Bernie Sanders Pushes PBMs to Expand Drug Coverage in Return for Price Cuts

U.S. Senator Bernie Sanders announced that pharmacy benefit managers have agreed to expand coverage for Novo Nordisk's diabetes and weight-loss drugs if the company lowers their list prices. Sanders criticized the high costs of Ozempic and Wegovy in the U.S. and called for substantial price reductions.

U.S. Senator Bernie Sanders revealed on Tuesday that he secured commitments from the nation's leading pharmacy benefit managers (PBMs) to broaden coverage for Novo Nordisk's diabetes and weight-loss medications if the pharmaceutical company reduces its list prices. The announcement was made during the opening remarks at a Senate Committee on Health, Education, Labor and Pensions hearing, which Sanders chairs.

Sanders stated that UnitedHealth Group's Optum, CVS Health's Caremark, and Cigna's Express Scripts confirmed their willingness to expand coverage for the drugs Ozempic and Wegovy, provided Novo Nordisk significantly lowers the prices. This promise challenges the common argument from pharmaceutical companies that price cuts lead to reduced coverage due to PBMs favoring more expensive medications for larger rebates.

During the hearing, Sanders directed criticism at Novo Nordisk CEO Lars Jorgensen for charging American consumers significantly more than those in other countries for the same drugs. Despite the pressure, Jorgensen did not commit to reducing the prices but expressed willingness to collaborate with PBMs to potentially make the drugs more affordable.