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 John TrumpMcCabe says he was fired because he 'opened a case against' Trump McCabe: Trump said 'I don't care, I believe Putin' when confronted with US intel on North Korea McCabe: Trump talked to me about his election victory during 'bizarre' job interview 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 Ann WarrenSenate Dems introduce bill to prevent Trump from using disaster funds to build wall Klobuchar, O'Rourke visit Wisconsin as 2020 race heats up Sherrod Brown pushes for Medicare buy-in proposal in place of 'Medicare for all' MORE (D-Mass.) and Tina SmithTina Flint SmithContractor back pay not included in shutdown deal Push to include contractor back pay in funding deal hits GOP roadblock Dems seeking path to Senate majority zero-in on Sun Belt 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 HatchOrrin Hatch Foundation seeking million in taxpayer money to fund new center in his honor Mitch McConnell has shown the nation his version of power grab Overnight Health Care — Presented by PCMA — Utah Senate votes to scale back Medicaid expansion | Virginia abortion bill reignites debate | Grassley invites drug execs to testify | Conservative groups push back on e-cig crackdown MORE (R-Utah) and Rep. Greg WaldenGregory (Greg) Paul WaldenDems ready aggressive response to Trump emergency order, as GOP splinters Former Ryan aide moves to K street Overnight Health Care — Presented by PCMA — Lawmakers pay tribute to John Dingell's legacy on health care | White House denies officials are sabotaging ObamaCare | FDA wants meeting with Juul, Altria execs on youth vaping MORE (R-Ore.) sent a letter to OMB Director Mick MulvaneyJohn (Mick) Michael MulvaneyMulvaney told Trump officials their 'highest priority' will be deregulation: Axios High stakes as Trump, Dems open drug price talks Trump declares national emergency at border 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 PriceIs a presidential appointment worth the risk? Former Ryan aide moves to K street Grassley to test GOP on lowering drug prices MORE and EPA Administrator Scott PruittEdward (Scott) Scott PruittOvernight Energy: EPA to make formal decision on regulating drinking water contaminant | Utility to close coal plant despite Trump plea | Greens say climate is high on 2020 voters’ minds EPA to announce PFAS chemical regulation plans by end of year Court tosses challenge to EPA's exclusion of certain scientists from advisory boards MORE were forced to resign as a result of their own ethical lapses and other cabinet secretaries including Commerce Secretary Wilbur RossWilbur Louis RossSupreme Court to hear census citizenship case this term Hillicon Valley: Lawmakers press officials on 2020 election security | T-Mobile, Sprint execs defend merger before Congress | Officials charge alleged Iranian spy | Senate panel kicks off talks on data security bill Apple, IBM, Walmart join White House advisory board MORE and Interior Secretary Ryan ZinkeRyan Keith ZinkeOvernight Energy: Zinke joins Trump-tied lobbying firm | Senators highlight threat from invasive species | Top Republican calls for Green New Deal vote in House Zinke, Lewandowski join Trump veterans’ lobbying firm Is a presidential appointment worth the risk? 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.