US Senator Sanders: Middlemen Won’t Penalize Novo if It Reduces Prices of Weight-Loss Drugs, Reports Reuters

By Ahmed Aboulenein and Patrick Wingrove

WASHINGTON – U.S. Senator Bernie Sanders announced on Tuesday that he has received assurances from leading pharmacy benefit managers (PBMs) to broaden coverage for Novo Nordisk’s widely-used diabetes and weight-loss medications, contingent on the company reducing their list prices.

During the Senate Committee on Health, Education, Labor and Pensions hearing—which he chairs—Sanders revealed that he has secured written commitments from major PBMs, including UnitedHealth Group’s Optum, CVS Health’s Caremark, and Cigna’s Express Scripts.

"I have received commitments in writing from all of the major PBMs that if Novo Nordisk substantially reduced the list prices for Ozempic and Wegovy, they would not limit coverage," Sanders stated. "In fact, all of them indicated they could expand coverage for these drugs if prices were lowered."

This announcement challenges a common argument from pharmaceutical companies, which often assert that reducing list prices would result in narrower coverage. Such companies argue that PBMs have a financial incentive to include pricier drugs on formularies due to the larger rebates they generate.

Sanders expressed frustration with Novo Nordisk CEO Lars Jorgensen, questioning why Americans face higher prices for Ozempic and Wegovy compared to consumers in other countries, where costs can exceed $1,000 a month.

Semaglutide, a drug in the GLP-1 class, is marketed as Wegovy for weight management and Ozempic for treating type 2 diabetes. Clinical evidence indicates that users can lose an average of 15% of their body weight while on these medications.

Lawmakers, including Sanders, have also voiced concerns regarding the pricing of Eli Lilly’s competing medications, Mounjaro and Zepbound.

The list prices for Ozempic and Wegovy are set at $935.77 and $1,349, respectively, for a month’s supply—significantly higher than their counterparts in various European nations, where they may be available for approximately $59 and $92, as noted by Sanders.

Jorgensen stated that since their launch, the price of Ozempic has fallen nearly 40%, with similar declines for Wegovy available to patients who qualify for discounts. However, he did not commit to further price reductions when questioned by Sanders.

"I can’t confirm under which conditions such a promise would be made. I have not seen any of that," he replied. While expressing a willingness to work with PBMs to enhance patient support, Jorgensen remained skeptical about their ability to make the medications more affordable.

He reported that 99% of U.S. commercial insurance plans currently cover Ozempic, while around half cover Wegovy. Notably, over 80% of insured U.S. patients pay less than $25 for a month’s supply, with 90% paying under $50.

"It is not our intention that anyone should pay the list price," he emphasized, referring to it as merely a starting point for negotiations with PBMs and insurers.

Despite this, Sanders argued that the net prices for the medications remain excessively high. "Even in your best-case scenario, the price for Ozempic that you charge Americans is still nearly $600 after all the rebates and discounts. That’s over nine times what consumers in Germany pay for the same product," he stated.