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Senators grilled Novo Nordisk CEO Lars Jørgensen Tuesday at a hearing over the costs of Ozempic, Wegovy and similar weight loss drugs, requesting explanations for why the U.S. faces a higher list price than other countries.

Since first entering the market nearly six years ago, the drugs have risen in popularity for diabetic patients and others looking to combat obesity. But doctors and patients have faced challenges in access and affordability.

Sitting in front of a chart showing the lower prices for Wegovy and Ozempic in other countries, Sen. Bernie Sanders, I-Vt., the chair of the Senate Health Committee, pressed Jørgensen on why it’s fair to charge more in the U.S.

“All we are saying, Mr. Jørgensen, is treat the American people the same way that you treat people all over the world. Stop ripping us off,” Sanders said to Jørgensen.

MORE: Video Ozempic CEO to testify about drug prices on Capitol Hill

Sanders asked Jørgensen why the U.S. faced higher prices. Novo Nordisk charges $969 per month for Ozempic in the U.S., compared to $155 per month in Canada and $59 in Germany. For Wegovy, the price is $1,349 per month in the U.S., but $265 in Canada and $137 in Germany.

“Bottom line is, you are charging the American people substantially more for the same exact drug than you are charging people in other countries. And my question is, why?” Sanders asked.

The CEO said the company was spending $30 billion to increase its production and access to the drugs. He also highlighted a 40% decrease in cost since Ozempic came on the market and a sliding scale of costs for people across the U.S., including programs for low-income Americans to access the medicine for cheaper.

But ultimately, Jørgensen cast the blame on the complexities of the U.S. health care system.

“Senator, we are very committed to make sure that Americans have access at an affordable price point for our medicines. There’s nothing we would rather see happen. We have just announced $30 billion in investments to increase capacity to serve these patients. There is a market we have to operate in, and we negotiate hard to make sure that Americans have access,” he said.

“With that said, it is clear that patients too often struggle to navigate the complex US health care system. It’s also clear that no single company alone can solve such vast and complicated policy changes,” Jørgensen added.

Novo Nordisk isn’t responsible for deciding what price patients pay their insurance companies, he said, and he argued that pharmacy benefit managers, or companies that help oversee prescription drug benefits and control costs, get in the way of companies passing discounts on directly to patients.

But Jørgensen didn’t provide a direct answer to why the U.S. faces a higher list price than other countries, instead pointing to “a very complex market and very complex health care system that creates a lot of misunderstandings.”

MORE: Video Ozempic’s high price questioned by researchers

“Everyone blames everyone else,” Sanders said, from pharma companies to PBMs to insurance companies.

Sanders connected the high prices of Wegovy and Ozempic to something he’s made the center point of his career, including his 2016 and 2020 campaigns: corporate greed.

“Are they acting illegally by charging us some such high prices? Are they violating the law? No, they’re not. What they’re doing is perfectly lawful. They are simply taking advantage of the fact that, until very recently, the United States has been the only major country on earth not to negotiate the cost of prescription drugs,” Sanders said.

“In other words, Novo Nordisk and other drug companies, not just Novo Nordisk, can charge us as much as the market can bear, and that is precisely what they are doing,” he added.

Jørgensen and a handful of Republican senators, including ranking member Sen. Bill Cassidy, pointed out that wholesale prices don’t offer a completely apples-to-apples picture because, in the U.S., insurance and rebates typically reduce the price patients pay by a significant amount.

MORE: Novo Nordisk announces $6B investment in Ozempic, Wegovy amid shortages

“There is a tension, a tension between the need to incentivize innovation and the ability to afford that innovation. We are here struggling with that balance,” Cassidy, who is a physician, said. “If anyone thinks going after big pharma is the silver bullet that if you do that, boom, health care costs or drug costs go down, they don’t understand what happens with pricing a drug.”

Sanders dismissed that argument, however, saying it’s still unfair for the initial list prices to be higher in the U.S. It trickles down to the U.S. patient, Sanders said, leaving Americans with higher prices even with rebates or insurance. Of course, uninsured Americans — around 8% of the country — also pay the full list price.

“Even factoring in all of the rebates that [pharmacy benefit managers] receive, the net price for Ozempic is still nearly $600 — over nine times as much as it costs in Germany. And the estimated net price of Wegovy is over $800 — nearly four and a half times as much as it costs in Denmark,” Sanders said.

When it comes to insurance coverage, drug prices become a “pass through to the insurance companies” resulting in higher plan prices, Sanders argued.

“What must also be understood is that not everybody can take advantage of the net price of these drugs. If you are uninsured, you pay the full list price. If you have a large deductible, you pay the full list price. If you have co-insurance, the percentage of the price you pay at the pharmacy counter is based on the list price,” Sanders said.

Novo Nordisk continued to place the blame on health insurance middlemen for the high drug prices in a statement released after the hearing.

“Our hope is that the conversation with the HELP Committee will result in real and tangible solutions that benefit patients and allow millions of people living with these serious and chronic diseases to be the direct beneficiaries of real change,” the company said. “While no single company can fix the American healthcare system alone, we look forward to continuing to work with policymakers and other stakeholders toward meaningful solutions for the people who rely on our medicines.”

ABC News’ Eric Strauss contributed to this report.

‘Stop ripping us off’: Ozempic producer CEO in hot seat in congressional hearing originally appeared on abcnews.go.com