Compared with other countries, the US is again seeing exorbitant prices for a medicine—even one it helped develop.

In the current COVID-19 booster campaign, the Centers for Disease Control and Prevention is paying around $82 for each dose of Moderna’s 2023–2024 updated mRNA COVID-19 vaccine for its program to provide vaccine for the uninsured. That price is a little over three times the $26 per dose the federal government paid for the last updated booster, which was exclusively distributed by the government.

The price hike marks the vaccine’s move from federal distribution to the commercial market. Moderna and rival manufacturer Pfizer raised the US list price of their COVID-19 vaccines by roughly 400 percent. (Moderna’s is listed at $128 and Pfizer’s is $115).

The price hike is particularly remarkable from Moderna, which developed its COVID-19 vaccine with substantial assistance from the federal government. It developed the vaccine in partnership with the National Institutes of Health and got $1.7 billion in federal grant money for its clinical development.

In a March Congressional hearing on the vaccine’s pricing, Moderna’s CEO Stéphane Bancel—who became a billionaire during the pandemic—unabashedly defended quadrupling the price. Specifically, Bancel downplayed the US government’s contribution and suggested the earlier pricing was actually a discount.

“We were under no obligation to do so, but, recognizing the US government’s investments, our company decided to provide the government with a discount,” Bancel said of the $26 per dose pricing.

Sen. Bernie Sanders (I-Vt.), who chaired the hearing, fired back, saying: “This vaccine would not exist without NIH’s partnership and expertise, and the substantial investment of the taxpayers of this country. And here is the ‘thank you’ that the taxpayers of this country received from Moderna for that huge investment: They are thanking the taxpayers of the United States by proposing to quadruple the price of the COVID vaccine.”

Now, adding insult to injury, the European Union may end up paying three times less than the US for the same vaccine. According to a report by the Financial Times, EU health authorities are in the process of negotiating a vaccine supply deal with Moderna—and, so far, the discussed price per dose is just 25 euros, or about $26, which Bancel had suggested previously was a discounted price for the US government. Though the EU’s price is not final, the discussed price in the negotiation is substantially lower than what the US is already forking over for the update shots.

The news, while perhaps enraging, is not surprising. During March’s Congressional hearing, Bancel hinted that the US would not get a good deal on the shots. Sanders asked him the question directly.

“The United States—the people in our country—pay the highest prices in the world for prescription drugs in general… will you at least tell us today that the price you are charging for the vaccine will be lower than what other countries around the world are paying?” Sanders implored.

Bancel eventually replied: “I cannot say the price will be lower than other countries.”