Indianapolis-based Eli Lilly has been ordered by a federal court to pay $3 billion in punitive damages over the diabetes drug Actos.
Eli Lilly's co-defendant, Takeda Pharmaceuticals, was ordered to pay $6 billion.
Takeda is Japan's biggest drug maker.
The legal fight was over Actos being the alleged cause of a patient’s bladder cancer.
The drug comes with warnings about serious side effects, including liver problems, broken bones and higher risk of bladder cancer.
Both Lilly and Takeda plan appeals as each thinks that the other is to blame and should pay.