Ex-Eli Lilly executive Azar wins Trump's nomination for top HHS post

President Donald Trump has picked a pharmaceutical insider to oversee the HHS at a time when drug prices, federal investigations and other industry issues are center stage. Just days after news that Trump was set to select ex-Eli Lilly executive Alex Azar for the U.S. government's top healthcare post, he tweeted the nomination Monday morning.

Trump picked Azar for the HHS chief position above other candidates such as Centers for Medicare & Medicaid Services director Seema Verma and FDA commissioner Scott Gottlieb, according to press reports on the selection process.  

Azar, who has served as an HHS deputy secretary during the George W. Bush administration and as Eli Lilly's U.S. president, will be tasked with advancing the president's repeal and replace push for the Affordable Care Act and ostensibly with tackling high pharmaceutical prices, an issue Trump campaigned on and has touched on during his time in the White House. But so far, critics contend the Trump Administration's actions and proposals have only favored the industry.

Trump famously said pharma is "getting away with murder," and previously crossed party lines to endorse Medicare price negotiations. Still, drug pricing talk hasn't gotten serious in Congress and four Congressmen wrote to the president last month to say his "inaction" on their Medicare negotiation proposal has left them with no option other than to press ahead alone. 

Cowen analyst Eric Assaraf, for his part, wrote in a note seen by Business Insider that even though "Trump specifically called out lowering drug prices in his announcement of Azar, we don't believe his appointment will mark a change in course in that realm." After leaving Lilly as part of an executive shakeup earlier this year, Azar formed a consultancy as he explored "new leadership opportunities," according to an online speaker profile.

Reacting to Azar's selection, Senate Finance Committee ranking member Sen. Ron Wyden said the president "at every turn ... has broken his promises to American families to lower health care costs, expand access and bring down the high price of prescription drugs." Sen. Wyden said he'll ask Azar to take "take decisive, meaningful action to curtail the runaway train of prescription drug costs."

Aside from pricing, the opioid epidemic has brought unwanted attention to some drugmakers, and intellectual property remains an important issue in Congress. At the same time, the generic industry is caught up in a broad price-fixing probe that's weighing on top players.

It isn't the first time President Trump has selected an industry insider for a top government job. The president earlier this year tapped Scott Gottlieb—who was pharma's top pick by a wide margin—for the crucial FDA commissioner post. During his time at the agency, Gottlieb has won praise for his moves to increase competition and provide relief on pricing, as well as to speed the FDA's approval process. 

Gottlieb's name was one floated for the HHS chief position after former secretary Tom Price resigned in September, but the FDA commissioner said in a Reuters interview he felt he is "most effective" at the drug agency. 

Azar's nomination is sure to encounter more pushback. On earlier reports that the ex-Lilly executive was under consideration, Public Citizen founder Robert Weissman said if Azar wins the nod, "then Big Pharma’s coup d’etat in the healthcare sphere will be virtually complete." 

Azar has argued against drug price controls in the past, Weissman said at the time, making it "highly unlikely" he would "advance real reform" on the issue.