What did the Senate find about Novo Nordisk and insulin prices?
The Senate Finance Committee found Novo and Sanofi raised insulin list prices sometimes within hours of each other — and that Novo's board voted down a price decrease specifically because lower prices would reduce the rebates PBMs expected.
The Senate Finance Committee's bipartisan 2021 report found that insulin makers engaged in "shadow pricing," raising list prices in close succession, and that Novo Nordisk and Sanofi in particular increased prices sometimes within hours or days of each other. PBM rebates rose from single digits in 2013 to 60% or more for large accounts.
Most strikingly, the investigation found that Novo Nordisk's board voted down a proposed insulin price decrease over concerns about reduced PBM revenues, suggesting that list prices were being kept high in part to preserve the rebates PBMs expected. The report criticised both manufacturers and PBMs, concluding that the system rewarded higher list prices, which translated into higher out-of-pocket costs for uninsured patients and those with deductibles.