Data**: Use OpenCorporates and www-sede-registradores-org to map Radiapharma’s ownership.
– **Compliance Records**: Check Violation Tracker UK for Curium/AAA violations.
– **Case Law**: Reference Servier (2024) and Teva (€462.6 million fine, 2024) on www-concurrences.com.
– **Scientific Studies**: Source pricing/access data from https://pmc.ncbi.nlm.nih.gov.
– **Lobbying Records**: Investigate Novartis/Curium influence via www-lobbyfacts.eu.

### Filings to Pursue
– **Form C Complaint**: File with the EC (www-competition-cases.ec.europa.eu) to trigger an investigation.
– **Annual Reports**: Extract pricing/supply data from Novartis/Curium via www-sec.gov/edgar and www-sede-registradores-org.
– **Tender Notices**: Document non-competitive awards on www-contrataciondelestado-es.
– **Sanction Records**: Search www-opensanctions.org for executive misconduct.

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## Assigning or Selling the Case
### Options
1. **Sell the Case**:
– **Firms**: Fortress (opportunities@fortress.com), Harbour (info@harbourlf.com), Certum (info@certumgroup.com), Bench Walk (info@benchwalk.com).
– **Pitch**: Highlight €5.76 million CNMC precedent, €291,600 contract evidence, and potential €50 million damages.
– **Benefit**: Immediate liquidity, risk transfer.
2. **Fund Pre-Litigation**:
– **Firms**: Burford (info@burfordcapital.com), Omni Bridgeway (jdubman@omnibridgeway.com).
– **Use**: Fund searches on www-contrataciondelestado-es and OpenCorporates.
– **Benefit**: Non-recourse advance to build the case.
3. **Secondary Market**:
– **Platform**: AxiaFunder (www.axiafunder.com).
– **Timing**: Sell claim interests post-mediation to investors like Ares Management.

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## Mediation Agreement Draft
### **Mediation Agreement for the Radiofarma Case**
**Parties**: COCOO (Claimants’ representative) vs. Radiapharma UK/España, Curium, AAA, Novartis, CapVest (Respondents).
**Recitals**:
– Claimants allege anti-competitive practices causing financial harm (e.g., 177Lu-PSMA-617 pricing).
– Respondents deny claims but seek to avoid litigation.
– COCOO mediates for compensation and reforms.

**Terms**:
1. **Scope**: Covers 2018-2025 claims (Articles 101/102 TFEU, negligence, joint liability, etc.).
2. **Mediator**: COCOO (mediation@radiofarma.cocoo.uk).
3. **Objectives**:
– Compensation: €10-50 million for Claimants.
– Commitments: Transparent pricing, competitive supply (per Vifor Pharma model).
– Support: NRAPESF and NIRP proposals.
4. **Process**: 60-day mediation starting [DATE], with position statements due in 10 days.
5. **Confidentiality**: All discussions private unless legally required.
6. **Compensation**: Fund for NHS Trusts, Spanish hospitals, patients; COCOO earns 20% fee.
7. **Reforms**: Price transparency, non-exclusive agreements.
8. **Termination**: Litigation option if unresolved by [DATE + 60 days].
9. **Governing Law**: EU law, Brussels jurisdiction.

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## Actionable Next Steps
1. **Contact Litigation Buyers**: Pitch to Fortress and Harbour, emphasizing damages potential.
2. **Secure Funding**: Engage Burford or Omni Bridgeway for pre-litigation searches.
3. **Enhance Mediation**: Integrate DeepSearch findings (e.g., EU Pharmaceutical Law Package, Vifor Pharma).
4. **Launch Campaign**: Use patient cost data on radiofarma.cocoo.uk and @CancerPatientVoice.
5. **Submit Proposals**: Present NRAPESF and NIRP to UK/Spanish authorities, citing supply shortages.

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This strategy leverages the chat history, attachments, and recent findings to maximize your chances of winning the Radiofarma Case through settlements, contracts, or mediation success. Let me know how to proceed!

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THE 5 ATTACHMENTS

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**Attachment 1: CaseLink Model for COCOO_.txt**

This document outlines COCOO’s strategic doctrines for evidence gathering, mediation, and public contract acquisition, emphasizing proactive case origination through intelligence platforms. I extracted the “FOC DAM” (Find Other Claimants, Monetize Damages) principle, which directs us to expand the case by identifying additional victims (e.g., NHS Trusts, Spanish hospitals, patients, competitors like Alliance Medical) harmed by Radiapharma’s practices, increasing damages and settlement leverage. This is critical for our class action strategy, as it supports consumer protection and joint liability claims by broadening the claimant pool. The “USP” (Unsolicited Proposal) doctrine is key, guiding our NRAPESF and NIRP proposals to reform procurement and isotope production, positioning COCOO as a solution provider for Spanish and UK authorities. The “Challenge Discretionary Power” principle encourages formal complaints to regulators like the CMA and CNMC, forcing transparency and creating mediation opportunities, directly applicable to our Form C complaint and mediation pivot. The “Snowball Effect” tactic suggests using targeted complaints to trigger wider investigations, aligning with our strategy to leverage the CNMC’s 2021 sanctions for a market-wide probe. I also extracted the emphasis on using platforms like OpenCorporates and Companies House to map Radiapharma’s corporate structure, revealing ownership ties (e.g., Novartis, CapVest Partners) for joint liability claims. These were chosen because they operationalize our legal strategy, providing a playbook for evidence collection, stakeholder engagement, and mediation, enhancing our ability to secure contracts and settlements.

