Joco Today

U.S. Senator Roger Marshall, M.D., questioned the CEO of Novo Nordisk during a Health, Education, Labor, and Pensions Committee hearing on drug pricing. The focus was on the role that Pharmacy Benefit Managers (PBMs) play in inflating the prices of essential drugs like Ozempic (semaglutide) and Wegovy (semaglutide). Senator Marshall's questions highlighted how PBMs are profiting significantly at the expense of patients and pharmaceutical companies.

Senator Marshall has been vocal against abusive pricing practices by PBMs, who control which medications are covered by insurance, thereby driving up costs for consumers. During the hearing, he pointed out that Novo Nordisk receives only 26% of the revenue from drugs like Ozempic, while PBMs take 74%. He emphasized the need for urgent reform to lower prescription drug prices.

Marshall's questioning included several key points about PBMs:

“Novo Nordisk is not the villain in this story – they’re a hero. We should be here celebrating this miracle innovation that’s responding to this diabetic epidemic we have in this country. It’s a miracle drug. 38 million Americans with diabetes that we’re helping out. This nation is spending $250, maybe $350 billion a year treating diabetes, not to mention the loss of work, and here’s a drug that’s going to help us treat the problem.”

“We all agree on this committee across the Senate that the cost of health care is too much, and that prescription drugs are too high, especially the out-of-pocket expenses, but we need to figure out who the villain is…Whatever the cost is, whichever number we want to use, Novo Nordisk keeps 24% of it, and the PBMs extract 74% – 26% and 74% – so really, the PBMs are making the bank here.”

“Let’s talk about PBMs for a second here, the real culprit in this room, in this story. So these three big parent companies—the three big PBMs—control 80%-85% of the industry. Their gross revenue last year was $800 billion.”

“This committee has worked so hard on PBM reform. We’ve not passed our delinking bill, and I would ask the chairman to consider bringing the delinking bill back to committee and let us mark it up as well. In that delinking bill, PBMs would receive a flat fee for their efforts as opposed to a percentage of sale; so we go to a flat fee model.”

“The other thing we can still work on is bringing competition. Promoting competition will bring this price down. We passed legislation; President signed legislation that helps drive biosimilars and generics to market more efficiently.”

“I’ll just close one more time just emphasizing that this committee needs to demand that leader bring our PBM reform to floor but we need include that delinking bill. There’s other opportunities drive price down again Novo Nordisk not villain story."

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