- At least one member of Congress has concerns about a new appointee at the Department of Health and Human Services who has a not-too-distant history working for big pharma and payers.
- Freshly minted HHS Secretary Alex Azar recently selected Daniel Best to serve as his senior advisor on drug pricing reform. Prior to the appointment, Best was a higher-up at CVS Health Corp. from 2011 to 2018, responsible for trade and industry relations. He also spent more than a decade at Pfizer Inc., where he helped lead business development.
- Azar, an industry veteran himself having worked at Eli Lilly & Co. for years, indicated those experiences will help Best in his new role — but not everyone is convinced. In an April 9 letter, Rep. Keith Ellison, D-MN, asked Azar to explain the rationale behind the appointment and how Best will avoid conflicts of interest.
High profile drug price increases have drawn congressional scrutiny in recent years. Lawmakers in both parties have demanded answers from some pharmaceutical companies about price hikes and the decision-making behind them. They've also held hearings with industry trade groups to better understand the pricing paradigm.
President Donald Trump too has called for lower drug prices.
Still, despite Trump's blasting of pharma as "getting away with murder" during his campaign, his administration has taken few actions to directly bring down drug prices. Trump-appointed FDA commissioner Scott Gottlieb has made boosting competition in the generic market a priority, but that effort remains in the early stages.
And the selection of Azar to lead HHS raised some eyebrows — for many of the same reasons Ellison takes issue with Best.
"Given Mr. Best’s career working for the pharmaceutical and pharmacy industry, the decision to hire him poses significant potential for conflicts of interest, placing him in a position to make decisions that may pit the income of his former employers against the interests of patients in reducing prescription drug prices," Ellison wrote in his letter.
Ellison noted that Pfizer fought against cheaper, generic versions of its drugs coming to market while Best was at the company. He also pointed out that pharmacy benefit managers (PBMs) like CVS Health have a record of "keeping a cut of the rebates they negotiate."
"The lack of transparency associated with their business model, as well as the high level of market concentration in the industry, casts doubt on the efficacy of their role in cost control. In fact, there is evidence to suggest CVS Caremark crossed legal and ethical lines during Mr. Best’s time at CVS Caremark."
To that end, Ellison asked Azar to answer a series of questions about Best's appointment, including what offices within HHS were part of the decision and how Best will meet ethics standards.