New US health secretary Azar will tackle drug prices, say Trump

President Trump has sworn in ex-pharma industry executive Alex Azar as his new Health Secretary – and says tackling drug prices and the opioid crisis will be among his top priorities.

Azar was head of US operations at Eli Lilly before stepping down in January last year, and has been a controversial choice as the new head of the Department of Health and Human Services.

Critics say Azar is deeply unsuited to the role, having headed up lobbying efforts at Lilly and the biotech industry trade group BIO, but these conflicts of interest didn’t stop Congress approving the appointment.

However unlike some other Trump appointees, Azar does have experience of government: during the George W. Bush administration he served as general counsel and deputy secretary at HHS. He also served as a clerk for Supreme Court Justice Antonin Scalia early on in his career.

Public Citizen, a campaigning group commented on Azar’s appointment: “Big Pharma’s takeover of our healthcare system is complete.”

While this fear has been echoed by many other public interest groups, President Trump has put bringing down drug prices front and centre, alongside fighting the opioid crisis as Azar’s top priorities.

“Alex knows inside and out the impact of government policy on patients, healthcare, and prices,” said Trump at the swearing-in ceremony.

“As the former president of Lilly USA — big company, great company, and he did an incredible job — Alex brings invaluable private sector experience to complement his years of public service."

Trump identified confronting the national emergency of addiction and death due to opioids as a priority for the new HHS secretary.

"And I think we’re going to be very tough on the drug companies in that regard and very tough on doctors in that regard, because what’s going on is pretty incredible. And finally, put an end to this plague on the lives on families and communities."

Trump’s speech was remarkable for declaring war on ‘special interests’- aka ‘The Swamp’ he talked about in his election campaign, even though Azar was very recently a representative of one of those groups.

“We have to get the prices of prescription drugs way down and unravel the tangled web of special interests that are driving prices up for medicine and for really hurting patients. And we’re going to get that done. That’s going to be so important.”

Trump continued: “You look at other countries — they pay a fraction for the exact same drug. The exact same pill, in an identical box from the same factory, costs us much more — many times more than it does in other countries. And nobody knows that process better than Alex. And we’re going to get that done because it’s very unfair to our country.”

Azar thanked President Trump, and said it was an honour to lead the HHS and its 79,000 employees.

He reiterated the president’s priorities of tackling the opioid crisis and said: “we will bring down prescription drug prices.”

Concerted action by FDA Commissioner Scott Gottlieb is certainly having effect, particularly in accelerating approval of new generics to help bring prices down.

Commentators believe Azar could lead a new push towards ‘value-based’ purchasing by Medicare, the federal health insurance programme. In the congressional hearings to confirm his appointment, Azar indicated he was in favour of so-called ‘mandatory bundles’ which would parcel up costs for procedures in order to bring total costs down.

Pharma companies are increasingly offering similar ‘beyond the pill’ services in conjunction with their medicines, but whether Azar will drive down prices directly with the industry through these or other mechanisms is yet to be seen.

A draft White House executive order last year had been mooted as a way to tackle drug prices, but intervention by the industry ensured that the document instead recommended easing regulation of the sector.