Novo Nordisk CEO defends Ozempic and Wegovy prices at Senate hearing
A Senate hearing compared U.S. list prices of $969 a month for Ozempic and $1,349 for Wegovy with far lower prices abroad, and Novo Nordisk made no promise to cut them.
Novo Nordisk CEO Lars Fruergaard Jørgensen testified before the Senate Health, Education, Labor and Pensions Committee on Sept. 24, 2024, where Chairman Bernie Sanders pressed him on why the company's diabetes drug Ozempic and weight-loss drug Wegovy cost far more in the United States than in other countries [1][2].
Sanders, an independent from Vermont, opened the hearing with a chart of international prices. He said Ozempic sells for $155 a month in Canada, $122 in Denmark, $71 in France and $59 in Germany, while the U.S. list price is $969 — more than 15 times the German figure. Wegovy, he said, lists at $1,349 a month in the U.S., compared with $265 in Canada, $186 in Denmark, $137 in Germany and $92 in the United Kingdom [1]. The two drugs are different brand names for the same molecule, semaglutide [1].
Sanders said list prices do not tell the whole story, but that rebates do not close the gap. He said the net price of Ozempic is still nearly $600, more than nine times the German figure, and estimated net Wegovy is over $800, nearly four and a half times Denmark's [1]. Patients who are uninsured, have a large deductible, or pay coinsurance calculated on the list price face the higher number, he said [1]. He also said 75% of Americans with insurance, more than 190 million people, cannot get Wegovy through their policies [1].
Jørgensen did not promise to cut prices [2]. He said he wants to work with lawmakers on policy solutions for the "structural issues" that drive up prescription drug costs, and committed to sit down with pharmacy benefit managers, the middlemen who negotiate rebates for insurers, to "collaborate on anything that helps patients get access and affordability" [2]. In written testimony, the company blamed PBMs for exercising "near-total control over the ability of hundreds of millions of Americans to get the medicines they need at affordable prices" [2]. Jørgensen cited Novo Nordisk's insulin Levemir, which he said was available to 90% of U.S. patients through insurance formularies before a list-price cut, after which coverage fell to 36% and the company discontinued the product [2].
Sanders said he had written commitments from all major PBMs that they would not limit coverage of Ozempic and Wegovy if Novo Nordisk substantially reduced list prices, and that they would be able to expand coverage [1][2]. Jørgensen called the letters "new information to me" but said he understands "that perhaps the PBMs have changed their minds" [2].
Other figures from the hearing: Sanders said Novo Nordisk has taken in nearly $50 billion in sales from the two drugs since 2018, with 72% of that revenue from the United States, and that the company spent $21 billion on research and development over that period against $44 billion on stock buybacks and dividends [1]. He cited a study by Yale health care economist Melissa Barber finding Ozempic can be profitably manufactured for less than $5 a month, while acknowledging that production cost is not a company's only expense, and a study by Yale epidemiologist Alison Galvani estimating more than 40,000 lives a year could be saved if Wegovy were widely available at an affordable price [1]. Sanders also said generic drugmakers have told him they could sell a version of Ozempic for less than $100 a month [1][2]. No generic Ozempic is currently available in the U.S. [2].
The committee said it would cost $411 billion a year if half of all Americans took weight-loss drugs, $5 billion more than what Americans spent on all prescription drugs at the pharmacy counter in 2022 [1][2]. Medicare spent $4.6 billion on Ozempic in 2022 alone, according to the health policy research group KFF [2]. "All we are saying, Mr. Jørgensen, is treat the American people the same way that you treat people all over the world," Sanders said. "Stop ripping us off" [2].
Why it matters for patients
The hearing did not change what anyone pays at the pharmacy. The $969 and $1,349 figures are list prices, and what an individual pays depends on insurance, deductibles and whether a plan covers the drug at all [1][2]. Sanders said uninsured patients and those with large deductibles pay full list price, and coinsurance is figured on the list price [1]. Many health plans cover GLP-1 drugs for diabetes but not for weight loss, and Medicare does not pay for weight-loss treatments unless they are approved and prescribed for another condition [2]. Some insurers and employers have added strict requirements or dropped coverage entirely [2]. With no generic semaglutide on the U.S. market, there is no lower-priced copy to switch to [2]. The pricing debate also extends beyond Novo Nordisk: Eli Lilly's Zepbound and Mounjaro, which contain tirzepatide, cost around $1,000 a month before insurance and rebates [2].
What happens next
Ozempic is likely to be eligible for the next round of Medicare drug price negotiations under the Inflation Reduction Act, with drugs selected in 2025 and negotiated prices taking effect in 2027, according to Wall Street analysts [2]. Lawmakers asked Novo Nordisk to commit not to sue the federal government if Ozempic and Wegovy are selected; Jørgensen did not make that commitment, saying the process is "not a fair negotiation, but actually price-setting" that would harm innovation [2]. He committed to meeting with the PBMs [2].
No price reduction, implementation date or follow-up hearing has been announced, and it has not been disclosed whether the PBM commitments would hold if Novo Nordisk actually cut its list prices [2].
Sources
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