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Legal & Regulatory Feature

Alex Azar / Courtesy of Wikipedia.org

Trump Nominates Drug Executive Azar as HHS Head

Walter Eisner • Fri, November 24th, 2017

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First, Donald Trump hired a device guy, (orthopedic surgeon and former Congressman Tom Price, M.D.) as Secretary of Health and Human Service to convince Congress to replace and repeal Obamacare. Price failed and was shown the door.

Now, Trump has picked Alex Azar, a drug guy, as the new HHS Secretary to lower drug prices. Given that drug prices have been the main price increase driver since the start Obamacare, this might be an easier task. “The drug companies, frankly, are getting away with murder,” Trump said at a Cabinet meeting this fall. Prices are “out of control.”

On November 13, 2017 the President twittered that he intends to nominate Azar, former president of Eli Lilly and deputy HHS secretary under George W. Bush as the next HHS secretary.

"He will be a star for better healthcare and lower drug prices," Trump wrote.

Azar is a lawyer and has spent most of the last 10 years with Eli Lilly, rising to president of its U.S. affiliate before the company reorganized. He left in January to start his own consulting firm.

RAPS (Regulatory Affairs Professional Society) reported that back in 2004, Azar pushed back against the idea of using pharmaceutical imports or the Bayh-Dole Act to lower drug prices, according to a transcript of a meeting from the California State Board of Pharmacy.

In 2014, Azar spoke at MIT and said having a "narrow focus on the cost of medicine at the exclusion of innovation would be self-defeating." He also said that the regulatory approval system for new drugs is outdated and that payers, both public and private, set an "unrealistically high bar for new innovations to clear." Azar will have an ally at the FDA, where the new commissioner, Scott Gottlieb, M.D. has been moving to speed up the agency's approval processes.

Statnews.com reported that last spring a Trump tweet, "sent drug stocks tumbling after the president said he was working on a new system that would foster competition and lead to much lower prices." In meetings with industry executives Trump promised he would seek speeding up drug approvals, a cost-reducing tactic they would back.

Azar is known for having an insider’s familiarity with the complex world of federal health care regulation, having been HHS’s chief lawyer deputy secretary. Given the failure to dump Obamacare, Statnews speculated that Trump might see the regulatory route as his best chance to make a mark on health care.

Azar received a B.A. degree summa cum laude with highest honors in government and economics from Dartmouth College in 1988, where he was a member of the Kappa Kappa Kappa fraternity. He earned a J.D. degree at the Yale Law School in 1991, where he served as a member of the executive committee of the Yale Law Journal. His father, also named Alex Azar, M.D., is a retired doctor of ophthalmology and teacher at Johns Hopkins Hospital.

From 1994 to 1996, he served as an Associate Independent Counsel for Kenneth Starr in the U.S. Office of the Independent Counsel, where he worked on the first two years of the investigation into the Clinton Whitewater controversy.

Between 1996 and 2001, he worked for Wiley Rein, a Washington, D.C. law firm, where he achieved partner status. He then joined the Bush Administration.

If Azar's nomination is approved by the U.S. Senate, the healthcare focus on the Trump Administration would seem to shift from getting rid of Obamacare to lowering drug prices. Measuring success will be a simple matter of math and if prices don't fall, another Trump HHS Secretary might get fired.

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