- The Washington Times - Wednesday, November 29, 2017

President Trump’s pick to lead the Health and Human Services Department said Wednesday that prescription drug prices are “too high” and that his time as a top pharmaceutical executive makes him the right person to tackle the problem.

Alex M. Azar II, a former top Bush administration official who spent a decade at Eli Lilly, told members of the Senate Health Committee that bringing down the prices consumers pay for drugs will be a top priority.

He promised to focus on speeding generics to market and preventing companies from gaming patents to halt competition.

He avoided Trump-style blistering attacks on Obamacare, which he would oversee as secretary, but tacitly endorsed Republicans’ stance that Americans need more affordable and tailored options than the 2010 health law is providing.

“Premiums have been skyrocketing year after year, and choices have been dwindling. We must address these challenges for those who have insurance coverage and for those who have been pushed out or left out of the insurance market by the Affordable Care Act,” Mr. Azar testified.

Mr. Trump picked him to fill the post left vacant by Tom Price, a former congressman who resigned as HHS secretary in September amid revelations he used expensive charter planes for business travel.

Mr. Azar said his experience in implementing the Medicare prescription-drug benefit under President George W. Bush and grasp of how government and private industry interact make him the ideal person to negotiate policy fixes.

Health Committee Chairman Lamar Alexander said Mr. Azar’s background is an asset but Democrats took the opposing view, saying his pivot from government to industry — and now back again — is his biggest liability.

“Your resume reads like a how-to manual for profiting from government service,” Sen. Elizabeth Warren, Massachusetts Democrat, said.

He still faces another hearing and a vote in the Senate Finance Committee, and then would need to clear the full Senate.

Democrats do not have the votes to block the nominee, though they’re turning the process into a referendum on drug prices and Mr. Trump’s antipathy toward Obamacare.

Sen. Patty Murray, Washington Democrat, said she is worried Mr. Azar is in lock-step with Mr. Trump’s policy moves, including the White House’s decision to let more employers duck the “contraception mandate” requiring plans to cover birth control.

“Your nomination could still be an opportunity for HHS to reset, to put aside the extreme politics that are actively endangering people nationwide and start focusing on the department’s mission, instead of President Trump’s ideological agenda,” she said. “But, Mr. Azar, I have to say with concern that my review of your record leaves me with serious doubts that you will.”

To Democrats’ chagrin, Mr. Trump wants to replace the entire Obamacare law with state block grants next year, meaning Mr. Azar would oversee the implementation of any changes or executive actions to dismantle Obamacare in the meantime.

The administration on Wednesday said Obamacare sign-ups for 2018 reached nearly 2.8 million on HealthCare.gov through Nov. 25, yet enrollment slowed significantly in its fourth week, which included Thanksgiving. Though sign-ups are outpacing last year’s overall, enrollees aren’t coming in fast enough to put the law on better footing by the Dec. 15 sign-up deadline.

Mr. Azar, 50, clerked for late Supreme Court Justice Antonin Scalia decades ago, served as general counsel and deputy HHS secretary under President George W. Bush from 2005 to 2007.

He then worked for Eli Lilly for a decade after leaving government, rising to president of its U.S. division in Indianapolis before leaving January.

His former company acknowledged that list prices for its insulin, Humalog, have gone up, but said the net amount it’s received has remained flat since 2009, after factoring in rebates and fees. It said the problem is that many people have shifted into high-deductible plans and are paying more out of pocket.

“We’re working hard to address concerns about the cost of insulin. It’s important to note that the price people pay at the pharmacy is the result of complex factors, most notably their insurance benefit design,” the company said.

Like his former employer, Mr. Azar said the shift toward high-deductible insurance is also to blame for high costs.

“That system is not working for patients who have to pay out of pocket,” Mr. Azar added.

Democrats want the Trump administration to go further, by negotiating down prices under Medicare.

Mr. Azar also caught heat from at least one Republican — Sen. Rand Paul of Kentucky — who said he might vote against Mr. Azar if he cannot produce a plan that lets U.S. consumers import prescription drugs from abroad.

Mr. Azar said he opposes the importation of unsafe drugs, though the senator said people in Canada and European Union aren’t taking dangerous medicines.

“I’m sure you’re an honest and upright person, but we all have our doubts,” Mr. Paul said.

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