Sen. Bernie Sanders is once again taking the pharmaceutical industry to task, issuing a report Tuesday that highlights the cost of three blockbuster drugs that are far pricier in the US than in other countries.

The differences are striking. The annual list price of Bristol Myers Squibb’s Eliquis, a blood thinner that reduces the risk of stroke, is $7,100 in the US. But in Japan, it’s $940; in Canada, it’s $900; in Germany, it’s $770; in the United Kingdom, it’s $760; and in France, it’s $650.

Johnson & Johnson’s arthritis drug Stelara carries an annual list price of $79,000 in the US. In Germany, it’s $30,000; in Canada, it’s $20,000; in the UK, it’s $16,000; in Japan, it’s $14,000; and in France, it’s $12,000.

And the annual list price of Merck’s cancer drug Keytruda is $191,000 in the US, while in the UK, it’s $115,000; in Canada, it’s $112,000; in France, it’s $91,000; in Germany, it’s $89,000; and in Japan, it’s $44,000.

Sanders, an independent from Vermont, issued the report ahead of a hearing Thursday with the CEOs of the three drugmakers before the Senate Committee on Health, Education, Labor and Pensions, which he chairs. The hearing has already proved fiery, with Sanders threatening to issue the committee’s first subpoenas in more than 40 years to compel the heads of Johnson & Johnson and Merck to testify. They agreed late last month to appear voluntarily.

Johnson & Johnson declined to comment on Sanders’ report. Merck and Bristol Myers Squibb did not return requests for comment.

Medicare launches drug price negotiations

Other nations typically pay far less for medications, in large part because their governments often determine the cost. However, that gap could begin to shrink for certain drugs in coming years.

Medicare has started its first-ever negotiations with drugmakers over the cost of 10 expensive medications, including Eliquis and Stelara. The prices charged in other countries are not a factor in the negotiation process, but the Biden administration, Sanders and others have repeatedly pointed to the differential as a major problem with the drug pricing system in the US.

While in office, former President Donald Trump pushed a measure that would have had Medicare pay the same price for certain expensive prescription drugs as other developed nations, known as a “most-favored-nation price.” It would have allowed the US to piggyback on discounts negotiated by other countries.

While the price patients pay for drugs typically depends on their insurance coverage, list prices factor into both their premiums and out-of-pocket costs. Those who have yet to meet their deductible and the uninsured may have to pay the full list price.

Big profits

Sanders’ report also cited the billions of dollars the three companies make in profits and the tens of millions their CEOs are paid. The drugmakers have made more money on their sales of the three drugs in the US than in the rest of the world combined.

The report also noted that Johnson & Johnson and Bristol Myers Squibb spent $17.8 billion and $12.7 billion on stock buybacks, dividends and executive compensation, compared with $14.6 billion and $9.5 billion on research and development in 2022, respectively. However, Merck spent almost twice as much on research and development as it did on dividends and executive compensation.

Drug companies have argued that Medicare’s price negotiations could chill their research and development, leading to fewer new medications coming to market.