Sen. Bernie Sanders highlighted a potential shift in the pricing of Ozempic during a Senate Health, Education, Labor and Pensions Committee hearing Sept. 24, during which three major pharmacy benefit managers said they would increase coverage if Novo Nordisk lowered the drug's list price.
Here are five key takeaways:
- During the hearing, Novo Nordisk CEO Lars Fruergaard Jørgensen attributed the high prices of drugs such as Ozempic and Wegovy to PBMs, arguing that "a high list price is more likely to lead to more access to patients," NBC News reported Sept. 24.
- Mr. Jørgensen also noted that when setting a list price for a medication, the company has to take into account the rebates it has to pay, illustrating the complex relationship between drug pricing and insurance coverage.
- The current price of Ozempic is $969 per month in the U.S, starkly contrasting from lower prices in countries such as Germany and in the U.K. Novo Nordisk previously told Becker's the net price of Ozempic has fallen 40% since launching in the U.S., adding that more than 99% of commercial plans cover Ozempic and 80% of insured Americans pay $25 or less each month.
- In response to Novo Nordisk claims that PBMs contribute to high drug prices, representatives from Cigna Group/Express Scripts, CVS Health/Caremark and UnitedHealth Group/OptumRx told Mr. Sanders a reduction in list price would not negatively affect Ozempic's formulary placement, according to a Sept. 24 news release from the senator's office. The PBMs also emphasized that lowering the price could improve patient access to the medication.
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During the hearing, Mr. Sanders asked Mr. Jørgensen if he would "substantially lower" GLP-1 prices in the U.S. Mr. Jørgensen responded by saying, "if it works in a way where patients get access to a more affordable medicine," suggesting Novo Nordisk may consider price reductions if they improve patient access, according to NBC News.