Health Care

Dems quiz Trump HHS nominee on drug pricing

Greg Nash

Drug prices took center stage at the confirmation hearing for President Trump’s nominee to lead the Department of Health and Human Services (HHS) as Democrats expressed concerns over the former pharmaceutical executive’s background.

Democrats say that Alex Azar — who previously held top positions at HHS — served at Lilly USA during a time when the prices of several drugs were increased. Republicans counter that Azar’s experience at the pharmaceutical company is an asset.

“Mr. Azar’s work in the pharmaceutical industry will give him important insights regarding the impact of policies designed and implemented by HHS,” Senate Finance Committee Chairman Orrin Hatch (R-Utah) said at the panel’s nomination hearing Tuesday.


Azar worked at the pharmaceutical company Eli Lilly for nearly a decade, most recently serving as the president of Lilly USA, a position he left in January 2017. He repeatedly said in nomination hearings that “drug prices are too high.”

The panel’s top Democrat, Sen. Ron Wyden (Ore.), laid out the Democratic argument against Azar during his opening remarks. Wyden pointed to four different drugs, including ones for heart disease and ADHD, saying they more than doubled during Azar’s tenure at the company.

“This morning the committee will likely hear that this is just the way things work — it’s the system that’s to be blamed,” Wyden said. “My view is, there’s a lot of validity in that. The system is broken. Mr. Azar was a part of that system.”

During the hearing, Wyden quizzed the nominee further, saying that, as president of Lilly USA, Azar chaired its U.S. pricing, reimbursement and access steering committee.

“Did you ever lower the price, ever, of a Lilly drug sold in the United States?” Wyden asked.

“Drug prices are too high, Sen. Wyden,” Azar responded. “I’ve said that. I said that when I was at Lilly. Every incentive — ”

Wyden interrupted. “That is not the question. Did you ever lower the price?”

“I don’t know that there is any drug price of a branded product that has ever gone down from any company on any drug in the United States because every incentive in this system is toward higher prices,” Azar said.

“And that is where we can do things together working as the government to get at this. No one company is going to fix that system, that’s why I want to be here working with you.”

Earlier in the hearing, Azar said his work in the drug industry would help him quickly jump into the issue of lowering drug pricing, if confirmed, saying the learning curve on this complex issue would be high for someone without prior knowledge of the industry.

If confirmed, Azar would be tasked with overseeing myriad facets of the health care system, including disease control, drug approvals, Medicare and Medicaid.

Azar wouldn’t be new to the HHS building, having previously served as general counsel from 2001 to 2005 at HHS under President George W. Bush. He then became the department’s deputy secretary for two years.

His former colleagues say he has a deep understanding of the regulatory process, which could come in handy as it appears unlikely Republicans will return to ObamaCare repeal and, instead, Trump could look to change the health care law administratively.

During the hearing, Democrats asked Azar if he supported cutting Medicaid — the health insurance program for low-income and disabled Americans — or ending ObamaCare’s Medicaid expansion.

He pushed back on the notion that Trump’s budget and block grants to states constitute cuts to Medicaid, saying, “I think this has to do with Washington speak. Slowing the rate of growth of a growing program is simply not a cut in my mind or the president’s mind.”

Azar will spearhead the department tasked with implementing a law Republicans hate. Senate Majority Leader Mitch McConnell (R-Ky.) has signaled his chamber won’t move to repeal Obamacare, as his majority became even slimmer this year.

But McConnell has encouraged Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) to continue work on their legislation that would repeal major parts of ObamaCare and send the money to states in the form of block grants.

Sen. Dean Heller (R-Nev.), a co-sponsor of that bill, asked if Azar had an opinion on that legislation.

“With the Graham-Cassidy-Heller legislation, the elements of that that are very positive are empowering states to run their budgets,” Azar responded.

It’s hard to see many Democrats supporting Azar’s nomination, with many expressing concerns on Tuesday and during a Senate Health Committee courtesy hearing on the nomination in late November.

Azar, however, is likely to be confirmed.

Sen. Rand Paul (Ky.) is the lone GOP senator who has expressed reservations, as Paul didn’t receive the endorsement of drug importation from Azar that he wanted at the Health panel’s hearing.

The Senate Finance Committee is the panel with the power to send Azar’s nomination to the full Senate for a vote.

– Updated at 1:53 p.m.

Tags Bill Cassidy Dean Heller Department of Health and Human Services Donald Trump HHS secretary Lindsey Graham Mitch McConnell Orrin Hatch Rand Paul Ron Wyden Senate Finance Committee

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