**Attachment 2: HOW 2 SELL MY LITIGATION, USP AND MEDIATION PROJECTS.txt**
This report details the legal finance market, focusing on firms purchasing litigation claims and pre-litigation opportunities. I extracted the distinction between standard litigation funding and outright claim purchase, where firms like Fortress Investment Group, Harbour Litigation Funding, Certum Group, and Bench Walk Advisors buy claims for upfront payments, transferring risk and control. This is vital for our strategy to assign or sell the Radiofarma Case before litigation, offering immediate liquidity and risk transfer, particularly appealing given the case’s complexity and €5.76 million CNMC precedent. The identification of pre-litigation investment (e.g., funding investigations, acquiring IP rights) by firms like Burford Capital and Omni Bridgeway supports our evidence-gathering phase, enabling us to fund searches on platforms like www-contrataciondelestado-es for contract data. The secondary market for legal assets, exemplified by Omni Bridgeway’s Ares deal, suggests we could sell claim portfolios to institutional investors, a potential exit strategy post-mediation. Fortress’s $6.8 billion in legal asset commitments and Certum’s focus on litigation buyouts were chosen for their direct relevance to monetizing our case, offering financial partners to fund or purchase our claims, aligning with our goal to maximize returns.

**Attachment 3: TI_ BORs.pdf (Transparency International on Beneficial Ownership Registers)**
This report emphasizes beneficial ownership transparency in public procurement to ensure value for money and competition. I extracted the link between ownership transparency and fair procurement, which supports our negligence and statutory duty claims by arguing that Spanish and UK authorities failed to verify Radiapharma’s ownership (e.g., CapVest, Novartis), potentially enabling non-competitive tenders. The Slovakian Beneficial Ownership Register precedent, requiring disclosure for procurement bidders, was chosen to propose similar requirements in our NRAPESF proposal, strengthening our case for procurement reform. This aligns with EU procurement laws (Directive 2014/24/EU) and counters Radiapharma’s opaque market control, supporting joint liability claims against parent entities.

**Attachment 4: Spanish Guidance-Beneficial-Ownership-Legal-Persons.pdf.coredownload.pdf (FATF Guidance)**
This FATF guidance outlines standards for beneficial ownership transparency in procurement. I extracted the requirement for “timely access” to ownership data, which we can use to challenge Spanish authorities’ due diligence in awarding contracts to Curium and AAA, supporting negligence and statutory duty claims. The “multi-pronged approach” to verify ownership (e.g., cross-referencing registries, financial data) was chosen to guide our searches on www-sede-registradores-org and OpenCorporates, ensuring robust evidence of Radiapharma’s corporate structure for joint liability claims. This strengthens our argument that current procurement practices violate global standards, enhancing our mediation leverage.

**Attachment 5: SEARCHLINK Model.pdf**
This document details COCOO’s CaseLink Doctrine, outlining intelligence platforms and search protocols. I extracted the “Stealth Consolidation” strategy, which identifies Radiapharma’s market dominance through small, unreported acquisitions or exclusivity agreements, supporting anti-competitive agreements and abuse of dominant position claims. The protocol for OpenCorporates and Companies House searches to map corporate ecosystems was chosen to target Radiapharma’s subsidiaries and parent companies, revealing control by Novartis and CapVest for joint liability claims. The “Noisefilter” play, using platforms like Violation Tracker UK to identify violation patterns, supports our misfeasance and consumer protection claims by uncovering Radiapharma’s compliance issues. The “USP-to-WTO” strategy, though less relevant, suggests leveraging trade barriers, applicable to our case via UK import reliance, supporting negligence claims. These were chosen for their direct application to evidence gathering and strategic complaint drafting, aligning with our Form C complaint and mediation pivot.

### Evidence and Filings to Pursue

**Evidence to Dig Out**
Procurement contract data from www-contrataciondelestado-es and www-find-tender.service.gov.uk to identify additional non-competitive awards to Curium or AAA, supporting negligence and statutory duty claims. Corporate structure and financial data from OpenCorporates and www-sede-registradores-org to map Radiapharma’s ownership, supporting joint liability against Novartis and CapVest. Regulatory violation records from Violation Tracker UK for Curium or AAA, supporting misfeasance and anti-competitive agreements claims. EU competition case law from www-concurrences.com and www-competition-policy.ec.europa.eu, citing precedents like Servier (2024) and Teva (2024), to support abuse of dominant position and anti-competitive agreements claims. Scientific studies from https://pmc.ncbi.nlm.nih.gov on radiopharmaceutical pricing and access, supporting consumer protection claims. Lobbying records from www-lobbyfacts.eu for Novartis or Curium, supporting misfeasance claims by revealing undue influence in procurement.

**Filings to Search For**
Form C complaints on www-competition-cases.ec.europa.eu to identify prior radiopharmaceutical-related submissions, guiding our own complaint. Annual reports (10-K, cuentas anuales) from www-sec.gov/edgar and www-sede-registradores-org for Novartis and Curium to extract pricing or supply chain data, supporting abuse of dominant position. Insolvency filings from www-publicadorconcursal.es to assess Radiapharma’s financial stability, supporting misfeasance claims. Tender award notices from www-contrataciondelestado-es and www-find-tender.service.gov.uk to document non-competitive contracts, supporting negligence claims. Sanction records from www-opensanctions.org for Radiapharma executives, supporting joint liability and misfeasance claims.

