Sanders questions Novo Nordisk CEO over US prices for Ozempic and Wegovy

Sen. Bernie Sanders (I-Vt.) pressed Novo Nordisk CEO Lars Fruergaard Jørgensen on the US prices of Ozempic and Wegovy at a Senate Health, Education, Labor and Pensions Committee hearing on Sept. 24, 2024 ^[1][2]. Jørgensen was the only witness on the panel ^[1].

Sanders said the list price for a four-week supply of Ozempic is $969 in the United States, compared with $155 in Canada, $122 in Denmark, $71 in France and $59 in Germany ^[1][2]. He said Wegovy's US list price is $1,349, against $265 in Canada, $186 in Denmark and $92 in the United Kingdom ^[1][2]. The two accounts differ slightly on Wegovy's price in Germany: Sanders' prepared remarks say $137, while CNN quotes him saying $140 ^[1][2].

Sanders argued the gap remains after rebates. He said the net price for Ozempic is still nearly $600, more than nine times the German net price, and the estimated net price for Wegovy is over $800, nearly four and a half times Denmark's ^[1]. Jørgensen told the committee Novo Nordisk pays back about 75% of its medicine sales in rebates, discounts and fees, so its net receipts are far below the list price ^[2].

Sanders also said his investigation found Novo Nordisk has made nearly $50 billion in sales from the two drugs since 2018, with 72% of that revenue coming from the United States ^[1]. He said the company spent $21 billion on research and development over that period and $44 billion on stock buybacks and dividends ^[1].

Sanders announced that the committee had obtained written pledges from the largest pharmacy benefit managers — the middlemen that negotiate drug discounts — to maintain access to Ozempic and Wegovy if Novo Nordisk lowered list prices ^[1][2]. Jørgensen said that was new information to him, adding, "Anything that will help patients get access to affordable medicine we'll be happy to look into" ^[2]. He said that when Novo Nordisk lowered the list price of some insulins in the past, the products were dropped from coverage and fewer patients got access ^[2]. The Pharmaceutical Care Management Association, the PBM trade group, said Jørgensen was trying to shift attention from drugmakers' pricing ^[2]. Sen. Roger Marshall (R-Kan.), a doctor, called Ozempic a "miracle drug" and said, "Novo Nordisk is not the villain in this story; they're a hero" ^[2].

Sanders asked Jørgensen: "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?" ^[2] He cited research from a Yale epidemiologist estimating that more than 40,000 lives a year could be saved if Wegovy were widely available at an affordable price ^[1][2]. Jørgensen replied that the company is "very committed to making sure that Americans have access at an affordable price point for our medicines" ^[2].

Separately, Sanders said Yale health care economist Melissa Barber found Ozempic can be profitably manufactured for less than $5 a month, and that generic drug companies told him they could sell a generic version for less than $100 a month ^[1].

Why it matters for patients

No price change was announced at the hearing, and no change to how the drugs are priced has been reported as a result of it ^[1][2]. The figures discussed are list prices, the starting point before insurance. Sanders said patients who are uninsured, who have a large deductible, or who pay coinsurance based on the list price face the full amount ^[1]. He also said 75% of Americans with insurance — more than 190 million people — cannot access Wegovy through their policies ^[1]. Novo Nordisk's stated position is that it wants Americans to have affordable access, while arguing that pharmacy benefit managers have cut access when it lowered list prices before ^[2]. Whether any of the PBM pledges would change what patients pay has not been disclosed ^[1][2].

What happens next

Ozempic will probably be eligible for the next round of Medicare drug price negotiations, Jørgensen said in written testimony, while rival products from Eli Lilly will not be eligible for another decade ^[2]. The Centers for Medicare and Medicaid Services is scheduled to announce the names of the next 15 drugs by February ^[2]. The first round of negotiations produced a 22% reduction in total net spending on 10 drugs ^[2]. Whether Congress takes further action on GLP-1 pricing has not been disclosed.