Trump turns to drug in­dus­try for his new health sec­re­tary

Starkville Daily News - - FORUM - By RI­CARDO ALONSOZALDIVAR

WASH­ING­TON (AP) — Turn­ing to an in­dus­try he’s re­buked, Pres­i­dent Don­ald Trump on Mon­day picked a for­mer top phar­ma­ceu­ti­cal and gov­ern­ment ex­ec­u­tive to be his health sec­re­tary.

If con­firmed, Alex Azar would over­see a $1 tril­lion depart­ment re­spon­si­ble for ma­jor health in­sur­ance pro­grams, in­clud­ing “Oba­macare,” as well as med­i­cal re­search, food and drug safety, and pub­lic health.

The nom­i­na­tion of Azar is un­usual be­cause Health and Hu­man Ser­vices sec­re­taries have come from the ranks of elected of­fi­cials such as gov­er­nors, lead­ers in academia and medicine, or top ex­ec­u­tive branch man­agers — not in­dus­tries reg­u­lated by the depart­ment.

“He will be a star for bet­ter health­care and lower drug prices!” Trump tweeted in a morn­ing an­nounce­ment. Trump has a track record of mak­ing in­dus­try-friendly nom­i­na­tions, such as for­mer ExxonMo­bil CEO Rex Tiller­son as sec­re­tary of state and wealthy in­vestor Wil­bur Ross as sec­re­tary of com­merce.

But Trump also has been a scathing critic of the drug com­pa­nies, both as a can­di­date and as pres­i­dent.

Azar, 50, a lawyer by train­ing, has spent most of the last 10 years with phar­ma­ceu­ti­cal gi­ant Eli Lilly, ris­ing to pres­i­dent of its key U.S. af­fil­i­ate be­fore leav­ing in Jan­uary to start his own con­sult­ing firm. He’s also seen as an ex­pert on gov­ern­ment health care reg­u­la­tion.

As sec­re­tary, Azar would be re­turn­ing to HHS af­ter serv­ing in se­nior posts in the George W. Bush ad­min­is­tra­tion. He would have to scrupu­lously avoid con­flicts with Lilly’s far-reach­ing in­ter­ests, from drug ap­proval to Medi­care re­im­burse­ment. The drug­maker has drawn crit­i­cism from pa­tient ad­vo­cacy groups for price in­creases to one of its big­gest prod­ucts: in­sulin, used to treat high blood sugar for nearly 100 years.

Azar’s ear­lier HHS nom­i­na­tions in the Bush era sailed through the Sen­ate. This time, he’ll face Democrats wary of the ad­min­is­tra­tion’s unyield­ing quest to re­peal the Af­ford­able Care Act.

Top Democrats in Congress were skep­ti­cal, but also said they hoped Azar would bring a shift from an ide­o­log­i­cal hard line on “Oba­macare.”

“It’s time to turn over a new leaf at HHS,” said Sen. Chuck Schumer of New York, the Demo­cratic leader.

Sen. Patty Mur­ray, D-Wash., flagged a po­ten­tial con­flict of in­ter­est, ques­tion­ing how Azar “can fairly ex­e­cute any sig­nif­i­cant ef­fort to lower drug prices for pa­tients.” Mur­ray is the se­nior Demo­crat on the Health, Ed­u­ca­tion, La­bor and Pen­sions Com­mit­tee.

But com­mit­tee chair­man Sen. La­mar Alexan­der, R-Tenn., cast Azar as a prob­lem solver, say­ing “he has the qual­i­fi­ca­tions and ex­pe­ri­ence to get re­sults.”

In­sur­ers and for-profit hos­pi­tals also re­acted pos­i­tively, while the Pub­lic Ci­ti­zen ad­vo­cacy group likened Azar’s nom­i­na­tion to a “coup d’etat” by drug com­pa­nies.

Amer­i­cans con­sis­tently rank the high cost of pre­scrip­tion drugs among their top health care pri­or­i­ties, ahead of di­vi­sive is­sues like re­peal­ing for­mer Pres­i­dent Barack Obama’s health care law.

Trump has been a sharp critic of the in­dus­try. “The drug com­pa­nies, frankly, are get­ting away with mur­der,” he said at a Cab­i­net meet­ing this fall. Prices are “out of con­trol.”

In the spring, a Trump tweet sent drug stocks tum­bling af­ter the pres­i­dent said he was work­ing on a new sys­tem that would foster com­pe­ti­tion and lead to much lower prices. In meet­ings with in­dus­try ex­ec­u­tives, how­ever, Trump has fo­cused on speed­ing up drug ap­provals, a cost-re­duc­ing tac­tic they would back.

Pro­fes­sion­ally, Azar has an­other set of skills that may be valu­able to the pres­i­dent. In his pre­vi­ous ser­vice at HHS, the Yale law grad­u­ate de­vel­oped an in­sider’s fa­mil­iar­ity with the com­plex world of fed­eral health care reg­u­la­tion, serv­ing first as the depart­ment’s chief lawyer and later as deputy sec­re­tary.

Frus­trated by fruit­less ef­forts to over­turn the Obama-era health law in Congress, Trump might see the reg­u­la­tory route as his best chance to make a mark on health care.

If con­firmed, Azar would join the club of Trump ad­min­is­tra­tion of­fi­cials from big busi­ness. Ross was chair­man of a pri­vate eq­uity firm he founded and later sold. Trea­sury Sec­re­tary Steven Mnuchin was a for­mer Gold­man Sachs ex­ec­u­tive and hedge fund man­ager. Tiller­son was CEO of ExxonMo­bil.

Ad­mir­ers say Azar’s drug in­dus­try ex­pe­ri­ence should be con­sid­ered an as­set, not a li­a­bil­ity.

“To the ex­tent that the Trump ad­min­is­tra­tion has talked about low­er­ing drug prices, here’s a guy who un­der­stands how it works,” said Tevi Troy, who served with Azar in the Bush ad­min­is­tra­tion and now leads the Amer­i­can Health Pol­icy In­sti­tute, a think tank fo­cused on em­ployer health in­sur­ance.

“Would (Azar) have been bet­ter off if he had been med­i­tat­ing in an ashram af­ter serv­ing as deputy sec­re­tary?” asked Troy.

Trump’s pick to lead the Food and Drug Ad­min­is­tra­tion, Scott Got­tlieb, also faced scru­tiny for re­ceiv­ing con­sult­ing pay­ments from drug­mak­ers and med­i­cal de­vice com­pa­nies while in the pri­vate sec­tor. Once in of­fice, Got­tlieb pushed ef­forts to lower drug prices by re­work­ing FDA drug re­views to in­crease com­pe­ti­tion.

Azar would be Trump’s sec­ond HHS sec­re­tary, re­plac­ing for­mer Ge­or­gia con­gress­man Tom Price, ousted af­ter his use of pri­vate char­ter planes for gov­ern­ment travel dis­pleased the pres­i­dent.

(Photo by Evan Vucci, AP)

In this June 8, 2006 file photo, then Deputy Health and Hu­man Ser­vices Sec­re­tary Alex Azar meets re­porters at the HHS Depart­ment in Wash­ing­ton. Azar was a top HHS of­fi­cial dur­ing the George W. Bush ad­min­is­tra­tion.

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