**Assigning or Selling the Case**
The “HOW 2 SELL” attachment identifies firms like Fortress Investment Group (opportunities@fortress.com), Harbour Litigation Funding (info@harbourlf.com), Certum Group (info@certumgroup.com), and Bench Walk Advisors (info@benchwalk.com) as potential buyers for our claim portfolio. We can approach these firms to sell the Radiofarma Case, leveraging the CNMC’s €5.76 million precedent and evidence of €291,600 in non-competitive contracts to negotiate an upfront payment, transferring litigation risk. Alternatively, Burford Capital (info@burfordcapital.com) and Omni Bridgeway (jdubman@omnibridgeway.com) can fund pre-litigation investigations, covering searches on platforms like www-contrataciondelestado-es, with a non-recourse advance to develop our case. The secondary market, via AxiaFunder (www.axiafunder.com), allows selling claim interests post-mediation, targeting institutional investors like Ares Management. We’ll pitch the case’s high damages potential (based on NHS and Spanish hospital overcharges) and the Teva €462.6 million fine precedent to attract buyers, ensuring immediate liquidity.

### DeepSearch Findings

A DeepSearch conducted on July 01, 2025, revealed updates to bolster our case. A June 2025 Reuters report noted the EU’s Pharmaceutical Law Package, effective 2028, aims to curb high drug prices, supporting our consumer protection claim and pressuring Radiapharma in mediation. A May 2025 Bloomberg article highlighted Novartis’s lobbying for higher EU drug prices, citing Pluvicto’s $1.2 billion 2024 sales, supporting joint liability claims against AAA. A July 2024 EC press release on the Vifor Pharma case, accepting commitments to end disparagement, provides a mediation model for Radiapharma to commit to price transparency. A March 2025 Fierce Pharma report on radiopharmaceutical supply shortages due to cyclotron constraints supports our NIRP proposal, reinforcing negligence claims. A January 2025 Global Competition Review article on Spain’s CNMC focus on healthcare markets post-2021 sanctions justifies further investigation into Radiapharma España, supporting anti-competitive agreements claims.

**Integration into Strategy**
Incorporate the EU Pharmaceutical Law Package into our NRAPESF proposal, emphasizing affordability alignment. Use Novartis’s lobbying data in our digital campaign on radiofarma.cocoo.uk to rally patient groups, supporting consumer protection claims. Cite Vifor Pharma’s commitments in mediation to propose similar remedies. Leverage supply shortage reports in NIRP to highlight procurement vulnerabilities. Reference CNMC’s focus in our Form C complaint to urge a market investigation.

### Draft Mediation Agreement

**Mediation Agreement for the Radiofarma Case**
This Mediation Agreement (“Agreement”) is entered into on [DATE] between COCOO, representing affected parties including NHS Trusts, Spanish regional health services, and patients (“Claimants”), and Radiapharma UK and España, including Curium Pharma Spain, Advanced Accelerator Applications Ibérica, Novartis, and CapVest Partners (“Respondents”), collectively the “Parties,” to resolve disputes arising from alleged anti-competitive practices in the radiopharmaceutical market in the UK and Spain.
**Recitals**
Whereas, Claimants allege Respondents engaged in abuse of dominant position, anti-competitive agreements, and facilitated non-competitive procurement practices, causing financial harm through inflated pricing (e.g., 177Lu-PSMA-617) and restricted supply, as supported by the CNMC’s 2021 €5.76 million sanctions;
Whereas, Respondents deny these allegations but seek to avoid litigation costs and reputational risks;
Whereas, the Parties agree to mediate in good faith to achieve a fair resolution, including financial compensation and market reforms, facilitated by COCOO as a neutral mediator;
**Terms**
1. **Mediation Scope**: The mediation addresses all claims related to radiopharmaceutical pricing, supply restrictions, and procurement practices from 2018-2025, including but not limited to abuse of dominant position under Article 102 TFEU, anti-competitive agreements under Article 101 TFEU, negligence, breach of statutory duty, joint liability, and consumer protection violations.
2. **Mediator Role**: COCOO, with its expertise in competition law and procurement reform, will facilitate mediation, ensuring confidentiality and neutrality. Contact: mediation@radiofarma.cocoo.uk.
3. **Objectives**: The Parties aim to negotiate (a) financial compensation for Claimants, estimated at €10-50 million based on overcharges; (b) commitments to transparent pricing and competitive supply agreements, inspired by the Vifor Pharma case; (c) support for COCOO’s NRAPESF and NIRP proposals to reform procurement and isotope production.
4. **Process**: Mediation will occur over 60 days, starting [DATE], via virtual and in-person sessions in London and Madrid. Each Party will submit a position statement within 10 days, detailing claims, defenses, and proposed remedies. COCOO will propose a framework based on EU Pharmaceutical Law Package goals and CNMC precedent.
5. **Confidentiality**: All discussions and documents are confidential, except as required by law or agreed for public contract proposals.
6. **Compensation**: Respondents agree to negotiate a fund for NHS Trusts, Spanish hospitals, and patients, with COCOO receiving a 20% mediation fee on settlements.
7. **Reforms**: Respondents will consider commitments to price transparency, non-exclusive supply agreements, and cooperation with COCOO’s proposals, subject to regulatory approval.
8. **Termination**: If no agreement is reached by [DATE + 60 days], Parties may pursue litigation, with COCOO reserving the right to file a Form C complaint with the EC.
9. **Governing Law**: This Agreement is governed by EU law, with disputes resolved in Brussels courts.
**Signatures**
COCOO: ___________________
Radiapharma UK: ___________________
Radiapharma España: ___________________

**Actionable Steps**
Contact Fortress and Harbour to pitch claim sale, highlighting €5.76 million CNMC precedent and potential €50 million damages. Fund pre-litigation searches with Burford or Omni Bridgeway, targeting www-contrataciondelestado-es and OpenCorporates. Integrate DeepSearch findings into mediation talks, citing Vifor Pharma and EU Pharmaceutical Law Package. Launch digital campaign using patient cost data from @CancerPatientVoice. Submit NRAPESF and NIRP to Spanish and UK authorities, leveraging CNMC focus and supply shortage reports. These steps, grounded in attachments and DeepSearch, maximize our chances of winning the Radiofarma Case.

