Backers Praise HHS Nominee Alex Azar’s Experience; Critics Worry Over Drug Prices

The former head of Eli Lilly’s U.S. operations has worked in public and private posts alike, a major asset in the eyes of some.

Organizations representing the healthcare industry have greeted President Trump’s pick for HHS secretary with largely positive responses. Those opposed have voiced concerns that the nominee’s allegiances could align more closely with pharmaceutical companies than consumers.

Alex Azar, JD, was president of Indianapolis-based drug giant Eli Lilly & Co.’s domestic operations from 2012 until earlier this year, when he left to launch his strategic consulting firm Seraphim Strategies LLC. When the president tweeted Monday that Azar would be nominated to replace former HHS Secretary Tom Price, the announcement prompted a slew of criticisms tying Azar to allegations involving Lilly’s drug-pricing practices.

“Choosing a top pharma executive to promote lower prices is like employing a lion to herd your sheep or cattle,” said Deborah Burger, RN, copresident of National Nurses United (NNU), in a statement condemning Azar’s nomination and denouncing Lilly’s past practices in the U.S. and abroad.

Lilly is among three companies defending themselves against a class-action lawsuit, for example, that alleges the firms drove up their own profits by exploiting the drug-pricing system, as Politico’s Sarah Karlin-Smith reported.

Even so, Azar’s boosters in the healthcare sector are numerous, with many organizations praising the former pharmaceutical executive’s previous work in public service. Azar was HHS deputy secretary during former President George W. Bush’s second term.

“He has the experience and expertise to combine the best from the private sector with the best of our public programs to make healthcare work for every American,” said Marilyn Tavenner, president and CEO of America’s Health Insurance Plans (AHIP).

Charles “Chip” N. Kahn III, president and CEO of the Federation of American Hospitals (FAH), praised Azar as “uniquely qualified” for the job, based on his past work for both the government and private industry.

“I have worked with Mr. Azar in the past and think he is the perfect pick for the times,” Kahn said. “His steady hand of leadership will be critically important as the deliberations over health reform and the many healthcare quality and cost issues proceed.”

Douglas Hoey, MBA, a pharmacist and CEO of the National Community Pharmacists Association (NCPA), was among those who cited Azar’s history with Lilly as an asset rather than a liability.

“His background in the pharmaceutical industry means he brings an understanding of supply chain issues and players that will be helpful to him in this role,” Hoey said.

Azar’s confirmation would deepen Vice President Mike Pence’s ties within the health department, where the former Indiana governor’s home-state allies—including CMS Administrator Seema Verma, Medicaid director Brian Neale, deputy chief of staff Brady Brookes, and top HHS spokesman Matt Lloyd—are embracing an anti-regulatory push, as Politico’s Adam Cancryn reported.

Even some who worry Azar’s allegiances could lead him to go easy on pharmaceutical companies say they’re willing to give him a chance. Ben Wakana, executive director of Patients For Affordable Drugs, said drug corporations already exercise “undue influence over health policy in America.”

“But actions speak louder than words. Mr. Azar is well-qualified and has the chance to stand up for patients because he knows exactly how our drug pricing system is broken,” Wakana said. “If he wants to take meaningful action to lower drug prices, we want to help him.”

More statements from healthcare organizations:

Rick Pollack, president and CEO of the American Hospital Association (AHA), said the AHA welcomes Azar’s nomination.

“We are confident that his extensive background in business, healthcare and medicine distinguishes him as a uniquely qualified candidate for the vacancy. The expertise garnered from his career in the private sector and prior public service at HHS as Deputy Secretary will prove to be particularly valuable in addressing the serious challenges facing our nation's healthcare system today,” Pollack said.

“We look forward to working side-by-side with him to achieve our mission of advancing the health of the patients and communities we are privileged to serve,” he added.

Peter Saltonstall, president and CEO of the National Organization for Rare Disorders (NORD), issued a statement in support of the nomination.

“In our view, Alex Azar brings superior credentials for this job, based on his extensive management experiences and deep understanding of our healthcare system. He understands the needs of the patient community and particularly the challenges of the rare disease community and the urgency of orphan drug development,” Saltonstall said.

“While we inevitably will discuss and debate policies that affect the rare disease community, what we value most is a Secretary who will listen carefully and decide thoughtfully,” Saltonstall added. “Alex Azar meets this test. We look forward to the opportunity to work with him if he is confirmed by the Senate.”

Darrell G. Kirch, MD, president and CEO of the Association of American Medical Colleges (AAMC) congratulated Azar.

“In this position, he will oversee many of the federal agencies that play a crucial role in how the nation’s medical schools and teaching hospitals are able to educate and train the next generation of doctors, care for the nation’s most vulnerable and complex patients, and conduct medical research that brings hope to countless Americans,” Kirch said.

“Upon his confirmation, we look forward to working with Mr. Azar on improving the health of all through high-quality clinical care, groundbreaking medical research, and a robust, diverse physician workforce.”

Susan DeVore, CEO of Premier Inc., commended President Trump’s for his selection.

“Premier has worked with Mr. Azar when he served in the Bush administration on some of the early value-based payment models pioneered by that administration, including the Hospital Quality Improvement Demonstration project. We know from that work he understands the need to move away from the perverse incentives in the Medicare fee-for-service payment system and to do so in a fashion that incents high-quality care,” DeVore said. “He also appreciates the need to have access to healthcare data and interoperability of health information systems. We are looking forward to working with Mr. Azar once confirmed.”

Richard Fiesta, executive director of the Alliance for Retired Americans.

“Prescription drug costs are the top driver behind high medical costs in this country, hurting retirees and all consumers. By nominating a drug corporation insider to lead the Department of Health and Human Services, President Trump appears to be putting a fox in charge of the henhouse,” Fiesta said.

“Congress must ask tough questions of this nominee during the confirmation process. In particular, Mr. Azar should be asked whether he supports giving Medicare the ability to negotiate drug prices, the way that Medicaid and the Veterans Administration do today,” Fiesta added.

Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, described the nomination as a major disappointment, a missed opportunity following the resignation of former HHS Secretary Tom Price.

“This is an ironic choice for a President who has pledged to lower prescription drug prices,” Richtman said of Azar’s nomination. “As President of Eli Lilly, Azar presided over frequent price hikes on medications that seniors on fixed incomes depend upon. In fact, the company is currently being sued for fixing the price of insulin. Equally discouraging is Azar’s support of reckless legislation to repeal-and-replace the Affordable Care Act. Like his predecessor, Azar would be an unreliable steward of Medicare and Medicaid, which the GOP-led Congress has proposed to cut despite the President’s promise to protect both programs.”

“This appointment is yet another example of President Trump restocking the pond with corporate chieftains instead of draining the swamp,” Richtman added. “Seniors and their families should vigorously oppose it."