Blockbuster weight-loss drug Wegovy could bankrupt the U.S. health care system unless the price drops, according to a staff report released Wednesday from the office of Senate Health Committee Chair Bernie Sanders (I-Vt.).
Unless prices dramatically decline, Wegovy and weight loss drugs could push Americans to spend $1 trillion per year on prescription drugs, the report concluded.
“Pricing drugs based on their value cannot serve as a blank check, or the sole determinant for how we understand what to pay for essential goods,” the report stated. As important as these drugs are, they will not do any good for the millions of patients who cannot afford them.”
The report ups the pressure from Sanders on Danish drugmaker Novo Nordisk to lower the price of Wegovy and Ozempic.
In April, Sanders and the Health Committee launched an investigation into why the company is charging Americans substantially higher prices than other countries.
Novo Nordisk charges Americans with Type 2 diabetes $969 per month for Ozempic, compared to just $155 in Canada, $122 in Italy, $71 in France and $59 in Germany.
The company lists Wegovy for $1,349 per month in the U.S. compared to $186 in Denmark, $137 in Germany and $92 in the U.K.
According to the Centers for Disease Control and Prevention, nearly 42 percent of American adults have obesity, and more than 11 percent of the population has diabetes.
If half of American adults with obesity took Wegovy and the other new weight loss drugs, it could cost the health care system $411 billion per year — more than total spending for all retail prescription drugs in 2022, the report found.
The committee report noted the company has not yet provided the net pricing data requested as part of the investigation, but staff estimated net prices to be $809 per month after rebates.
Many private health insurance plans cover the drugs to some extent, though employers and plans have increasingly restricted access or ended coverage completely as they struggle with the costs.
Medicare is prohibited by law from covering drugs solely for weight loss. However, Wegovy was recently approved by the Food and Drug Administration to reduce the risk of serious heart problems in people who are overweight or obese.
With that new approval, the Centers for Medicare and Medicaid Services has opened the door for coverage for more patients.
In a statement, a Novo Nordisk spokesperson said the company is reviewing the report and continues to cooperate with the investigation.
