While grilling Novo Nordisk’s chief executive over the price of its blockbuster diabetes and weight-loss drugs, Ozempic and Wegovy, on Tuesday, Sen. Bernie Sanders alleged that 40,000 people a year in the US could die if the company doesn’t make the medicines more affordable.
“From a moral perspective, does it bother you knowing that keeping the price of Ozempic and Wegovy so high in the United States could lead to the preventable deaths of tens of thousands of Americans?” Sanders, chairman of the US Senate Health, Education, Labor and Pensions Committee, asked the Danish drugmaker’s CEO, Lars Fruergaard Jorgensen, citing research from a Yale epidemiologist.
“We are very committed to making sure that Americans have access at an affordable price point for our medicines,” Jorgensen replied. “There’s no thing we would rather see happen.”
It was the latest in a series of hearings Sanders has led with pharmaceutical company CEOs about the price of medicines in the US, which are higher – often by multiple times – than in other wealthy countries. But perhaps no drugs have garnered more attention than Novo Nordisk’s Ozempic, approved for diabetes, and its sister drug, Wegovy, for weight loss and reduction of heart risk. The medicines, also referred to as GLP-1s for the hormone they mimic, are now used by millions of Americans but are still unaffordable and out of reach for many.
Sanders, who launched an investigation of Novo Nordisk in April over what he called “outrageously high prices” for the medications in the US, has focused on the drugs’ comparative cost in other countries: He noted that the list price for a four-week supply of Ozempic is $969 in America, but the drug can be purchased for $155 in Canada, $122 in Denmark and $59 in Germany. Similarly, Wegovy’s list price is $1,349 in the US, but it costs $186 in Denmark, $140 in Germany and $92 in the United Kingdom, he said.
Tuesday’s hearing boiled down to a familiar argument over who is responsible for the US’s higher prices: drug companies that set starting – or “list” – prices or pharmacy benefit managers, the middlemen that negotiate discounts on those list prices in exchange for favorable insurance coverage and access.
Jorgensen said Novo Nordisk pays back about 75% of its medicine sales in rebates, discounts and fees, so the net price it receives is far lower than the list price.
And he argued that when Novo Nordisk has lowered list prices in the past, it’s been penalized by PBMs that profit from discounts, or rebates, on higher prices, in the form of reduced access for patients to its medicines.
“The broad totality is that less patients have access to our medicines when we lowered the price,” Jorgensen told Sen. Maggie Hassan, D-New Hampshire, after she pressed him to reduce list prices.
The Pharmaceutical Care Management Association, the PBMs’ industry group, said in a statement that Jorgensen is trying to shift attention from drugmakers’ moves that keep costs high.
“PBMs are the only entities in the health care system working to mitigate the impact on patients, employers, and taxpayers of Big Pharma’s outrageous prices on blockbuster GLP-1s facing minimal competition,” the association said in a statement. “The critical value of PBMs is being demonstrated in real-time as they are effectively helping plan sponsors navigate a challenging balance between access and cost on GLP-1s for weight loss.”