How Big Pharma will get off scot-free

The Washington Post - - NEWS - Twit­ter: @Mil­bank Dana Mil­bank

Pres­i­dent Trump could not have been more clear.

“The drug com­pa­nies, frankly, are get­ting away with mur­der,” he said in mid-Oc­to­ber. He had used the same “get­ting away with mur­der” line pre­vi­ously, adding that “pharma has a lot of lob­bies and a lot of lob­by­ists and a lot of power.”

Yet just four weeks later, Trump nom­i­nated the for­mer pres­i­dent of Eli Lilly’s U.S. busi­ness to run the Depart­ment of Health and Hu­man Ser­vices. If drug com­pa­nies are mur­der­ers, Alex Azar is the guy with the rusty hatchet.

Azar was deputy sec­re­tary at HHS dur­ing the Ge­orge W. Bush ad­min­is­tra­tion be­fore he cashed out and made mil­lions at Lilly while the com­pany’s prices for in­sulin and other drugs soared. Now he’s tak­ing an­other spin through the re­volv­ing door — nom­i­nated by a phony pop­ulist who had promised to drain the swamp but is in­stead hand­ing over the gov­ern­ment to cor­po­ra­tions and the trea­sury to the rich.

The Se­nate will prob­a­bly con­firm him. This Se­nate would con­firm Mr. Fox as sec­re­tary of hen­house se­cu­rity. But even a cou­ple of the Repub­li­cans at Azar’s first con­fir­ma­tion hear­ing Wed­nes­day were squea­mish about the spec­ta­cle of a Big Pharma ex­ec­u­tive be­ing in­stalled as the ul­ti­mate po­lice­man of drug prices.

“You’ve got some con­vinc­ing to make me be­lieve that you’re go­ing to rep­re­sent the Amer­i­can peo­ple and not Big Pharma,” said Sen. Rand Paul (R-Ky.). “And I know that’s in­sult­ing . . . but we all have our doubts, be­cause Big Pharma ma­nip­u­lates the sys­tem to keep prices high.”

And that was re­strained com­pared with the Democrats’ treat­ment of Azar.

“Your re­sume reads like a how-to man­ual for prof­it­ing from gov­ern­ment ser­vice,” said Sen. El­iz­a­beth War­ren (DMass.), not­ing the $3.5 mil­lion pay­out Azar got last year from Eli Lilly. “I think the Amer­i­can peo­ple have a right to know that the per­son run­ning HHS is look­ing out for them and not for their own bank ac­count or for the prof­itabil­ity of their for­mer and maybe fu­ture em­ploy­ers.”

Azar of­fered lit­tle be­yond an ac­knowl­edg­ment that “drug prices are too high.” When it came to re­duc­ing prices, he tossed out the usual ob­jec­tions of­fered by the phar­ma­ceu­ti­cal lobby — for ex­am­ple, that we can’t reim­port drugs from the Euro­pean Union, where prices are lower, be­cause the medicines wouldn’t be “re­li­able and safe.”

“It’s a ca­nard,” Paul said. “That’s BS, and the Amer­i­can peo­ple think it’s BS.”

If the “for­got­ten” man and woman were think­ing Trump was re­ally go­ing to lower their drug prices — well, they can for­get about it.

They cer­tainly shouldn’t be sur­prised. They’ve al­ready seen Trump stock his ad­min­is­tra­tion with cor­po­rate ti­tans and bil­lion­aires and be­gin to dis­man­tle the Con­sumer Fi­nan­cial Pro­tec­tion Bureau. Nor should they be shocked to dis­cover that they aren’t get­ting that big, beau­ti­ful tax cut Trump promised. The Tax Pol­icy Cen­ter projects that un­der the “cut,” the wealth­i­est 1 per­cent of Amer­i­cans will get 62 per­cent of the ben­e­fit in 2027, while the bot­tom 95 per­cent will see no real change.

Tax dis­tri­bu­tion anal­y­sis is hard to un­der­stand. Putting a drug ex­ec­u­tive in charge of drug pric­ing is easy. Sen. La­mar Alexan­der (R-Tenn.), chair­man of the com­mit­tee hold­ing Wed­nes­day’s hear­ing, tried to in­oc­u­late Azar against the in­evitable ac­cu­sa­tions of plu­toc­racy. “What do you say to the skep­tics,” he asked at the start, “who ques­tion the in­crease in in­sulin prices while you were a leader at Eli Lilly?”

Azar ex­plained that his knowl­edge of “how the money flows” would be an as­set — in much the way Trump said that his ex­pe­ri­ence gam­ing the tax sys­tem qual­i­fied him to fix it.

Sen. Patty Mur­ray ( Wash.), the rank­ing Demo­crat, asked how he would re­duce prices. Azar spoke about the need to stop “gam­ing in the sys­tem” of patents.

Paul asked him to ac­knowl­edge Big Pharma’s role in ma­nip­u­lat­ing patents. Azar re­peated that there are abuses “in the sys­tem.”

Sen. Tammy Bald­win (D-Wis.) asked Azar how he would ex­plain the tripling of in­sulin prices dur­ing his ten­ure at Eli Lilly to a fa­ther of di­a­bet­ics.

Azar ex­plained, once more, that “the prob­lem is that sys­tem.”

“The sys­tem?” Bald­win asked. “So I should just tell them it’s the sys­tem?”

War­ren asked Azar whether the $515 mil­lion crim­i­nal fine Lilly paid in 2009 was “ad­e­quate ac­count­abil­ity” — even though the com­pany made bil­lions from the il­le­gal marketing. Azar said it was. Asked whether Lilly’s CEO should have been held per­son­ally re­spon­si­ble, Azar merely replied, “I’m sat­is­fied with our dis­cus­sion.”

The plu­to­crat was not help­ing mat­ters. Sen. Johnny Isak­son (RGa.) tossed Azar a life­line. Would he do some “home­work” and “come back to us in six months” with rec­om­men­da­tions to end the “gam­ing of the sys­tem”?

“Ab­so­lutely. Ab­so­lutely. Yeah,” the nom­i­nee replied.

How re­as­sur­ing.

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