The Honorable Bernie Sanders, Chairman
United States Senate Committee on Health,
Education, Labor and Pensions
428 Dirksen Senate Office Building
Washington, D.C. 20510

The Honorable Bill Cassidy, Ranking Member
United States Senate Committee on Health,
Education, Labor and Pensions
428 Dirksen Senate Office Building
Washington, D.C. 20510

Re: Full Committee Hearing: Why Is Novo Nordisk Charging Americans with Diabetes and Obesity
Outrageously High Prices for Ozempic and Wegovy?

Chairman Sanders, Ranking Member Cassidy, and Members of the Senate Committee on Health,
Education, Labor, and Pensions:

Consumer Action for a Strong Economy (CASE) writes today to express strong opposition to the
committee’s plan to hold a show trial during its hearing entitled, “Why Is Novo Nordisk Charging
Americans with Diabetes and Obesity Outrageously High Prices for Ozempic and Wegovy?”

While CASE welcomes the opportunity for constructive dialogue about ways to help lower prescription
drug costs for consumers, the committee’s hearing is shaping up to be little more than an attempt at
scoring cheap political points. The hearing fails to address the real problems plaguing the American
healthcare system and ignores how the pharmaceutical innovation ecosystem actually works.

Bringing a new drug to market is expensive and time-consuming. Innovative companies like Novo
Nordisk spend an average of $2.6 billion on research and development over 10+ years before they can
offer a new treatment to patients. Moreover, according to the Congressional Budget Office, only 12
percent of drugs that start clinical trials ultimately receive approval from the U.S. Food and Drug
Administration. Creating new medicines is a risky business, and companies need to be able to secure a
return on investment. Without strong patent and intellectual property (IP) rights to protect their
innovations, businesses will lack the incentive to engage in the crucial research that goes into
developing novel treatments and therapies, ultimately depriving patients of access to quality care.

Calls to undermine these IP protections also ignore the root causes of skyrocketing prices, which lie in
anti-competitive practices by pharmacy benefit managers (PBMs), as established by a Federal Trade
Commission report from earlier this year. With just six companies controlling 95 percent of the
prescription drug market in the United States, PBMs wield outsized power over prescription drug prices.

The committee’s time would be far better spent investigating the role these middlemen play in creating
the “outrageously high prices” for prescription drugs in this country. Particularly, lawmakers should
focus their attention on PBMs’ rebate system, which favors drugs with higher list prices due to the larger
rebates PBMs can extract from manufacturers. This incentive structure means one thing: the largest and
most powerful PBMs profit while consumer costs rise.

Thanks to medical innovators like Novo Nordisk, Americans now have access to revolutionary new
diabetes and obesity medications. Rather than wasting time attacking a company for being successful,
the committee should take this opportunity to praise an innovation success story. Making a boogeyman
out of a single company does nothing to address our healthcare system’s real problems.

As long as politicians are more interested in soundbites than they are solutions, patients and consumers
will continue to suffer, all while healthcare middlemen get away with manipulating the system to line
their own pockets.

Sincerely,
Consumer Action for a Strong Economy (CASE)
____________________________
Consumer Action for a Strong Economy
1800 Diagonal Road, Suite 600
Alexandria, VA 22314
@CASE_forAmerica