A rare issue unites Americans across the political divide: the nation’s broken healthcare system, which is slowly killing its citizens. The crisis has even bridged the gap between unlikely allies: MAGA proponent and billionaire Elon Musk and Vermont Senator Bernie Sanders.
Sanders, a champion of Europe’s social market model, recently joined President Biden in urging Danish drugmaker Novo Nordisk to slash the prices of its popular treatments.
The inability to provide affordable access to life-saving drugs, particularly for diet-induced diabetes and obesity, claims more than 43,000 lives annually—deaths that could be prevented if the prices of medications like Ozempic and Wegovy were lower.
“Solving obesity greatly reduces [the] risk of other diseases, especially diabetes, and improves quality of life. We do need to find a way to make appetite inhibitors available to anyone who wants them,” Sanders said on Tuesday, quoting the Tesla CEO from earlier this month. “And Mr. Musk is right.”
The centibillionaire has repeatedly clashed with the senator over income inequality, with Musk once posting how he keeps forgetting Sanders isn’t dead yet. But it’s hard to fight with someone who agrees with you.
Musk himself has waged a constant battle with the scale, having been fat-shamed by his very own father before opting to take Novo Nordisk’s Wegovy to help slim down chemically.
“I really am with Bernie on this one,” Musk posted on Tuesday.
74 cents of every dollar in sales goes to middlemen
Sanders was speaking at a subcommittee hearing that called Novo Nordisk CEO Lars Fruergaard Jørgensen as a witness. By the senator’s estimate, Jørgensen is charging U.S. patients nine times what they charge German peers net of list price rebates.
Nearly three-quarters of the revenue Novo Nordisk has generated from the $50 billion in total sales since the 2018 launch of its so-called GLP-1 drug semaglutide (marketed under the brand name Ozempic and Wegovy) comes from the U.S. market, a figure Jørgensen did not dispute.
“The United States is Novo Nordisk’s cash cow for Ozempic and Wegovy,” Sanders said. “All we are saying, Mr. Jørgensen, is treat the American people the same way that you treat people all over the world—stop ripping us off.”
Jørgensen said his company is investing $30 billion to expand production and lower the drug’s cost.
Instead, he blamed pharmacy benefit managers (PBMs), the middlemen who negotiate prices with customers in a U.S. healthcare system that is incentivized to keep costs up at the expense of patient outcomes.
“They get a fee based on list price—so the higher list price, the more fee they get for the same job,” he said, adding, on average, 74 cents of each dollar revenue Novo Nordisk makes in the U.S. ends up in the pockets of PBMs and insurers.
“In our experience, products that come with a low list price get less coverage. It’s less attractive.”
When Sanders countered that he had secured a written commitment from three major PBMs that they would not lower or drop coverage of Novo Nordisk drugs if the company cut its list prices, the CEO was skeptical.
“That’s new information for me.” Jørgensen replied. “I don’t know under which conditions such a promise comes. I haven’t seen any of that.”
When contacted by Fortune for comment, a spokesman for Novo Nordisk reiterated his CEO’s comment that no single company can fix the American healthcare system alone.
Nonetheless, it looked forward to continuing to work with policymakers toward “meaningful solutions” for patients relying on its medicines.