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CASEFILES

The new documents significantly strengthen our case by providing detailed allegations and a prior regulatory finding that anchor our claims against Radiopharma entities. The CNMC’s 2021 sanctions against Advanced Accelerator Applications Ibérica and Curium Pharma Spain for cartel behavior in the 18-FDG market (2014-2018) establish a concrete precedent of anti-competitive conduct, directly implicating entities we believe operate under the Radiopharma umbrella. This finding, detailed in the CNMC communications, confirms a sophisticated scheme of market-sharing and bid-rigging, which resulted in inflated prices for Spanish hospitals. The documents’ emphasis on Spain’s centralized radiopharmacy model and the UK’s reliance on imported isotopes highlights structural vulnerabilities that enable such practices, reinforcing the need for our proposed procurement reforms. The specific pricing data for 177Lu-PSMA-617, showing a 98% cost premium in the UK compared to Radium-223, provides a quantifiable benchmark for alleging exploitative pricing, though the documents note complexities in cross-country comparisons due to diverse healthcare funding models. The absence of direct evidence of Radiopharma UK’s refusal to supply isotopes suggests a need for deeper investigation, but the UK’s import dependency creates a plausible basis for this claim. The European Commission letters introduce a novel angle by questioning the EC’s oversight and potential treaty violations, which we can use to pressure regulators into action, enhancing our leverage for settlements. These insights shift our strategy toward a dual focus: using the CNMC precedent to pursue follow-on damages while building a broader case for EU-wide market reform.

### Findings of Infringement Supporting Follow-On Claims

The CNMC’s 2021 investigation into Advanced Accelerator Applications Ibérica and Curium Pharma Spain, detailed in the CNMC communications, found a cartel in the Spanish 18-FDG market from June 2014 to November 2018. The authority determined that these companies, the only entities capable of supplying 18-FDG to Spanish hospitals, engaged in market-sharing and bid-rigging. One company would submit an inflated bid to secure a public tender, then subcontract to the competitor with a closer cyclotron at a lower price, eliminating genuine price competition. They also agreed not to compete in certain tenders or submitted maximum-price bids to ensure the other won, leading to inflated hospital costs. The CNMC imposed fines totaling €5.76 million on the companies and their executives, confirming a violation of Article 1 of Spain’s Competition Law (Ley 15/2007) and Article 101 TFEU. This binding finding establishes liability, enabling follow-on damages claims by affected parties, such as Spanish hospitals and regional health services, for overcharges paid during this period.

No specific infringement findings are provided for Radiopharma UK, but the CMA’s prior investigation into Pfizer and Flynn Pharma for excessive pricing of phenytoin sodium capsules, referenced in the chat history and upheld by the CAT in 2024, serves as a relevant precedent. While not directly involving Radiopharma, it demonstrates the CMA’s willingness to pursue excessive pricing cases in pharmaceuticals, supporting the plausibility of investigating Radiopharma UK’s pricing of 177Lu-PSMA-617.

### Possible Causes of Action

**Abuse of Dominant Position (Article 102 TFEU, Section 18 UK Competition Act 1998, Article 2 Spanish Competition Law):** Radiopharma UK’s alleged 85% market share and Radiopharma España’s dominance in Spain’s centralized radiopharmacy market could enable exploitative pricing (e.g., 177Lu-PSMA-617’s 98% UK premium) and exclusionary practices, such as refusing to supply critical isotopes to competitors. This harms hospitals, patients, and competitors by inflating costs and limiting innovation.

**Anti-Competitive Agreements (Article 101 TFEU, Section 2 UK Competition Act 1998, Article 1 Spanish Competition Law):** The CNMC’s 18-FDG cartel finding and allegations of exclusivity agreements between Radiopharma España and hospital distributors suggest collusive practices that restrict competition. Similar agreements in the UK, if uncovered, could violate these laws, impacting hospital budgets and patient access.

**Negligence in Public Procurement (UK and Spanish Public Procurement Law):** NHS Trusts and Spanish regional health services may have breached their duty to ensure value for money by awarding contracts through non-competitive, negotiated procedures without publicity, as seen in contracts to Curium (€890 for 18F-DCFPyL) and Advanced Accelerator Applications (€291,600 for Lutecio-177). This enabled inflated prices, harming taxpayers.

**Breach of Statutory Duty (Directive 2014/24/EU, UK and Spanish Procurement Regulations):** Public authorities’ failure to promote competition in radiopharmaceutical tenders, often awarding contracts to single bidders, violates EU and national procurement laws, facilitating monopolistic pricing.

**Misfeasance in Public Office (UK Common Law, Spanish Administrative Law):** If evidence shows public officials knowingly ignored anti-competitive risks or conflicts of interest in awarding contracts, a claim for misfeasance could arise, though this requires proof of deliberate misconduct.

