HHS should look into Azar's close ties to the drug industry

HHS should look into Azar's close ties to the drug industry
© Camille Fine

Over the next several weeks, it is anticipated that the White House will roll out its recommendations for reducing drug prices. For the millions of Americans struggling with medical costs, this proposal could determine whether or not they will be able to afford life saving drugs. The Department of Health and Human Services (HHS) is responsible for developing the administration’s drug price policy. 

Given the significance of this issue, it is critical that the American people have confidence that the proposed changes are based on sound policy. This is why my organization, Campaign for Accountability a nonprofit, nonpartisan watchdog group focused on public accountability, called on ethics officials at HHS to open an investigation into HHS Secretary Alex Azar and his relationship with his former employer, the pharmaceutical manufacturing giant Eli Lilly.

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Notably, between June 2007 and January 2017, Secretary Azar worked for Eli Lilly, serving most recently as the company’s president. While at the company, Sec. Azar championed the pharmaceutical industry’s goal of limiting the ability of pharmacy benefit managers (PBMs) to negotiate rebates. Drug companies, including Eli Lilly, have long complained that the rebates drive up drug prices and put money into the pockets of PBMs.

Shortly after Sec. Azar joined the Trump administration, Eli Lilly called on HHS to limit the rebates that drug manufacturers are forced to negotiate with PBMs Notably, it appears, Sec. Azar may have authored the administration’s “blueprint” to reduce prescription drug prices — a plan that specifically cites PBM rebates as a chief cause of high prescription drug costs.

On July 18, 2018, HHS essentially acceded to the drug makers’ demands and submitted a proposed rule to OMB that would drastically reduce PBM rebates. The text of the rule has not been released, but it appears that Eli Lilly would greatly benefit from the new regulation.

If Sec. Azar contacted Eli Lilly or worked with the company’s representatives to curb PBM rebates, he may have violated Executive Order 13770: Ethics Commitments by Executive Branch Employees, issued by President TrumpDonald TrumpFormer chairman of Wisconsin GOP party signals he will comply with Jan. 6 committee subpoena Overnight Defense & National Security — Pentagon tells Russia to stand down Billionaire GOP donor maxed out to Manchin following his Build Back Better opposition MORE on January 28, 2017, which prohibits presidential appointees from working with their former employers on government business for two years after joining the administration.

In response to CfA’s request for an investigation, HHS responded only that “as required by the Ethics Pledge, [Sec. Azar] does not participate in any particular matters where his former employer is a party to the matter, or a party representative.” Notably, the agency did not deny that Sec. Azar may have met or spoken with company representatives.

As a result, to ascertain definitively whether or not the secretary has communicated with anyone from Eli Lilly, CfA filed a FOIA request with the agency for records of contacts between his office and the company.

CfA is not alone in its concern about the relationship between Sec. Azar and Eli Lilly. Members of Congress also have questioned Sec. Azar’s motivation for supporting the new rule. On August 17, Sens. Elizabeth WarrenElizabeth WarrenDemocrats press cryptomining companies on energy consumption Ocasio-Cortez: Supporting Sinema challenge by someone like Gallego would be easy decision Over 80 lawmakers urge Biden to release memo outlining his authority on student debt cancellation MORE (D-Mass.) and Tina SmithTina Flint SmithOvernight Energy & Environment — High court will hear case on water rule Biden comments add momentum to spending bill's climate measures  Democrats call on Biden administration to ease entry to US for at-risk Afghans MORE (D-Minn.) sent a letter to Sec. Azar asking whether he had worked with Eli Lilly to limit PBM rebates. Additionally, earlier in August, Sen. Orrin HatchOrrin Grant HatchMeet Washington's most ineffective senator: Joe Manchin Lobbying world Congress, stop holding 'Dreamers' hostage MORE (R-Utah) and Rep. Greg WaldenGregory (Greg) Paul WaldenEx-Sen. Cory Gardner joins lobbying firm Ex-Rep. John Shimkus joins lobbying firm Lobbying world MORE (R-Ore.) sent a letter to OMB Director Mick MulvaneyMick MulvaneyLobbying world Trump's relocation of the Bureau of Land Management was part of a familiar Republican playbook Jan. 6 committee issues latest round of subpoenas for rally organizers MORE calling for a “transparent, open, and deliberative process” before changing regulations with such a far-reaching impact on patients, federal programs, and taxpayers.

Regrettably, it seems that high-level Trump administration officials have a track record of operating in their own, rather than the public’s interests. Former HHS Secretary Tom PriceThomas (Tom) Edmunds PriceHP printer vs. Canon printer vs. Epson printer Want to evaluate Donald Trump's judgment? Listen to Donald Trump Former Georgia ethics official to challenge McBath MORE and EPA Administrator Scott PruittEdward (Scott) Scott PruittTrump's relocation of the Bureau of Land Management was part of a familiar Republican playbook Understanding the barriers between scientists, the public and the truth Overnight Energy & Environment — Biden makes return to pre-Trump national monument boundaries official MORE were forced to resign as a result of their own ethical lapses and other cabinet secretaries including Commerce Secretary Wilbur RossWilbur Louis RossMomentum builds to prohibit lawmakers from trading stocks Census memo notes 'unprecedented' Trump administration meddling: report Holding defiant Trump witnesses to account, Jan. 6 committee carries out Congress's constitutional role MORE and Interior Secretary Ryan ZinkeRyan Keith ZinkeGOP-aligned Congressional Leadership Fund unveils first midterm endorsements Trump's relocation of the Bureau of Land Management was part of a familiar Republican playbook Watchdog: Trump official boosted former employer in Interior committee membership MORE remain under investigation.

Last year, during a Cabinet meeting, President Trump said drug companies are “getting away with murder,” in part because of the extent of their political influence in Washington. He’s right. This is exactly why HHS must investigate whether Sec. Azar has been in cahoots with his former employer, which stands to benefit dramatically if this new regulation is implemented.

Daniel Stevens is the executive director of Campaign for Accountability, a government watchdog in Washington.