Until January, Alex Azar was Eli Lilly's USA pharma chief, the company's top post in North America. Now he's reportedly in line for the top job at HHS, where he could help pharma navigate some turbulent political waters.
According to multiple media reports, the Trump Administration's search to fill the top vacancy at HHS is closing in on Azar, whose resume also includes experience at the department during the George W. Bush years.
According to one of Politico's White House sources, President Donald Trump himself has signed off on Azar to replace Tom Price, who resigned from the secretary position amid a travel scandal. Another source told the publication Azar is on a short list of candidates and a third said no selection is set in stone until a formal announcement.
For the drug industry, Azar is likely a preferable choice to Scott Gottlieb, the current head of the FDA whose name had also been floated as a potential replacement for Price. Gottlieb has largely won industry praise for his moves at the agency so far, and he's poised to streamline operations and drug reviews even further. But in a recent Reuters interview, Gottlieb said he's "most effective" at the drug agency, and he is now out of consideration, Politico reported.
With Azar in the HHS role, pharma could have two powerful allies at the top of the U.S. regulatory apparatus, at a time when drug pricing, patent protections and opioid use are among the most contentious issues facing the government. Trump has repeatedly—if intermittently—vowed to bring down drug prices, and members of Congress have a variety of initiatives in the works, some favorable to pharma, some not.
Reports had also pegged Centers for Medicare and Medicaid Services head Seema Verma as a top candidate to lead the HHS, but the publication's sources said she's out of the running too.
Azar ran Eli Lilly's U.S. unit until he stepped aside early this year in a management shakeup engineered by incoming CEO David Ricks. After Lilly, he formed a consultancy called Seraphim Strategies while exploring new opportunities, according to an online speaker profile. He has represented the biopharma industry as a board member of BIO, according to his LinkedIn page, and has experience as a general counsel and deputy secretary at HHS.
Pharma already has plenty of influence in Washington, D.C.; the industry spends more than any other on lobbying. As a former executive turned top health official, Azar might be more inclined to understand the industry's point of view in debates over a range of issues, even those beyond the high-profile drug pricing and opioid addiction problems.
For instance, the FDA has faced questions from Congress about its rare disease development incentives, and a new type of patent challenge, the inter partes review, has attracted the political spotlight in recent weeks as Allergan sought to avoid it by licensing key patents to the Saint Regis Mohawk Tribe.
Pricing, however, may be the biggest challenge for drugmakers, and news of Azar's consideration comes the same week that President Trump again hit out at the drug industry, reiterating his quote that pharma is "getting away with murder" and pledging to lower prices to levels comparable with other countries.
President Trump on prescription drug prices: "The drug companies, frankly, are getting away with murder." https://t.co/8JgNHMCnrn— NBC News (@NBCNews) October 16, 2017
In a statement, Public Citizen president Robert Weissman said if Azar ends up in the position, "then Big Pharma’s coup d’etat in the health care sphere will be virtually complete." Azar has argued against drug price controls in the past, Weissman said, making it "highly unlikely" he would "advance real reform" on the issue.
Of course, it remains to be seen what action Congress can take on drug pricing as they've had their hands full with healthcare reform so far during the Trump presidency. In lieu of pricing action in Washington, D.C., many states have taken the issue into their own hands. Maryland, Nevada and California have all passed laws aiming to tackle drug prices in different ways.