A top executive with Eli Lilly for nearly nine years, Azar would replace Tom Price, who resigned in September amid a scandal over his use of private planes while leading the Department of Health and Human Services.
Azar served as general counsel and deputy secretary of the agency under former President George W. Bush. He then joined Eli Lilly, becoming president of Lilly USA in 2012. As part of his role there, Azar was on the board of directors of the Biotechnology Industry Organization (BIO), a trade group. He left Lilly USA and BIO in January and now runs a consulting firm.
The first is the cost of prescription medicine.
"Drug prices are too high," he said, noting his experience implementing the Medicare Part D drug plan under Bush. "The president has made this clear. So have I."
Also, he said health care must be made more affordable, available and tailored to what people want and need.
"Under the status quo, premiums have been skyrocketing year after year, and choices have been dwindling," he 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."
Azar also wants to use Medicare's power to shift how the nation pays for health care, from reimbursing for procedures to paying for outcomes. Finally, he said the nation must "tackle the scourge of the opioid epidemic that is destroying so many individuals, families and communities."
When Trump unveiled his pick for health secretary
on Twitter, he called Azar "a star for better healthcare and lower drug prices!" The President campaigned on lowering drug prices, but has yet to take any real steps on the issue.
Azar's views and actions on drug prices quickly drew scrutiny, though the overall tenor of the hearing was less contentious than Price's was in January. Both Republicans and Democrats questioned Azar's ties to the pharmaceutical industry and his dedication to lowering drug prices for consumers.
"You've got some convincing to make me believe that you're going to represent the American people and not big pharma," said Kentucky Sen. Rand Paul, a Republican. "I'm sure you're an honest and upright person. But we all have our doubts, because big pharma manipulates the system to keep prices high."
Responding to senators' questions, Azar said he wants to increase generic and branded competition, as well as stop drug companies from abusing the patent system to prevent generic competitors. Also, he would look into why Americans pay more for drugs than European or Japanese consumers.
Several lawmakers asked him about whether he supports importing drugs from other countries, to which he replied he would want to guarantee the medications were reliable and safe.
As deputy HHS secretary, Azar pushed for more free competition in the pharmaceutical and medical device markets. Government cost containment measures serve as a barrier to advances in treatments, he said in at least two speeches in 2006.
"The more governments do this, the more innovation is put at risk," said Azar, who also said he supported greater price transparency for consumers. "Instead, consumers are served best by free competition. Strong competition creates choices and better prices and benefits everyone. And it encourages sustainable innovation."
"In sum, a vigorous and profitable drug industry is not a problem to be solved, but a goal to be encouraged," he concluded.
More recently, Azar has said that patients are paying too much for drugs, but it's largely because of the greater prevalence of high-deductible plans, according to a report in an industry publication
. But the solution doesn't lie with the government.
"It's something for insurance and pharma to work together to solve as opposed to the government," he said.
Democrats and critics, however, say choosing Azar is like having the fox watch the hen house.
"The nomination of Alex Azar, the former head of Eli Lilly's U.S. operations, shows that Trump was never serious about his promise to stop the pharmaceutical industry from 'getting away with murder,'" said Vermont Independent Sen. Bernie Sanders.
Democratic Sen. Amy Klobuchar of Minnesota tweeted that she would oppose Azar's confirmation.
If his nomination is successful, Azar would also be responsible for overseeing Obamacare, which Trump has vowed to dismantle. HHS has already taken several steps that are expected to limit participation in the exchanges in 2018, including slashing the open enrollment period
in half and cutting advertising and support for it.
Azar has called the Affordable Care Act a "fundamentally broken system" and noted the government has "fairly few levers" to fix it.
"It's certainly circling the drain," he said on Fox Business Network in May.
Several Democratic senators pressed Azar about his views on the Affordable Care Act and on whether the Trump administration is sabotaging enrollment.
Azar toed the party line, saying that Americans should be able to buy the insurance coverage they want and not what the federal government forces them to purchase. Also, it shouldn't penalize people for opting to go uninsured. He repeated a phrase used often by former Secretary Price -- that consumers need real access to health care, not just an insurance card.
"I want to make sure as many people have affordable insurance as possible," he said.
Azar will also appear before the Senate Finance Committee, which has yet to schedule his confirmation hearing.