President Donald Trump’s choice for Health and Human Services secretary sought to convince lawmakers Tuesday that he would work to lower prescription drug prices even though he used to lead a major US pharmaceutical company.
Senate Democrats and consumer advocates have raised concerns that Trump selected former Eli Lilly executive Alex Azar to replace Tom Price, who resigned last year over his use of private planes. The President has promised to crack down on the pharmaceutical industry and lower drug prices, though he has done little in this arena so far.
Several Democratic lawmakers pressed Azar during his nomination hearing before the Senate Finance Committee on potential conflicts of interest, noting that Eli Lilly raised drug prices during Azar’s time there.
“Mr. Azar told committee staff that while he chaired the company’s pricing committee he never – not even once – signed off on a decrease in the price of a drug,” said Oregon Sen. Ron Wyden, the top Democrat on the committee. “The system is broken. Mr. Azar was a part of that system. Given ample opportunity to provide concrete examples as a nominee of how he’d fix it, Mr. Azar has come up empty.”
Azar, however, argued that his experience in the pharmaceutical industry, which he joined after serving in the Department of Health and Human Services during the George W. Bush administration, makes him better qualified to tackle high drug costs. He said the department has to ensure robust competition in the drug market, as well as stop drug companies from abusing the patent system to prevent generic competitors. Also, Azar would like to create incentives to lower the list prices of medications “so that, when the patient walks in … needing to pay out of pocket at the pharmacy – that they’re not hit with that kind of cost.”
“To just know how that system works … I think, bring a great advantage to being able to hit the ground running,” he said. “There’s no silver bullet, here, though. I want to be very clear. There’s not one action that all of a sudden fixes this.”
Senators also touched on a wide range of topics, including combating the opioid epidemic, preserving the Children’s Health Insurance Program, known as CHIP, and reining in the high cost of medical care generally.
During his testimony, Azar showed he is in lockstep with the Trump administration when it comes to overhauling the Affordable Care Act, also known as Obamacare, and Medicaid. He said he supports letting states make changes to their programs through waivers, which Trump officials have aggressively promoted.
On ACA, Azar said he wants to increase choice and competition.
“What we have now is not working for people,” he said. “I want to work with states on these 1332 waivers and work with our authorities to just try to make that health insurance more affordable, make it real insurance and make it tailored to what they feel they need.”
As for Medicaid, Azar said turning the safety net program into a block grant program – which limits federal support, but provides states with more flexibility – can be appealing, though there needs to be sufficient funding. And he said he does not support reducing funding, but does want to curtail its growth – which many Democrats and consumer advocates say equates to a cut.
“I don’t believe any of the proposals that the President or I would support involve cutting Medicaid, or cutting the expansion, but rather slowing the rate of growth over the next 10 years in the interest of sustainability.”
Both Trump’s budget and the Republican bills to repeal and replace Obamacare would have reduced federal support for Medicaid over a decade, compared to current law.