- The Washington Times - Tuesday, January 9, 2018

President Trump’s pick to run the Department of Health and Human Services vowed Tuesday to work with Congress to cut prescription drug prices — and said his own history as a pharmaceutical executive doesn’t taint him.

But Alex M. Azar, a former executive at Eli Lilly, said he’s wary of having the federal government negotiate prices directly with drug companies, saying it would amount to too much control and could limit choices for patients.

Mr. Azar, testifying to the Senate Finance Committee in his confirmation hearing, also said Obamacare needs more changes beyond the repeal of the individual mandate that the GOP pushed through Congress last year. He said Republican plans to package Medicaid money in block grants to the states to experiment was an attractive idea.

Senate Finance Committee Chairman Orrin Hatch said Mr. Azar, who also served in the George W. Bush administration, is highly qualified to oversee the sprawling HHS and its $1 trillion budget, after former Secretary Tom Price resigned amid questions about his pricey travel habits.

“Experience in the private sector and dealing with the policies and regulations that come from government agencies is, in my view, a mark in favor of a nominee’s qualifications,” said Mr. Hatch, Utah Republican.

Mr. Azar’s confirmation is all but assured in the GOP-controlled Senate, though Democrats — eyeing the 2018 election year — said Mr. Azar’s nomination is Exhibit A in Mr. Trump’s failure to drain the Washington swamp and to replace Obamacare with something better for the American health care system.

They also prodded Mr. Azar on the question of drug pricing.

“Did you ever lower the price — ever — of a Lilly drug sold in the United States?” Oregon Sen. Ron Wyden, the committee’s ranking Democrat, asked Mr. Azar.

“Drug prices are too high. I said that when I was at Lilly,” Mr. Azar said.

Mr. Wyden said that didn’t answer the question.

“I don’t know that there is any drug price of a branded product that has ever gone down from any company on any drug in the United States, because every incentive in this system is toward higher prices, and that is where we can do things together, working as the government, to get at this,” Mr. Azar said. “No one company is going to fix that system, that’s why I want to be here working with you.”

Mr. Azar said he would work with both parties on ways to “pull down” the list prices of prescription drugs. That includes speeding generic alternative drugs to market and making sure companies don’t game the patent-exclusivity system, he said.

Private-plan negotiators already snag good prices within Medicare’s prescription-benefit program for seniors, he said, so direct government intervention wouldn’t improve things.

Mr. Azar said it would be acceptable for the government to negotiate targeted purchases of drugs for things like the opioid crisis, and it is “worth looking at” some form of negotiation for doctor-administered drugs under Medicare Part B, so long as it doesn’t hinder the innovation of new cures.

Republicans will be counting on Mr. Azar to use his regulatory know-how to reshape Obamacare and offer people more affordable insurance options.

Mr. Trump has taken a series of administrative actions to chip away at the law, allowing like-minded professionals to band together in “association” plans across state lines and eyeing moves to let people hold onto “short-term” plans for a full year. He’s also urging states to require Medicaid recipients to seek work as a condition for receiving taxpayer-funded benefits.

Democrats say Mr. Trump and congressional Republicans are destabilizing the markets by siphoning customers from its individual insurance exchanges and repealing the “individual mandate” to obtain health insurance, saying those moves could force consumers to pay higher rates.

They’re also wary of a GOP push to block-grant health care funding to the states, saying it’s a budget tactic to cut Medicaid spending.

Mr. Azar said the “devil is in the details,” on block-granting, though he saw promise in the idea.

“There is a lot that can appeal from notions of block-granting,” he said, “because I do think it helps align incentives better where the states have the empowerment and also the accountability to manage those dollars as their own.”

The Senate panel will vote on whether to advance the nominee for confirmation by the full Senate. A date hasn’t been set.

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