- Alex Azar — President Donald Trump’s pick to replace Tom Price as HHS Secretary — testified before the Senate HELP Committee on Wednesday.
- Azar largely defended what Democrats called sabotage of the Affordable Care Act (ACA), saying it was his understanding that recent actions by HHS to reduce funding for advertising and outreach were made based on what the department sees as most effective.
- He said tackling high prescription drug prices would be his top priority, and that increasing competition between generic and branded drugs could help lower costs. But critics say the former pharmaceutical executive would not enact meaningful reform to bring down the costs of drugs.
Despite a tough hearing that included one Republican threatening to vote against his confirmation, Azar is still likely to be approved as the next HHS secretary. The nominee previously served at the department as general counsel and then as deputy secretary under President George W. Bush.
During the hearing, Sen. Al Franken (D-Minn.) asked Azar if he would support direct government negotiation under Medicare Part D, but the nominee argued pharmacy benefit managers already capture savings for the program.
Instead, Azar suggested the government look at making Medicare Part B more like Part D. “What I’d like to do is think about how do we take the learnings from Part D maybe into Part B. Part B does not have negotiations,” Azar responded.
In his prepared opening statement, Azar argued that Medicare must focus on shifting from paying for procedures to paying for health and outcomes. During the hearing, Azar appeared to endorse the idea of revisiting Medicare block grants, saying it could be an effective approach. But the nominee also lauded former HHS Secretary Sylvia Mathews Burwell’s work on new alternative payment models, saying he would like to continue exploring such efforts.
Azar slammed the implementation of EHRs, saying that without improved interoperability, EHRs place too much of a burden on physicians. HELP Committee Chair Lamar Alexander (R-Tenn.) said he would work with Ranking Member Patty Murray (D-Wa.) on the potential creation of a bipartisan roundtable to continue discussing EHRs.
Sen. Rand Paul (R-Ky.) threatened to vote against Azar’s nomination after questioning if Azar would support a path toward importing drugs. The nominee pointed to past Food and Drug Administration commissioners from both parties who have been unable to certify safe drug importation, saying he would not support unsafe importation.
Consumer advocate group Public Citizen slammed Azar on Wednesday, saying he would be opposed to meaningful drug pricing reform and favor weaker safety approval standards. Azar’s testimony largely echoed FDA Commissioner Scott Gottlieb’s efforts, pointing squarely at increasing generic competition to branded drugs and preventing the evergreening of patents as methods to reduce pharmaceutical costs.
The former Eli Lilly executive still needs to testify before the Senate Finance Committee, which has jurisdiction to advance his nomination. The committee has not announced when that confirmation hearing will be held.