We’ve all heard President Trump talk about the need to bring drug prices “way down.”[i]

And when he said drug companies were “getting away with murder,”[ii] he voiced a widely-held belief: 73% of Americans say they think drug companies make too much profit, and 77% say the cost of prescription drugs is unreasonable.[iii]

This makes all the more troubling that on November 13, Trump officially announced that Alex Azar is his nominee for Secretary of the U.S. Department of Health and Human Services (HHS).[iv]

Congressional Progress Caucus Co-Chairs Raul Grijalva and Mark Pocan, and CPC Healthcare Taskforce Chair Jan Schakowsky, did not mince their words in a letter sent to President Trump expressing their strong opposition to the nomination of career pharma executive Alex Azar’s as HHS Secretary:

“Mr. Azar’s appointment would send a very clear signal that your Administration is happy to put the pharmaceutical fox in charge of the health care henhouse.”

The appointment would contradict the President’s pledge to “drain the swamp” and change Washington’s pay-to-play atmosphere, where a lucrative revolving door moves former federal regulators into jobs at huge corporations – and back again into government.[v]

Azar’s Resume of Swampy Experience

Alex Azar served as Deputy Director of HHS under President George W. Bush before moving to Eli Lilly. Between June 2007 and January 2017, Mr. Azar held various senior roles at Lilly USA, LLC, the final five years of which he served as President.

During this period, Eli Lilly and Company:

  • Boosted the price of a vial of its best-selling insulin product to $255, a 1,214%, increase from 1996;
  • Became the subject of several legal proceedings and law enforcement investigations related to the company’s pricing of insulin products;
  • Allegedly bribed officials in multiple foreign countries;
  • Conducted illegal off-label marketing, resulting in “the largest criminal fine for an individual corporation ever imposed in a United States criminal prosecution of any kind”;[vi] and
  • Spent millions in federal and state lobbying to thwart efforts at price transparency, and placed Mr. Azar as a senior executive in BIO, the powerful prescription drug lobby trade association.

Worse Than Luxury Jet-Setting

Alex Azar risks replicating the troubled tenure of his predecessor, Tom Price.

Price was drummed from office after his repeated use of taxpayer money to fund trips on private planes was revealed,[vii] but his short stint as HHS Secretary was marred throughout by questions of conflict of interest.

As a Congressman, Price had introduced legislation that would have directly benefited drug companies in which he held stock,[viii] and during his confirmation he failed to fully explain his legislative efforts on behalf of the drug industry.[ix],[x]  [xi]

Alex Azar’s conflicts are clearer and more troubling than Mr. Price’s.

Eli Lilly’s involvement in drug price gouging, in crimes that drew the largest corporate fines in U.S. history, and in the unleashing of a gusher of lobbying cash during his tenure at Lilly USA make Alex Azar uniquely unsuited to any cabinet post, let alone one with oversight of America’s struggling health care system.

Azar has been a lead fox in the hen house of American health care, ripping off Americans while the President of the prescription drug company Eli Lilly USA, LLC and as an executive of the powerful prescription drug lobbying organization BIO.

Americans Deserve Better for their Health Care

Time and again, when asked to list their number one public policy priority, Americans choose healthcare.[xii]

For many, their own health and the health of their families is an existential issue. Of the issues plaguing our health care system, soaring prescription drug costs are among the most financially devastating for working Americans.

These crippling prices are protected by one of the world’s most powerful special interests: the lobbying power of the pharmaceutical industry.[xiii]

Congress must stop the Azar nomination and put the health care needs of the American people ahead of corporate interests.

Serving Whose Interests?

While 76% of people favor allowing Americans to buy prescription drugs imported from Canada,[xiv] when asked about this on Fox Business’ Varney & Co. on June 16, 2017 Mr. Azar said,

“One of the best things in the American health care system is our closed distribution system. We have such tight control on product here in the United States [….] This thing about importing drugs from Canada is a canard [….] The U.S. distribution system is a crown jewel, let us not mess that up.”[xv]

While 87% of Americans want spending on Medicaid to stay about the same or to increase,[xvi] Mr. Azar has said,

“I think there’s a lot to commend a block grant approach [to Medicaid] because the states are the laboratory for experimentation [….] It makes them better stewards of the money. It becomes their money again to make the choice.”[xvii]

But experts agree that changing Medicaid to a block grant would reduce the program’s funding over time.[xviii]

