Three major Pharmaceutical Benefit Managers (PBMs) confirmed that lower list prices would make the blockbuster drugs more widely available
WASHINGTON, Sept. 24 – Sen. Bernie Sanders (I-Vt.), Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, today released a new report uncovering how Novo Nordisk, as one health insurance plan described it, is using its “position of power” to “squeeze” plans, and “boost its corporate profits.”
“Today, Novo Nordisk charges Americans with Type 2 diabetes $969 a month for Ozempic, while this same exact drug can be purchased for just $59 in Germany, $71 in France, $122 in Denmark, and $155 in Canada,” said Sanders. “There is only one reason they can justify charging Americans such outrageous prices for the drugs they need: Excessive corporate greed.”
Novo Nordisk claims that PBMs and health insurance plans are the reason for high prices for Ozempic and Wegovy, and previously stated that PBMs failed to assure the company that its products would maintain formulary access if it lowered its list prices.
Today, three major PBMs that help determine drug coverage for most of the nation – Cigna Group/Express Scripts, CVS Health/Caremark, UnitedHealth Group/Optum Rx – confirmed to Chair Sanders that a list price reduction would not negatively impact formulary placement for Ozempic and Wegovy, and affirmed that lower list prices would, in fact, make the drugs more widely available to patients in need.
- Cigna/Express Scripts said: “No, if Novo Nordisk lowered their list price for Ozempic and Wegovy tomorrow to a price that was the same or lower than current net cost, that change by itself would not result in less favorable formulary placement.” To support this claim, the company provided an example: It did not disfavor a competing weight-loss product, Eli Lilly’s Zepbound, even as it launched at a list price 20% lower than Wegovy.
- UnitedHealthGroup/Optum Rx said: “No. Assuming the net price remains the same or lower, lowering a medicine’s list price would not lead to less favorable formulary placement by Optum Rx – particularly for high-demand drugs like Ozempic and Wegovy.
- CVS Health/Caremark said: “The simple answer is no. In fact, we can point to recent history as a proof point. When Novo-Nordisk drastically reduced the price of their insulin, Novolog, in 2023, it did not result in a less favorable formulary placement with Caremark.”
Novo Nordisk has also justified its astronomical prices by arguing a need to fund future research and development.
However, since launching Ozempic in 2018, Novo Nordisk has spent twice as much on stock buybacks and dividends ($44 billion) as it has on research and development ($21 billion), according to financial filings.
Novo Nordisk has also lavished cash and perks on health care providers, sending doctors on trips to Alaska, Hawaii, and Florida and paying for nearly 1.7 million meals and snacks to doctors to promote Ozempic and Wegovy, federal records show.
The report can be read here.
