- Alex Azar, President Donald Trump's pick to lead HHS, was confirmed by the Senate Wednesday in a bipartisan vote, 55 to 43, with six Democrats and one independent voting for the Republican nominee.
- Critics have argued the former Eli Lilly executive is too cozy with the pharmaceutical industry, but he has insisted he sees bringing down drug costs as a top priority.
- Azar previously served as general counsel for HHS under former President George W. Bush, and has held other leadership positions at the department.
The next leader of the health department has largely echoed conservative ideas, calling increased generic competition as a way to drive down prices, while remaining opposed to allowing Medicare to negotiate drug prices and to drug importation.
Just one Republican, Sen. Rand Paul of Kentucky, voted against the nomination, presumably for Azar's unwillingness to consider a plan to import drugs from other countries.
Azar has said the government needs to reverse the incentives for high-list prices for drugs and appears to be open to the idea of mandatory Medicare pilots.
Azar’s willingness to consider mandatory programs is good news for those concerned the private sector needs a push from CMS to fully embrace value-based care. Former HHS Secretary Tom Price strongly opposed the mandatory nature of the projects.
Backers of value-based reimbursement models were disappointed last year when CMS canceled some mandatory bundled programs and rolled back others. The agency has also signaled a new approach to pilot programs in the Trump administration. CMS did, however, recently move forward with the Bundled Payment for Care Improvement Advanced model, but it is voluntary.
Azar is taking the helm at HHS well into the administration’s efforts to hobble the Affordable Care Act. Republicans in Congress have floundered in their attempts to fully repeal the law, but they did succeed in axing the individual mandate penalties in their tax cut bill late last year.
The executive branch has also taken steps to weaken the law, including stopping cost-sharing reduction payments and slashing advertising for open enrollment.
Like nearly every Republican, Azar has frequently criticized the ACA and would be unlikely to oppose more attempts to repeal or roll it back. He did however tell senators he would implement the law so long as it remains on the books.
The nominee has noted that pharmacy benefit managers already negotiate Medicare Part D prices, and has suggested that the government should explore allowing them to play a similar role in Medicare Part B.
Consumer group Public Citizen argues Azar's pledge to tackle drug prices is an empty promise.
"There is no reason to expect him to hold prescription corporations accountable, and every reason to anticipate that his tenure will enable Big Pharma to continue and worsen its blatant rip-offs of American consumers and taxpayers," Peter Maybarduk, director of Public Citizen’s Access to Medicines Program, said in a statement.
Azar is set to replace Price, who resigned after news reports discovered he spent more than $1 million of taxpayer money on private air travel for himself and other HHS staff. Eric Hargan led the department in the interim after being appointed as acting HHS secretary.