AILSA CHANG, HOST:
Ozempic and Wegovy have been a boon to people with diabetes and obesity, but with prices around $1,000 a month or more, the drugs are out of reach for many, many people who need them. Today Senator Bernie Sanders and his powerful Senate HELP Committee spent two hours questioning the CEO of Novo Nordisk about the drugs' prices. NPR pharmaceuticals correspondent Sydney Lupkin is here to tell us how it went. Hi, Sydney.
SYDNEY LUPKIN, BYLINE: Hi, Ailsa.
CHANG: All right, so how did the hearing go?
LUPKIN: So Senator Sanders kicked it off, not surprisingly, by talking about how Wegovy and Ozempic cost so much more in the United States than in other countries. In the United Kingdom, Wegovy is $92 a month, but...
CHANG: Wow.
LUPKIN: ...In the U.S. - yeah, it's more than $1,300 in the U.S. And when it came time to question the Novo Nordisk CEO, Lars Jorgensen, Sanders asked, why? Why charge Americans so much more? Jorgensen didn't give a direct answer, even though Sanders asked repeatedly.
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BERNIE SANDERS: But you still have not answered my question - it's a very simple question - why Novo Nordisk is charging Americans substantially higher prices for these drugs than the people in other countries.
LUPKIN: The majority of Novo Nordisk's sales of Ozempic and Wegovy are in the U.S.
CHANG: OK, well, what did Jorgensen have to say for the company, then?
LUPKIN: Jorgensen said that Novo Nordisk wants to help people. He talked about investing billions of dollars to expand manufacturing. Demand for the drugs has exceeded supply. He also talked about how many patients with insurance coverage don't pay more than $25 at the pharmacy counter for Ozempic. Sanders countered that, even if that's true, patients pay more for their insurance every month because their insurance still pays for the rest of the cost of the drug.
Ozempic's main use is for diabetes. Wegovy is the version of the drug for obesity, and many insurers just don't cover it. When it came to pricing, Jorgensen pointed the finger at pharmacy benefit managers, or PBMs, which are the middlemen between drug companies and health insurance companies. If you have insurance, they're the medication gatekeepers.
CHANG: OK, so what's his argument? Like, what evidence did he give for pinning the blame on PBMs?
LUPKIN: Jorgensen said high list prices are a starting point for negotiations with the PBMs. Novo Nordisk doesn't get the sticker prices. In the past, when the company has lowered list prices on other drugs, he said that made those drugs less attractive to PBMs, who pocket part of the confidential discount they negotiate. As a result, the lower-price drugs get worse insurance coverage, which means patients can have a harder time getting them.
But Sanders had a surprise for Jorgensen. He had written commitments from the major PBMs that if Novo Nordisk lowered the list prices of Ozempic and Wegovy, they would not limit access to them. He then asked Jorgensen to commit to lowering the prices, and Jorgensen didn't say yes. He said the PBM promise was news to him. Here's their next exchange.
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SANDERS: Are you prepared to have Novo Nordisk sit down with the PBMs who have made that commitment to me, sit in a room with us and work on an agreement?
LARS JORGENSEN: I'll be happy to, as I said, do anything that helps patients.
CHANG: OK, maybe that's progress, I guess. But this isn't the first time that there's been public pressure to reduce the price of a particular drug, right?
LUPKIN: That's definitely true. We've seen a lot of public pressure around the price of insulin and the price of asthma inhalers, including from this Senate committee. And in those cases, it kind of worked. For insulin, patients pay lower copays. But policy experts tell me that may have been more response to other rules, in Medicaid, for example. It wasn't public pressure alone. Ozempic and Wegovy are fairly new, so we'll have to wait and see if Senator Sanders' approach pays off.
CHANG: That is NPR's Sydney Lupkin. Thank you, Sydney.
LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.
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