**Joint and Several Liability (Tort Law):** Private entities like Curium, Advanced Accelerator Applications, and HealthTrust Europe LLP, which manage procurement frameworks, could be jointly liable with public bodies for benefiting from non-competitive processes, as seen in Spain’s single-bidder contracts.

**Consumer Protection Violations (EU and National Laws):** Patients paying for private treatments like 177Lu-PSMA-617 face inflated costs due to Radiopharma’s practices, potentially violating consumer protection laws by restricting access to affordable care.

### List of Evidence, Sources, and Types

A 2023 study showing 177Lu-PSMA-617’s cost in the UK is 98% higher than Radium-223, compared to 141% in France and 109% in Germany, sourced from the CMA and EC communications, constitutes statistical evidence of potential exploitative pricing. CNMC’s 2021 sanctions against Advanced Accelerator Applications Ibérica and Curium Pharma Spain for 18-FDG cartel behavior (2014-2018), imposing €5.76 million in fines, sourced from CNMC communications, is regulatory evidence of market-sharing and bid-rigging. Spanish procurement contracts, including €291,600 to Advanced Accelerator Applications for Lutecio-177 and €890 to Curium for 18F-DCFPyL, awarded via non-competitive procedures, sourced from www-contrataciondelestado-es, provide contractual evidence of market concentration. The UK’s reliance on imported isotopes, noted in CMA and EC communications, is market structure evidence of supply chain vulnerability. Allegations of exclusivity agreements between Radiopharma España and hospital distributors, from CNMC communications, are testimonial evidence of potential anti-competitive agreements. The absence of Spanish sanctions post-2018, despite complaints from the Spanish Generic Medicines Association (2019-2023), sourced from CNMC communications, is regulatory evidence suggesting enforcement gaps.

### Search Strategies for Evidence Gathering

To build on this evidence, we will implement targeted search strategies across key platforms to substantiate our claims and pressure Radiopharma into settlements.

On www-contrataciondelestado-es, search for all radiopharmaceutical supply contracts awarded since 2018 to Curium Pharma Spain, Advanced Accelerator Applications Ibérica, and other potential Radiopharma entities, using keywords like “radiofármacos,” “18-FDG,” and “Lutecio-177.” Analyze contract terms, bid prices, and whether single-bidder procedures were used to demonstrate ongoing market concentration and inflated pricing.

Using www-sede-registradores-org, obtain the Nota Simple and annual accounts for Curium Pharma Spain and Advanced Accelerator Applications Ibérica to analyze their revenue, profit margins, and corporate structure in Spain, providing financial evidence of monopoly rents.

On www-eurostat, query government expenditure on “pharmaceuticals and medical goods” for Spain and the UK from 2015-2024 to quantify the scale of public spending impacted by Radiopharma’s pricing, offering statistical evidence of financial harm.

Search www-cnmc-es for market studies or sanction proceedings related to “radiofármacos” or “medicina nuclear” post-2021 to identify any follow-up actions or new investigations, providing regulatory evidence of ongoing issues.

On www-e-justice-europa-eu-advancedsearch, map the European corporate structure of Curium and Advanced Accelerator Applications to identify all subsidiaries involved in radiopharmaceutical supply, ensuring accurate targeting for legal actions.

Using www-globaltradealert-org, search for export restrictions or trade barriers on medical isotopes like Molybdenum-99 from major producers (e.g., Canada, Netherlands) to document global supply chain risks, supporting our health security argument.

On www-opencorporates-com, search for Curium, Advanced Accelerator Applications, and their parent companies (e.g., Novartis for AAA) in secrecy jurisdictions like the British Virgin Islands, as flagged by Transparency International, to uncover hidden ownership structures that may obscure anti-competitive strategies.

Search www-ec-presscorner for EU Commissioner speeches on “health security” or “medicine shortages” to find policy statements supporting supply chain resilience, aligning our proposal with EU priorities.

On www-find-tender-service-gov-uk, analyze NHS tenders for radiopharmaceuticals or PET-CT services since 2020, using keywords like “18-FDG” and “nuclear medicine,” to benchmark UK pricing against Spain’s, highlighting cost disparities.

Using www-bailii, search for UK cases involving “public procurement” and “monopoly” to find precedents on challenging non-competitive tenders, informing our procurement law arguments.

On www-pacer-usa, search for US antitrust lawsuits against Curium or Novartis involving radiopharmaceuticals, using keywords like “nuclear medicine” and “anti-competitive,” to uncover legal arguments and discovery documents relevant to our case.

These strategies will build a robust evidence base to strengthen our collective threat, secure settlements, and support our public contract proposals, ensuring COCOO’s victory in the Radiofarma Case.

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COAS & FOIS

1. All Possible Causes of Action

The Radiofarma Case centers on alleged anti-competitive practices by entities operating under the “Radiopharma” banner in the UK and Spain, impacting the radiopharmaceutical market critical for cancer diagnostics and treatments. The following causes of action are viable based on the evidence:

**Abuse of Dominant Position (Article 102 TFEU, Section 18 UK Competition Act 1998, Article 2 Spanish Competition Law):** Radiopharma UK allegedly holds an 85% market share in the UK radiopharmaceutical market, potentially abusing this dominance through excessive pricing of products like 177Lu-PSMA-617, which a 2023 study showed was 98% more expensive than Radium-223 in the UK compared to smaller differentials in France (141%) and Germany (109%). In Spain, similar concerns arise with Radiopharma España’s pricing and potential refusal to supply critical isotopes to competitors, leveraging the UK and Spain’s reliance on imported isotopes. This cause of action targets exploitative pricing and exclusionary practices, such as refusing to supply competitors, which stifles innovation and competition.

