New HHS secretary vows to ‘bring down prescription drug prices’
Alex M. Azar II, President Donald J. Trump’s second secretary of the United States Department of Health and Human Services, acknowledged that in his new position, he intends to tackle the opioid epidemic and “bring down prescription drug prices”.
Tapped to replace Rep. Tom Price, MD, (R-Ga.), who resigned in September amidst a scandal surrounding his use of private charter airplanes for government business trips, Azar previously served as general counsel and deputy secretary at HHS during the George W. Bush administration. However, given his prior affiliation with the pharmaceutical industry, Azar has been considered an unlikely choice to lead the charge for lower drug prices.
During Azar’s swearing-in ceremony on January 29, Trump noted that Azar would be expected to bring “those prescription drug prices way down”.
“The Department of Health and Human Services has already achieved a great deal rolling back regulations that drive up health care costs, but we have a long way to go,” Trump said. “A lot of people are very happy with the amount we’ve done already, but Alex is going to bring that to a big, brand-new level. Alex knows inside and out the impact of government policy on patients, health care and prices. As the former president of [Eli] Lilly USA, Alex brings invaluable private sector experience to complement his years of public service.”
In his testimony during a Senate Finance Committee hearing, Azar outlined his strategy, which included expanding the government’s ability to negotiate drug prices, reversing the incentive on list prices, having what Azar called a “robust” competition for both generic and branded drugs, as well as a “viable and robust” biosimilar market, and review the patent process.
He also claimed that other countries “are not paying their fair share” in developing new medications and that he was generally in favor of transparency on drug pricing with some exceptions.
“Transparency is generally very helpful, but we have to be careful around drug pricing to make sure we don’t do anything that could be anti-competitive and counter-productive to what we are trying to do,” Azar said during the hearing. “We also have to think about what the benefit and the harm would be to the consumer.”
He added that though his prior experience — which includes five years as the president of the U.S. division of Eli Lilly and a board of directors position with the Biotechnology Innovation Organization — will help him hit the ground running in this area, slowing or reversing the curve on drug prices will require a long-term fix.
“This is such a complex area, the learning curve for any other individual would be so high,” Azar said at one point. “There’s no silver bullet here. There’s not one action that all of a sudden will fix [high drug prices]. I want to hear ideas from others.”
Lawmakers disagreed how Azar’s former experience in the pharmaceutical industry would help bring that goal to fruition.
“Mr. Azar had a major role over drug prices for every product Lilly marketed in the United States,” Senator Ron Wyden (D-Oregon) said. He went onto point out that Eli Lilly’s arthritis, diabetes and ADHD drug prices doubled during Azar’s tenure.
“Some people think that Azar’s work in the pharmaceutical industry as an executive over the past 10 years disqualifies him to serve this position,” Senator Orrin Hatch (R-Utah) said. “That was not the standard some applied to nominees during the previous administration, and it should not apply to this one.”
During the hearing, Azar also faced questions on the opioid epidemic, the solvency of Medicare and Medicaid and the future of the Affordable Care Act. Though he declined to comment on specific administration plans announced thus far as he has not been privy to the discussions behind them, Azar offered his personal thoughts on how he would address these health care issues if confirmed.
Azar said the “scourge” of the opioid epidemic would be brought under control by supporting prevention, regulatory and enforcement efforts. He also said it will take a combination of additional ideas originating outside of Washington, in the communities where the epidemic is especially severe, to find suitable solutions.
“When it comes to prevention and treatment programs, there is not a one-size-fits-all approach, he said. “We need to get out there and see what’s working, not just so we can support them but so that we can replicate them and make them available elsewhere.”
Azar indicated he would work to keep Medicaid as efficient and effective as possible, noting that its focus must be shifted from paying for disease and sickness to paying for health and outcomes.
He was pressed by Senator Bob Casey (D-Pennsylvania) on whether or not the “guarantee” of Medicaid would still be there.
“Whatever we do in Medicaid, we need to make sure it’s doing its job,” Azar said. “For individuals with disabilities… we have to make sure its funded and supported for them.”
Azar also indicated he favors a tailored approach to Medicaid where each state “meets the needs of their citizens,” rather than making across the board, nationwide changes. Block grants to the states were a significant component of GOP efforts at repealing and replacing the Affordable Care Act in 2017. He added that President Trump has stated that the federal budget deficit cannot be filled by cutting Medicare, Medicaid, and other programs.
“I would advise [Trump] to keep his word on that,” Azar said, “but I don’t have the broader context of any discussions [currently] going on.”
Affordable Care Act
“We must make health care more affordable, more available and more tailored to what individuals want and need in their care. We all share a common concern for our Americans who are struggling to achieve access to quality health care,” Azar said. “Even if we do not necessarily agree on how to best address that challenge, under the status quo premiums have been skyrocketing year after year and options have been dwindling. We’ve got to address these challenges… What we have now is not working.”
He also indicated he is in favor of empowering states to run their own health care budgets, as was described in the Graham-Cassidy Bill. He also stated that he is in favor of allowing health insurance to be purchased across state lines. – by Janel Miller
Disclosure: Healio Rheumatology was unable to determine relevant financial disclosures prior to publication.