1000 dollars a month. This is the price that patients in the US have to shell out to get their hands on ozempic, the “anti-hunger” drug that has become a global blockbuster for Novo Nordisk. A price that has made the profits of the Danish pharmaceutical company skyrocket, but which now risks turning into a media and legal boomerang.
Yes, because according to research just published in JAMA Network Open (I link it to you here), that price would be inflated up to 200 times compared to the actual cost of producing the drug, estimated between 89 cents and $4,73 per month.
Ozempic, the dream factory (slimming)
Semaglutide: a name that perhaps doesn't mean much to most people, but which for Novo Nordisk has become synonymous with banknotes. This is the active ingredient of ozempic e wegovy, the two "miracle" drugs that have transformed the Danish pharmaceutical company into the undisputed queen of the market for treatments for diabetes and obesity.
A kingdom built with weekly injections, capable of keeping the appetite in check and making the scale drop as if by magic. A formula that has won over millions of patients around the world, from diabetics to the obese, through to celebrities and influencers looking for the perfect physique.
Behind the mask
Beyond the "media" success of Ozempic and Wegovy lies a less glittering reality. While they are undoubtedly effective in combating extra pounds, their cost is a huge burden on healthcare budgets. In the United States, Ozempic's list price is close to 1000 dollars a month, and that of Wegovy even reaches 1300.
Mind-boggling figures, which made the fortune of Novo Nordisk: in 2023, combined sales of the two drugs exceeded $18 billion, more than the GDP of many countries. But which now risk becoming a boomerang, in light of the study just released.
The pricing trick
According to the research, conducted by a team of economists from Yale, King's College London and Doctors Without Borders, the production cost of Ozempic would actually be negligible compared to its list price. Just 89 cents for a month's supply in the most optimistic estimate, $4,73 in the most conservative one.
Figures that include not only the cost of the active ingredient semaglutide (just 29 cents a month), but also that of the disposable pens used to inject it (2,83 dollars), the filling of the pens (20 cents) and the other chemical ingredients (15 cents). All this even calculating the profit margin for the manufacturer.
In other words? Novo Nordisk would be applying a mark-up ranging from 10000% to 20000% compared to actual production costs. A mark-up that would make even the most experienced used car salesman pale, and which raises serious questions about the transparency and fairness of the drug pricing system in the United States.
The Danish pharmaceutical company defends itself by claiming that a large part of its profits are reinvested in research and development (nearly $5 billion in 2022), and that 75% of its gross profits go into discounts and rebates to ensure access to patients . But the numbers revealed by the study are still impressive, and risk fueling the already heated debate on drug prices overseas.
The shadow of Congress
The publication of the research sparked indignant reactions in the US Congress. The senator Bernie Sanders, who has always been at the forefront in the battle against drug prices, thundered:
This outrageously high price has the potential to bankrupt Medicare, the American people, and our entire healthcare system.
Sanders then called on Novo Nordisk to lower Ozempic's list price to $155 a month or less, in line with what is practiced in other countries. A move that would certainly put the pharmaceutical company in difficulty, but which responds to a logic of equity and sustainability that is difficult to counter.
Moreover, drug pricing is an increasingly hot topic in the United States, where prices are among the highest in the world and continue to grow dramatically. In 2022, Americans spent more than $500 billion on prescription drugs, more than double what they spent a decade earlier. And many patients are forced to forgo treatment or go into debt to afford the medications they need.
An unsustainable situation, unworthy of a country that defines itself as democratic, which risks undermining the right to health and access to treatment for millions of people. And which calls into question the responsibility not only of pharmaceutical companies, but also of political decision-makers and regulatory authorities.
Ozempic, bitter pills for Big Pharma
The study on Ozempic is only the latest in a long series of research that has highlighted the distortions of the drug pricing system in the United States. Distortions that affect not only innovative treatments such as those for diabetes and obesity, but also essential medicines such asinsulin, available for decades but still unaffordable for many patients due to exorbitant prices.
A situation that has pushed the Biden administration to put pressure on pharmaceutical companies to obtain significant price cuts, such as those of up to 75% announced last year by Novo Nordisk and other insulin producers. Cuts which, however, according to some analysts, would have made those products even more profitable for companies, eliminating discounts given to intermediaries who negotiate prices on behalf of insurance companies and employers.
In short, an opaque and distorted system, in which prices seem disconnected from actual production costs and driven more by the logic of profit than access to care. A system that now risks imploding under the weight of its unsustainability, putting at risk the health of millions of Americans and the very stability of Medicare, the public program that guarantees healthcare for the elderly and disabled.
A recipe for the future
Faced with this scenario, the study on Ozempic sounds like a wake-up call that is impossible to ignore. An invitation to radically rethink the way in which drug prices are set, starting with greater transparency on the actual costs of research, development and production. And not just in the United States.
Of course, no one denies the right of pharmaceutical companies to a fair profit, nor the value of therapeutic innovation in improving patients' health and quality of life. But this cannot translate into a license to speculate on the skin of the sick, applying stratospheric mark-ups that put the most vulnerable segments of the population out of business.
Once again, what is at stake is not just the cost of a diet pill, no matter how miraculous it may seem. It is the kind of society we want to live in, and the value we place on the life and dignity of every human being. A utopia? Perhaps. But it is necessary. Because to cure the evils of the present, a good dose of utopia is needed. And who knows, there might also be room in the recipe for a little semaglutide, but at the right price. For all.
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