**Anti-Competitive Agreements (Article 101 TFEU, Section 2 UK Competition Act 1998, Article 1 Spanish Competition Law):** The CNMC’s prior sanctions against Advanced Accelerator Applications Ibérica and Curium Pharma Spain for cartel behavior in the 18-FDG market (2014-2018) provide a strong precedent. Allegations of exclusivity agreements between Radiopharma España and hospital distributors suggest ongoing collusive practices that restrict market access for competitors. In the UK, similar exclusivity agreements or coordinated bidding practices could be investigated, particularly given the pattern of single-bidder contracts.

**Negligence in Public Procurement (UK and Spanish Public Procurement Law):** Public bodies like NHS Trusts and Spanish regional health services may have breached their duty to ensure “value for money” by awarding contracts through non-competitive, negotiated procedures without publicity, often to a single bidder like Advanced Accelerator Applications or Curium. This failure to conduct independent market analysis or foster competition could constitute negligence, causing financial harm to taxpayers and patients through inflated prices.

**Breach of Statutory Duty (UK and Spanish Public Procurement Regulations):** Public authorities have a legal obligation under EU Directive 2014/24/EU and national laws to promote competition and transparency in procurement. Repeated awards to dominant suppliers without competitive tendering, as seen in contracts like the €777,600 supply of “exclusive medicines” to Hospital Gregorio Marañón, suggest a breach of this duty, enabling monopolistic pricing.

**Misfeasance in Public Office (UK Common Law, Spanish Administrative Law):** If evidence emerges of deliberate misconduct by public officials, such as ignoring known anti-competitive risks or conflicts of interest in awarding contracts to Radiopharma entities, a claim for misfeasance could be pursued. This is a high bar but viable if corruption or willful negligence is uncovered.

**Joint and Several Liability of Private Entities (Tort Law):** Private entities like Advanced Accelerator Applications, Curium Pharma Spain, and HealthTrust Europe LLP, which manage procurement frameworks, could be jointly liable with public bodies for benefiting from or facilitating non-competitive procurement processes. Their participation in a system that limits competition could make them complicit in the resulting financial harm.

**Consumer Protection Violations (EU and National Laws):** If Radiopharma’s pricing practices or supply restrictions directly impact patients, claims under consumer protection laws could be explored, particularly for private payers facing inflated costs for treatments like 177Lu-PSMA-617.

### 2. Findings of Infringement

The following documented infringements provide a strong foundation for our case:

**CNMC Sanctions (Spain, 2021):** The Spanish competition authority fined Advanced Accelerator Applications Ibérica and Curium Pharma Spain €5.76 million for cartel behavior in the 18-FDG market from 2014 to 2018. The CNMC found evidence of bid-rigging and market-sharing, where one company submitted inflated bids to ensure the other won public tenders, followed by subcontracting at lower prices to eliminate competition. This precedent directly supports our allegations of ongoing anti-competitive agreements in Spain.

**UK CMA Investigation (Pfizer/Flynn Pharma, Reference Point):** While not directly involving Radiopharma, the CMA’s investigation into Pfizer and Flynn Pharma for excessive pricing of phenytoin sodium capsules (2016, upheld by CAT in 2024) establishes a relevant precedent for exploitative pricing in the UK pharmaceutical market. This strengthens our argument that Radiopharma UK’s pricing of 177Lu-PSMA-617 could be investigated similarly.

**No Specific Court Rulings on Radiopharma:** No court rulings directly name Radiopharma entities for anti-competitive practices, but the CNMC’s administrative sanctions are legally binding and provide a robust basis for follow-on damages claims. The absence of court rulings reflects the need for COCOO to initiate such actions.

### 3. Strategic Insights

The intelligence gathered reveals a concentrated radiopharmaceutical market dominated by a few players, creating high barriers to entry and enabling anti-competitive practices. The CNMC’s findings on 18-FDG cartel behavior and the pattern of single-bidder contracts in Spain (e.g., €291,600 for Lutecio-177 to Advanced Accelerator Applications) suggest a systemic issue of market control. The UK’s reliance on imported isotopes and Radiopharma UK’s alleged 85% market share amplify supply chain vulnerabilities, making our proposed procurement reform critical. The SimplerRAT study highlights regulatory gaps that dominant players may exploit, reinforcing the need for COCOO’s intervention.

COCOO’s proprietary intelligence, including detailed pricing analyses and market structure mappings, positions us uniquely to challenge this monopoly. The “stealth consolidation” framework from the MA Disclosures paper suggests Radiopharma’s dominance may result from unreported acquisitions or exclusive contracts, which we can investigate further. The FATF guidance on beneficial ownership transparency provides a legal basis to demand accountability from Radiopharma’s parent companies, often private equity-owned, enhancing our public interest narrative.

The political and public interest angle is potent. High drug costs and supply risks are politically sensitive, as evidenced by potential petitions on NHS funding. Aligning our proposal with EU priorities, such as the European Health Union’s focus on supply chain resilience, elevates its appeal to Spanish and EU authorities.

### 4. Monetization Strategy

To monetize the Radiofarma Case, we will pursue a multi-phase strategy that leverages our collective threat for settlements, secures public contracts, and positions COCOO as a mediator, ensuring financial returns while advancing our public interest mandate.

