Trump Pick to Lead HHS Faces Senate Questions on Drug Prices

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  • Azar lists competition, patent fixes as ways to lower costs
  • Paul pushes nominee on opposition to importing cheaper drugs

Alex Azar

Photographer: Stephane de Sakutin/AFP via Getty Images

Senators grilled President Donald Trump’s selection to lead the U.S. Department of Health and Human Services about his close ties to the pharmaceutical industry and plans tackling high drug prices.

Nominee Alex Azar was an executive at drugmaker Eli Lilly & Co. until January, a role that Democrats say raises concerns about whether he will take on rising drug costs. Azar took questions on his views before the Senate Committee on Health, Education, Labor and Pensions, one of two committees he’ll face as part of the nomination process, on Wednesday.

Alex Azar

Photographer: Stephane de Sakutin/AFP via Getty Images

“He is certainly going to need to address our concerns that he comes from big pharma,” Senator Maggie Hassan, a New Hampshire Democrat who sits on the committee, said in an interview Tuesday. “This is an industry that has not been cooperative at all, and that’s putting it mildly, in terms of drug prices that are of such concern to so many working and middle-class families.”

Azar told the committee in opening remarks that drug prices are a primary concern he will focus on.

“I believe I can bring the skills and experiences to the table that can help us address these issues, while still encouraging discovery so Americans have access to high quality care,” Azar said.

Prices and Patents

During questioning from senators, Azar listed three areas that needed focus to bring down drug prices: increasing competition; cracking down on companies that game the patent system; and examining the reasons Americans pay more than people in other countries for medications.

Food and Drug Administration Commissioner Scott Gottlieb has made boosting competition a priority and has taken several steps to encourage lower drug prices, particularly easing access to cheaper generic medications.

A recent effort by Allergan Plc to extend protection of a best-selling eye drug by selling patents to the St. Regis Mohawk tribe is one of the more visible examples of attempts to use the patent system to protect a drug’s sales. A district court invalidated the patents Allergan attempted to protect but not before the move attracted the ire of lawmakers in Congress.

Senator Rand Paul, a Republican from Kentucky, asked Azar about the nominee’s previous public statements opposing importation of cheaper drugs from other countries. Trump has supported the idea. Azar noted that earlier Democratic and Republican administrations have determined they couldn’t endorse importation as a safe practice.

“They’ve been wrong and beholden to the drug industry, frankly,” Paul said.

“You need to convince those of us that are skeptical that you’ll be part of fixing it and won’t be beholden to Big Pharma," Paul added referring to the drug industry generally.

Senator Lamar Alexander, the Tennessee Republican who is chairman of the committee, said the panel will hold a hearing on drug prices Dec. 12 to hear from the National Academies of Sciences, Engineering and Medicine, which is expected to release a report on the topic on Thursday.

Administration Inaction

Trump has frequently raised the issue of high drug costs but hasn’t taken any direct action to contain them. In public remarks earlier this year, Azar blamed insurers and managers of prescription plans for soaring medicine costs, an argument often made by drug companies.

But Democratic senators seemed to have more questions for Azar than direct lines of attack, noting they don’t know a lot about him.

“What we need to see from the new nominee is somebody who’s committed to the health-care safety net, whose knowledge of the pharmaceutical issue enables him to find better solutions to pharmaceutical costs,” said Senator Tim Kaine, a Virginia Democrat on the health panel.

Kaine said he’s also interested to see how Azar plans to manage the Affordable Care Act, known as Obamacare. Trump has backed various failed attempts by Republicans in Congress to overturn the health law and his administration has taken steps to weaken it.

“I want to see if this is the guy who’s going to be part of the wrecking crew that’s hurt people,” Kaine said. “Insurance companies are being very plain about why premiums are going up and it’s that the administration is trying to sabotage the law. They’re entitled to some certainty.”

Azar told the committee making health care more affordable and available will be another priority for him.

“Under the status quo, premiums have been skyrocketing year after year, and choices have been dwindling,” Azar said. “We must address these challenges for those who have insurance coverage and for those who have been pushed out or left out of the insurance market by the Affordable Care Act.” 

Under Tom Price, who resigned as HHS secretary in September amid a scandal over his use of private jets at taxpayer expense, the department stripped funding for advertising open enrollment for Obamacare plans, and cut off money for workers who had helped consumers choose coverage. Trump has also stopped making payments to insurers meant to help defray health-care costs for low-income Americans.

Emphasizing Experience

Republicans have touted Azar’s background, including as deputy health secretary under President George W. Bush.

“I see your broad experience as one of your principle assets,” Senator Alexander told Azar during opening remarks at the hearing.

Azar met on Monday with Senator Orrin Hatch, the Utah Republican who is chairman of the Finance Committee. Hatch’s panel, which must vote on Azar before the full Senate considers his nomination, hasn’t scheduled a hearing.

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