As president of the United States and the chairman of the Health, Education, Labor, and Pensions Committee in the Senate, we have long been concerned about the outrageous prices that the pharmaceutical industry charges the American people for prescription drugs.

There is no rational reason why Americans, for decades, have been forced to pay, by far, the highest prices in the world for the prescription drugs they need.

There is no rational reason why, for decades, 1 out of 4 Americans have been unable to afford the medicine their doctors prescribe.

And it is most certainly not Americans’ patriotic duty to pay high drug prices at home so others abroad can enjoy the fair prices that every American is entitled to.

That’s why over the last several years, working together, we have made substantial progress.

As a result of the Inflation Reduction Act that passed Congress without a single Republican vote, seniors with diabetes are paying no more than $35 a month for insulin. Starting in January, no senior in America will pay over $2,000 a year for prescription drugs. And, for the first time in history, Medicare is now doing what every other major country does: Negotiate with the pharmaceutical companies to lower the price of some of the most expensive drugs in America.

This commonsense policy is one that the American public overwhelmingly agrees with, including more than 60% of Republicans.

By working with some of the largest drug companies in the world, we also have managed to lower the cost of inhalers that millions of Americans, with asthma and chronic obstructive pulmonary disease, need to breathe from as much as $645 down to just $35.

We are very proud of these achievements. The U.S. government is finally standing up to Big Pharma. But much more needs to be done to lower the unaffordable price of prescription drugs.

We plan to expand negotiations on drug prices

What does that mean?

It means that, at a time when many Americans are dealing with the myriads of chronic illnesses, no one in our country should be forced to pay over $2,000 a year for the prescription drugs they need, not just seniors. It also means that the number of prescription drugs up for price negotiation must be expanded to at least 50 a year. We are working together on legislation to do just that. We look forward to every member of Congress supporting this legislation.

But let’s be clear. It’s not just Congress that needs to act. Prescription drug companies also must stop ripping off the American people.

Bernie Sanders: US is turning its back on long COVID. We’ll pay the price if we don’t act.

Let us give you one example – a major one. Today, tens of millions of Americans are struggling with Type 2 diabetes and obesity.

The good news is that Novo Nordisk, one of the world’s leading pharmaceutical companies, has created new blockbuster drugs, Ozempic and Wegovy, that effectively treat these conditions.

Obesity drugs are too expensive

The bad news is that Novo Nordisk is charging the American people unconscionably high prices for these prescription drugs. If your doctor prescribes you a GLP-1, the prices of Ozempic and Wegovy can be up to several times higher than prices in Canada, Germany, Denmark and other major countries. That’s unacceptable.

And it’s not just Novo Nordisk. Eli Lilly also is charging unconscionably high prices for Mounjaro, a drug with similar health effects as Ozempic. That cost is roughly $1,100 a month.

Why should people in Burlington, Vermont, pay so much more than people in Copenhagen or Berlin for the same drug? The simple fact of the matter is that people in Paris, Texas, shouldn’t be paying much higher prices for Ozempic and Wegovy as people in Paris, France.

These inequities are made even more stark when the profit margins of these companies are examined. For example, in March, a study from researchers at Yale University found these drugs could be profitably manufactured for less than $5 a month, or $57 per year.

The scientists at Novo Nordisk deserve great credit for developing Ozempic and Wegovy. These drugs have the potential to be a game changer for people throughout the world struggling with Type 2 diabetes and obesity. But, as important as these drugs are, they will not do any good for the millions of patients who cannot afford them.

Moreover, if the prices of these drugs are not substantially reduced, they have the potential to bankrupt the American health care system.

We will not allow that to happen.

If half of adults with obesity took Wegovy and the other new weight loss drugs, it could cost $411 billion per year −$5 billion more than what Americans spent on all prescription drugs at the pharmacy counter in 2022.

If half of all Medicare and Medicaid beneficiaries who are obese took Wegovy and other weight loss drugs, Medicare and Medicaid could spend $166 billion per year, rivaling what the two federal health programs spent on all retail prescription drugs in 2022.

This is not morally responsible or fiscally responsible.

President Biden: I’m doing everything I can to reduce gun violence, but Congress must do more

Americans struggle while pharma companies make massive profits

Let’s be clear. Year after year, while so many Americans struggle to buy the prescription drugs they need, the pharmaceutical industry makes huge profits. In fact, 10 top pharmaceutical companies made over $110 billion in profits last year.

In 2023, for example, Novo Nordisk made over $12 billion in profits, in part by charging Americans over $1,000 a month for a prescription drug that can be profitably manufactured for less than $5. That is not making a reasonable return on investment. That is price gouging. That is corporate greed.

Now, pharma companies will claim that Americans may end up paying lower prices than they charge for their drugs because they rely on opaque discounting mechanisms run through middlemen. But these non-transparent tactics prevent payers from understanding what the drugs actually cost, thereby lowering their negotiating position.

Pharma will also claim that, even if the actual prices are exorbitantly high, reducing them would drive down innovation and make innovative drugs like Ozempic less likely to be developed in the future. But reaping the rewards of innovation is not in fundamental conflict with fair prices for consumers or helping the broadest set of possible people.

If Novo Nordisk and other pharmaceutical companies refuse to substantially lower prescription drug prices in our country and end their greed, we will do everything within our power to end it for them. Novo Nordisk must substantially reduce the price of Ozempic and Wegovy.

As Americans we must not rest until every person in our country can afford the prescription drugs they need to lead healthy, happy and productive lives.

Let us go forward together.

Joe Biden is the 46th president of the United States. Sen. Bernie Sanders, an independent from Vermont, is chair of the Senate Health, Education, Labor and Pensions Committee.