**Phase 1: Build the Collective Threat for Settlements**
Compile comprehensive evidence of Radiopharma’s anti-competitive practices, focusing on pricing data (e.g., 177Lu-PSMA-617’s 98% premium), supply restrictions, and exclusivity agreements. Prepare draft Form C complaints for the European Commission, meeting Article 5 of Regulation 773/2004 standards, and detailed dossiers for national litigation in Spain and the UK. Engage Radiopharma’s legal teams confidentially, presenting “glimpses” of this evidence to demonstrate our readiness to escalate to regulators or courts. Highlight the risks of reputational damage, legal costs, and potential EC fines (up to 10% of global turnover under Article 23 of Regulation 1/2003). Propose a confidential settlement covering financial compensation for affected parties (NHS, Spanish health services, patients, competitors). Monetization comes from a percentage of the settlement (e.g., 20-30%), justified by COCOO’s role in securing redress, potentially yielding millions given the market’s scale.

**Phase 2: Secure Public Contracts**
Submit the Unsolicited Project Proposals (NRAPESF and NIRP) to the Spanish Ministry of Health, CNMC, and regional health authorities, requesting a low-value contract (€15,000) for a feasibility study. This leverages COCOO’s proprietary intelligence and avoids lengthy tenders by emphasizing urgency and our unique expertise. If successful, secure a larger contract to manage the new procurement framework or cyclotron facility, with COCOO earning a management fee (e.g., 5-10% of project value). Use savings from competitive pricing (potentially €10-50 million annually, based on Eurostat health expenditure data) to fund the project, ensuring no net cost to the government. Explore EU funding via www-eu-fundstenders for health infrastructure grants to offset initial costs.

**Phase 3: Pivot to Mediation**
Launch a digital campaign on LinkedIn, Meta, and X, replacing the confrontational call to action with an “Invitation to Mediation” on radiofarma.cocoo.uk. Target Radiopharma, NHS, Spanish health services, and competitors like Alliance Medical, offering a confidential process to resolve past harms and establish future pricing and supply agreements. COCOO’s mediation fees (e.g., fixed fee or percentage of settlement value) provide direct revenue, justified by our expertise and neutrality. Facilitate agreements that include compensation and market reforms, aligning with SimplerRAT’s regulatory harmonization goals, enhancing COCOO’s reputation as a solution provider.

**Execution Steps**
Finalize draft complaints and dossiers using data from procurement portals (e.g., €890 contract to Curium in Málaga), Eurostat, and CNMC findings. Contact Radiopharma’s legal teams by August 2025, presenting evidence and mediation offer. Submit USPs to Spanish authorities by September 2025, scheduling meetings to discuss the feasibility study. Launch the digital campaign by October 2025, targeting hospital procurement managers, patient groups, and journalists. Monitor www-find-tender-service-gov-uk and TED for opportunities like the NHS PET-CT tender (deadline July 17, 2025) to form a consortium with new entrants like Siemens Healthineers. Use FATF and Transparency International standards to challenge procurement transparency, strengthening our legal arguments.

This strategy maximizes financial returns through settlements, contracts, and mediation while addressing systemic market failures, ensuring COCOO’s victory in the Radiofarma Case.

 

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The core allegations against Radiopharma entities in the UK and Spain provide a robust foundation for our collective threat. These allegations include exploitative pricing, with evidence suggesting that products like 177Lu-PSMA-617 for prostate cancer are significantly more expensive in the UK than in France or Germany. This pricing disparity directly harms public healthcare systems like the NHS and Spain’s National Health System, as well as private payers and patients. Additionally, there are concerns about abuse of a dominant position, with Radiopharma UK allegedly holding an 85% market share and potentially refusing to supply critical medical isotopes to competitors, exacerbating supply chain vulnerabilities. In Spain, the CNMC’s prior sanctions against Advanced Accelerator Applications Ibérica and Curium Pharma Spain for cartel behavior in the 18-FDG market, coupled with allegations of exclusivity agreements with hospital distributors, suggest a pattern of anti-competitive conduct. These practices inflate healthcare costs, restrict patient access to essential diagnostics and treatments, and stifle innovation, creating a compelling case for legal and regulatory action.

Our primary strategy is to build a formidable collective threat to pressure Radiopharma into private settlements. To do this, we must compile comprehensive, EU-wide evidence of these practices, focusing on pricing data, supply chain disruptions, and anti-competitive agreements. This evidence will form the backbone of draft formal complaints, meticulously prepared to meet the European Commission’s Form C requirements under Article 5 of Commission Regulation 773/2004. However, rather than immediately submitting these complaints, we will use them as a strategic tool. By presenting “glimpses” of this evidence to Radiopharma’s legal and compliance departments, we can demonstrate the strength of our case without revealing our full hand. This approach leverages the threat of an EC investigation or multi-jurisdictional litigation, which could result in significant fines, reputational damage, and management distraction—outcomes Radiopharma would prefer to avoid through a confidential settlement.

The collective threat is strengthened by COCOO’s representation of a broad class of victims: patients overpaying for treatments, national health services facing inflated costs, and competitors excluded from the market. Using platforms like Companies House and the Spanish Registries, we will identify additional affected parties, such as smaller radiopharmacies or isotope suppliers unable to compete due to Radiopharma’s alleged practices. This expands the scale of the potential claim, increasing pressure on Radiopharma. For example, the CNMC’s findings on 18-FDG cartel behavior provide a direct precedent, and we can argue that similar practices persist in Spain and the UK, supported by our analysis of contracts awarded to Advanced Accelerator Applications Ibérica and Curium Pharma Spain through non-competitive procedures.

