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Trump nominates former pharma executive to lead HHS and “lower drug prices”

Alex Azar formerly worked for Eli Lilly and the second Bush administration.

Alex Azar in 2006.
Evan Vucci/Associated Press
Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.

President Donald Trump has nominated Alex Azar, a former top pharmaceutical executive and George W. Bush health official, to lead the US Department of Health and Human Services after his initial pick, Tom Price, was forced to step down following an ethics scandal.

Trump announced the nomination by promising that the ex-Eli Lily executive would “lower drug prices” and deliver better health care.

The president promised during the campaign to help bring down the rising costs of medicine and accused drug companies of “getting away with murder.” But his administration has yet to take any concrete steps to reduce pharmaceutical prices, and he has now nominated a HHS secretary closely tied to the industry.

Azar would also be responsible for overseeing the Affordable Care Act, which Trump and congressional Republicans have so far failed to repeal but the administration has taken independent steps to dismantle.

Azar worked for Eli Lilly, one of the 15 largest drug companies in the world, for a decade, according to Bloomberg. He oversaw US operations before stepping down in January. He also served on the board of the biopharmaceutical industry trade group BIO, according to Politico.

During the George W. Bush administration, Azar served as general counsel and deputy secretary at HHS. He also clerked for Supreme Court Justice Antonin Scalia earlier in his career.

The top items on the HHS agenda: Obamacare and drug prices

Lowering drug prices was one of Trump’s signature campaign promises. He railed against Big Pharma repeatedly in stump speeches and during debates.

“They’re getting away with murder. Pharma has a lot of lobbies and a lot of lobbyists and a lot of power,” Trump said back in January before he took office.

He pledged to take action — even hinting he’d be open to Medicare directly negotiating prices with drugmakers, a position that is usually anathema to Republicans and is more common with Democrats.

“We’re going to save billions of dollars over a period of time,” Trump said.

But the Trump administration has not yet taken any notable steps to address drug prices.

The president appointed a Food and Drug Administration commissioner, Scott Gottlieb, who is generally considered friendly to the industry. His party’s various health care bills did not touch the pharmaceutical companies.

The White House is reportedly working on an executive order to target drug prices, but, as Politico reported this summer, the order is expecting to be industry friendly and forego provisions like Medicare negotiations and drug reimportation that drug manufacturers oppose.

Azar, for his part, has acknowledged that drug prices are a problem.

“Patients are paying too much for drugs,” he said earlier this year.

But it remains to be seen whether a former pharmaceutical executive can jumpstart work on one of Trump’s most neglected campaign pledges.

As for Obamacare, which despite the Trump administration’s explicit sabotage saw record sign-ups in its first week of open enrollment, Azar seems likely to follow the party line. He has called the health care law “fundamentally broken” and signaled he would use the administrative leeway that the law affords the HHS secretary to give more flexibility to states.

HHS is responsible for overseeing Obamacare enrollment, which ends December 15, possibly before Azar will take over the agency. Trump has also signaled he wants to roll back the law’s individual mandate and allow more non-ACA-compliant plans back onto the market, policies Azar could be responsible for overseeing.

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