[i] For example: Michael Scherer, “2016 Person of the Year: Donald Trump,” Time, December 7, 2016, http://time.com/time-person-of-the-year-2016-donald-trump/; Damian Paletta, Thomas M. Burton and Jonathan D. Rockoff, “Trump Tells Pharmaceutical CEOs He Wants Prices Down,” Wall Street Journal, January 31, 2017, https://www.wsj.com/articles/trump-tells-pharmaceutical-ceos-he-wants-prices-down-1485875553?mg=prod/accounts-wsj.
[ii] Sarah Karlin-Smith, “Trump says drug industry ‘getting away with murder’,” Politico, January 11, 2017, https://www.politico.com/story/2017/01/trump-press-conference-drug-industry-233475.
[iii] Kaiser Family Foundation, “2015-2017 Kaiser Family Foundation Health Tracking Polls” https://www.kff.org/slideshow/public-opinion-on-prescription-drugs-and-their-prices/.
[iv] ANDREW RESTUCCIA, ELIANA JOHNSON, SARAH KARLIN-SMITH and JOSH DAWSEY, “Trump leaning toward former pharma exec for health secretary,” Politico, October 17, 2017, https://www.politico.com/story/2017/10/17/alex-azar-trump-health-secretary-243876.
[v] Isaac Arnsdorf, Josh Dawsey and Daniel Lippman, “Will ‘drain the swamp’ be Trump’s first broken promise?,” Politico, December 12, 2016, https://www.politico.com/story/2016/12/trump-drain-swamp-promise-232938.
[vi] Press Release, “Eli Lilly and Company Agrees to Pay $1.415 Billion to Resolve Allegations of Off-label Promotion of Zyprexa: $515 Million Criminal Fine Is Largest Individual Corporate Criminal Fine in History; Civil Settlement up to $800 Million,” Department of Justice, January 15, 2009, https://www.justice.gov/archive/opa/pr/2009/January/09-civ-038.html.
[vii] The Editorial Board, “The Trump administration is using Obamacare marketing dollars to attack Obamacare,” The Los Angeles Times, July 21, 2017, http://beta.latimes.com/opinion/editorials/la-ed-hhs-obamacare-attack-ads-20170721-story.html.
[viii] Sam Frizell, “Donald Trump’s Cabinet Pick Invested in 6 Drug Companies Before Medicare Fight,” Time, January 17, 2017, http://time.com/4636351/tom-price-drug-companies-investments/
[ix]  Robert Faturechi, “Tom Price Bought Drug Stocks. Then He Pushed Pharma’s Agenda in Australia,” Pro Publica, June 1, 2017, https://www.propublica.org/article/tom-price-bought-drug-stocks-then-he-pushed-pharma-agenda-in-australia
[x] Sam Frizell, “Donald Trump’s Cabinet Pick Invested in 6 Drug Companies Before Medicare Fight,” Time, January 17, 2017, http://time.com/4636351/tom-price-drug-companies-investments/; Robert Faturechi, “Tom Price Intervened on Rule That Would Hurt Drug Profits, the Same Day He Acquired Drug Stock,” ProPublica, March 31, 2017, https://www.propublica.org/article/tom-price-intervened-rule-hurt-drug-profits-same-day-acquired-drug-stock?utm_source=suggestedarticle&utm_medium=referral&utm_campaign=readnext&utm_content=https%3A%2F%2Fwww.propublica.org%2Farticle%2Ftom-price-intervened-rule-hurt-drug-profits-same-day-acquired-drug-stock.
[xi] Peter Baker, Glenn Thrush, Maggie Haberman, “Health Secretary Tom Price Resigns After Drawing Ire for Chartered Flights,” New York Times, September 29, 2017, https://www.nytimes.com/2017/09/29/us/politics/tom-price-trump-hhs.html.
[xii] For example: Dylan Stafford, “Poll: Americans say health care is most important issue,” CNN, July 17, 2017, http://www.cnn.com/2017/07/17/politics/bloomberg-poll-health-care-findings/index.html (poll conducted by Bloomberg News on July 8-12, 2017); Art Swift, “Healthcare Surges as Top Problem in U.S.,” Gallup News, May 12, 2017, http://news.gallup.com/poll/210545/healthcare-surges-top-problem.aspx (poll conducted by Gallup on May 3-7, 2017); and “Early Exit Polls: Health Care Most Important Issue for Virginia Voters,” NBC News, November 7, 2017, https://www.nbcnews.com/card/early-exit-polls-health-care-most-important-issue-virginia-voters-n818691 (exit polls indicating that health care was the top priority for Virginia voters in the gubernatorial election of November 7, 2017).
[xiii] According to the Center for Responsive Politics, “The pharmaceutical and health products industry — it includes not only drug manufacturers but also dealers of medical products and nutritional and dietary supplements — is consistently near the top when it comes to federal campaign contributions.” Open Secrets, “Summary: Pharmaceuticals/Health Products,” Center for Responsive Politics, https://www.opensecrets.org/industries/indus.php?cycle=2018&ind=H04, accessed 11/8/2017. See also the recent Washington Post and “60 Minutes” investigation about “A handful of members of Congress, allied with the nation’s major drug distributors, prevailed upon the DEA and the Justice Department to agree to a more industry-friendly law, undermining efforts to stanch the flow of pain pills [….] The law was the crowning achievement of a multifaceted campaign by the drug industry to weaken aggressive DEA enforcement efforts against drug distribution companies that were supplying corrupt doctors and pharmacists who peddled narcotics to the black market. The industry worked behind the scenes with lobbyists and key members of Congress, pouring more than a million dollars into their election campaigns….” Scott Higham and Lenny Bernstein, “The Drug Industry’s Triumph Over the DEA,” The Washington Post, October 15, 2017, https://www.washingtonpost.com/graphics/2017/investigations/dea-drug-industry-congress/?utm_term=.e8ab3ecbeb57.
[xiv] Kaiser Family Foundation, “2015-2017 Kaiser Family Foundation Health Tracking Polls,” https://www.kff.org/slideshow/public-opinion-on-prescription-drugs-and-their-prices/.
[xv] “White House tackles drug costs,” Varney & Co., Fox Business, June 16, 2017, http://video.foxbusiness.com/v/5474141290001/?#sp=show-clips.
[xvi] Kaiser Family Foundation, “Data Note: 10 Charts About Public Opinion on Medicaid,” June 27, 2017, https://www.kff.org/medicaid/poll-finding/data-note-10-charts-about-public-opinion-on-medicaid/.
[xvii] Dan Diamond, “Does the Alexander-Murray deal to patch ACA have a shot at success?,” Politico Pulse, October 18, 2017, https://www.politico.com/tipsheets/politico-pulse/2017/10/18/does-the-alexander-murray-deal-to-patch-aca-have-a-shot-at-success-222867.
[xviii] Robin Rudowitz, “5 Key Questions: Medicaid Block Grants & Per Capita Caps,” Kaiser Family Foundation, January 31, 2017, https://www.kff.org/medicaid/issue-brief/5-key-questions-medicaid-block-grants-per-capita-caps/.