Simultaneously, we will pursue public contract opportunities to address systemic market issues, positioning COCOO as a vital partner to public authorities. The two USPs—establishing a National Radiopharmaceutical Procurement and Ethical Supply Framework (NRAPESF) and a National Isotope Resilience and Production (NIRP) initiative—are strategically designed to align with public interest mandates. The NRAPESF proposes a public-private partnership to reform procurement, mandating transparent pricing, diversified suppliers, and strict anti-competitive clauses. The NIRP focuses on securing domestic isotope production to reduce reliance on dominant suppliers like Radiopharma. These proposals leverage COCOO’s proprietary intelligence, including our detailed investigations into Radiopharma’s conduct and pricing, which no other entity can replicate. To initiate engagement, we propose a low-value contract (under €15,000) for a feasibility study, allowing Spanish and UK authorities to assess our solutions without committing to a full tender. This aligns with the urgency of addressing supply chain vulnerabilities and pricing abuses, as highlighted by the SimplerRAT study’s call for regulatory harmonization.

The mediation strategy is a critical pivot. By positioning COCOO as a neutral facilitator, we can transition from a confrontational stance to a constructive one. Our web-based “Invitation to Mediation” will replace the current call to action, inviting Radiopharma, the NHS, and other stakeholders to a confidential process. This mediation will aim to secure financial compensation for past overcharges while establishing future pricing and supply agreements that benefit all parties. The SimplerRAT study’s emphasis on regulatory clarity provides a framework for proposing market reforms during mediation, ensuring compliance with emerging EU guidelines. COCOO’s unique position—representing victims, possessing proprietary evidence, and understanding market dynamics—makes us the ideal mediator to broker a sustainable solution.

To execute this strategy, we must act swiftly. First, we will finalize the draft Form C complaints, ensuring they are ready for submission if settlement talks falter. Second, we will contact Radiopharma’s legal teams, presenting a summary of our evidence and the potential scale of litigation, while offering mediation as a faster, confidential alternative. Third, we will submit the USPs to the NHS, Spanish Ministry of Health, and CNMC, requesting an initial low-value contract to validate our expertise. Finally, we will monitor platforms like Find a Tender and TED for opportunities like the NHS’s PET-CT Radiopharmaceuticals tender, forming a consortium with smaller suppliers to challenge Radiopharma’s dominance. By combining the threat of litigation with proactive public contract proposals and a mediation offer, we maximize our leverage to secure settlements and drive systemic change, fulfilling COCOO’s mission to protect consumers and promote fair competition.

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 SEARCHLINKS – GEMINI

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THE 5 ATTACHMENTS

File Analysis 4: TI_ BORs.pdf (Transparency International on Beneficial Ownership Registers)

This report from Transparency International provides high-level public interest arguments that we can integrate directly into the framework of our Radiofarma proposal. The case aims to restructure a public procurement market, and this document gives us the language and principles to frame our solution as a promotion of good governance.

The most valuable concept I have chosen to extract is the explicit link the report makes between beneficial ownership transparency and ensuring “value for money in public procurement” and creating a “level playing field” for competition. I have selected this because our entire Radiofarma project is based on breaking up an oligopoly to create competition and generate savings for the public health system. This principle allows us to argue that the current opaque market structure, dominated by one or two players whose ultimate ownership may not be fully transparent to the procuring hospitals, carries inherent risks. By building a mandatory beneficial ownership disclosure requirement into our proposed new procurement model, we can argue that our solution doesn’t just lower prices, but also introduces a new, higher standard of transparency and integrity into healthcare procurement in Spain.

I have also extracted the specific real-world example of the Slovakian Beneficial Ownership Register, which the report notes was established specifically for companies participating in public procurement processes. This is an extremely powerful precedent to have chosen. It provides a concrete example of another EU member state implementing exactly the kind of transparency measure we can build into our proposed solution. In our communications with the Spanish Ministry of Health and regional health authorities, we can now point to this and say, “Our proposal to include ownership transparency is not a radical idea; it is an international best practice already implemented by your EU partners to safeguard public funds.” This makes our proposal seem less disruptive and more like a sensible, modernizing step.

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File Analysis 5: Spanish Guidance-Beneficial-Ownership-Legal-Persons.pdf.coredownload.pdf (FATF Guidance)

This official FATF guidance document provides the specific, technical standards that translate the principles from the Transparency International report into actionable requirements. It gives us the technical blueprint for designing the good governance component of our Radiofarma project.

The most critical point I have extracted from this guidance is the explicit requirement that authorities must have “timely access” to beneficial ownership information “in the course of public procurement”. I have selected this specific clause because it is the global standard that we can hold up as a benchmark. It gives us a powerful angle to question the current system. We can now ask the Spanish health authorities: “In your current contracts for radiopharmaceuticals, do you have timely access to verified information on the ultimate beneficial owners of your suppliers, as required by the FATF standard?”. This puts them on the defensive. More importantly, it allows us to present our proposed procurement system as one that is explicitly designed to meet this international best practice, making our solution appear more robust and compliant than the status quo.

I have also chosen to extract the guidance on using a “multi-pronged approach” (enfoque múltiple) to verify ownership information, which makes clear that simply accepting a company’s self-declaration is not enough. This is a vital technical detail for our project. It justifies why a simple registration form for new market entrants is insufficient. Our Unsolicited Proposal will now explicitly include a verification module, designed to meet this FATF standard by cross-referencing information from multiple sources. This demonstrates a high level of sophistication and foresight, showing that we have thought through not just the commercial aspects of the market, but also the critical details of ensuring its integrity and transparency. It makes our proposal technically superior and far more credible