Alex Azar, a former pharmaceutical industry executive, was confirmed by the Senate today by a roll call vote of 55-43 to become the next secretary of the Department of Health and Human Services (HHS).
Earlier this week, the Senate advanced the nomination of Azar with a 54-43 vote that mostly followed party lines. According to a report this week in The Hill, “Backers of Azar tout him as a well-qualified manager, while many Democrats have attacked his time as a pharmaceutical executive at Eli Lilly, pointing to drug price hikes under his watch.”
In the Senate vote on Tuesday, seven Democrats joined Republicans as they voted to move Azar’s nomination forward. In fact, just one Republican senator who voted on the nomination—Rand Paul (R-KY)—was against him.
During a Senate Health, Education, Labor and Pensions Committee (HELP) hearing in November, Sen. Paul said he wouldn’t support Azar “unless he shows he’s open to the idea of allowing drugs to be imported from other countries where they often cost much less,” as reported by USA Today. The report added that federal officials have said they can’t guarantee the safety of imported drugs. Paul then said he wanted Azar to tell him how this could be done safely; if Azar couldn’t do that, he wouldn’t get Paul’s vote.
Paul added during that hearing, per the USA Today report, ““You’ve got some convincing to make me believe that you’re going to represent the American people and not big pharma.”
Nonetheless, Azar, a Trump nominee, will now officially replace Tom Price, M.D., who resigned in September following an investigation about his use of private jets for official business. In the days prior to his resignation, Price was facing intense criticism regarding his work-related travel on private jets, with Politico reporting that his travel cost taxpayers nearly $1 million, or about $400,000 for private charters and $500,000 in military airplane costs.
Confirmed as HHS Secretary in February, Price only served that role for about seven months.
Azar previously served as president of Lilly USA, LLC, the largest affiliate of global biopharmaceutical firm Eli Lilly and Company, from 2012 until 2017, a position he recently left to pursue other career opportunities.
Azar also has experience working in the federal government. He served as HHS General Counsel in the George W. Bush administration, and following Bush’s first term, Azar was asked to stay at HHS, serving as Deputy Secretary of HHS, the number two official and chief operating officer of the department. He worked in that role until February 2007.
During his past Congressional hearings, Azar has noted that like President Trump, he also thinks that drug prices are too high. As The Hill reported, “He generally embraced Republican-leaning solutions, like increasing competition in the marketplace, rather than Democratic-leaning options like allowing Medicare to negotiate drug prices.”
Regarding health IT, a Politico Morning eHealth briefing last fall noted that Azar “helped lay the foundation for establishing the department's health IT office,” according to an interview Politico did with David Brailer, M.D., Ph.D., the first head of the Office of the National Coordinator for Health IT (ONC). Brailer, per that report, called Azar “an unflinching supporter of health IT,” while also recalling that Azar felt that in the pre-HITECH days, “the government couldn't or shouldn't regulate EHRs’ (electronic health records) use into existence.”
Also of note, as it relates to value-based care, during a recent Senate Finance Committee hearing, Azar said he was open to the idea of mandatory bundled payment models, signaling a shift from what ex-Secretary Price and current CMS (Centers for Medicare & Medicaid Services) Administrator Seema Verma have said in the past.
As reported by Healthcare Informatics earlier this month, responding to Sen. Mark Warner (D-VA), who advocated for “more force” when it comes to mandatory Center for Medicare & Medicaid Innovation (CMMI) pilots, Azar said during that hearing, “I believe that we need to be able to test hypotheses. And if we need to test a hypothesis, I want to be a reliable partner, I want to be collaborative in doing this, I want to be transparent and follow appropriate procedures, but, if to test a hypothesis there around changing our healthcare system, if it needs to be mandatory as opposed to voluntary to get adequate data, then so be it.”