WASHINGTON — For the millions of people living with diabetes or obesity, drugs like Ozempic and Wegovy can significantly improve their health.
But the out-of-pocket costs can add up fast. Patients could have to pay more than $950 a month for Ozempic and more than $1,300 for Wegovy.
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These same drugs are a fraction of the price overseas. For example, lawmakers say the price for Ozempic is $155 in Canada and $59 in Germany.
“The vast majority of the American people are sick and tired of paying outrageously high prices for prescription drugs,” Sen. Bernie Sanders, (I) Vermont, said.
Lawmakers say the drug company has made $50 billion on the sales of those two drugs since 2018. Tuesday, members of the U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) pressed the drug company’s CEO, Lars Jørgensen for answers.
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“We don’t decide the price for patients, that’s set by the insurance company,” Lars Fruergaard Jørgensen, President and CEO of Novo Nordisk said.
He told lawmakers his company doesn’t set the expensive price tag. Novo Nordisk works with Pharmacy Benefit Managers or PMBs. These are the middlemen that negotiate costs between drug companies and the pharmacies that sell them.
“I would prefer doing business on the net price where I compete against competitors based on what is the real price for our medicine and what is the value of the medicine,” Jørgensen said.
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Jørgensen also testified that he expects Ozempic will eventually be part of the federal government’s efforts to negotiate prices for Medicare patients.
“I have nothing against negotiation pricing with the objective of approving affordability for patients,” Jørgensen said. “But if it’s not a fair negotiation but actually price setting, I think it will have negative consequences on the innovation being brought.”
Ahead of this Senate committee hearing, the Pharmaceutical Care Management Association (PCMA), which represents PBMs, released a statement saying they aren’t to blame for high prices. It added in part, “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.”
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Jørgensen also talked with lawmakers about adjusting the rebate structure to help lower costs.
“If we pass [rebates] on to patients then they are faced with the net price at the pharmacy counter. I think that would dramatically change it to a much more affordable system,” he said.
The America’s Health Insurance Plans (AHIP) pushed back on this suggestion.
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“Drugmakers want a blank check to continue charging the exorbitantly high prices they set and raise arbitrarily. If drugmakers wanted American consumers to pay less – or even the same prices as consumers in Europe – they would simply lower them,” AHIP in a written statement to the Washington News Bureau said.
As they craft legislation, some lawmakers say the key is finding the right balance for all parts of the industry.
“We still have to preserve the profit incentive for the creativity for drug companies to invest in order to develop the drugs,” Sen. Bill Cassidy, (R) Louisiana, said.
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