PBMs willing to expand coverage if Novo Nordisk cuts prices: report

Leading pharmacy benefit managers are reportedly willing to expand coverage for Novo Nordisk’s (NVO) popular diabetes and weight-loss drugs if the company cuts list prices for the products.

During a senate committee hearing Tuesday, U.S. Sen. Bernie Sanders said that UnitedHealth’s (NYSE:UNH) Optum, CVS Health’s (NYSE:CVS) Caremark and Cigna’s (NYSE:CI) Express Scripts have confirmed they would look to expand coverage if Novo lowered list prices for drugs such as Ozempic and Wegovy. The PBMs also confirmed they would not limit coverage if prices were reduced, according to Reuters.

Sanders made the remarks during a hearing of the U.S. Senate Committee on Health, Education, Labor and Pensions, which he chairs. Novo Nordisk CEO Lars Jorgensen was reported to be the hearing’s only witness.

On Monday, Bloomberg reported that a transcript of Jorgensen’s scheduled testimony said that Novo received only a fraction of the list price on drugs, with the bulk going to PBMs. He added that coverage of the medications could be limited if list prices were reduced.

During Tuesday’s hearing, Sanders criticized Novo for charging Americans far more for Ozempic and Wegovy than consumers in other countries. Sanders noted that Ozempic’s list price in the U.S. is $935.77 a month, compared to $59 in some European markets, while Wegovy lists for $1,349 a month in the U.S. versus $92, according to Reuters.

Jorgensen responded that Ozempic’s price has declined about 40% since it was launched, while prices have fallen for some Wegovy customers due to rebates. He also expressed skepticism over PBM commitments to make the drugs more affordable, Reuters added.