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November 30, 2017

The 4 top priorities of Trump’s HHS secretary nominee

Daily Briefing

    President Trump's HHS secretary nominee, Alex Azar, on Wednesday said prescription drug prices are too high and the federal government should work to address the issue.

    Today at 3 pm ET: Streamline PA processes for provider-administered drugs

    Azar made the comments during a Senate Health, Education, Labor, and Pensions Committee hearing on his nomination. The comments come amid questions about whether Azar would tackle rising prescription drug prices if confirmed as HHS secretary given his background as a pharmaceutical executive. Azar during the hearing said becoming HHS' secretary would be the "most important job [he] will ever have in [his] lifetime, and [his] commitment is to the American people and not any industry [he has] worked for."

    Azar added, "Through my experience helping to implement [Medicare] Part D and with my extensive knowledge of how insurance, manufacturers, pharmacy, and government programs work together, I believe I can bring the skills and the experiences to the table that can help us address these issues while still encouraging discovery so Americans have access to high-quality care." He continued, "I believe I can hit the ground running to work with you and others to identify solutions here."

    Four priorities

    During the hearing, Azar said he would focus on four priorities if he is confirmed as HHS secretary:

    • Addressing the U.S. opioid misuse epidemic;
    • Increasing access to health care and making care more affordable;
    • Lowering prescription drug prices; and
    • Moving Medicare away from fee-for-service payments and toward a value-based payment structure.

    Regarding prescription drug prices, Azar said he thinks "there are constructive things [the federal government] can do" to curb costs, such as working to increase competition in the prescription drug market by fostering the development of generic drugs. Azar said the federal government should look to stop brand-name drugmakers from "gaming … the system by patents and exclusivity agreements." He added that the government should examine why prescription drug prices are higher in the United States than they are in other countries.

    Regarding the shift toward value-based care, Azar said HHS under his leadership would "harness the power of Medicare to shift the focus in our health care system from paying for procedures and sickness to paying for health and outcomes." He added, "We can better channel the power of health information technology, and leverage what is best in our programs and in the private, competitive marketplace to ensure the individual patient is at the center of decision making and his or her needs are being met with greater transparency and accountability."

    According to the Washington Post, Azar did not comment on how he would address the other focus areas he named during the hearing.

    Other comments

    When asked about his views on contraceptives, Azar said he believed the Trump administration has successfully reached a balance between ensuring U.S. residents have access to affordable contraceptives and honoring "the conscience objections" of groups and people who oppose contraceptives.

    According to the Post, Azar also indicated that he was open to considering proposals to shift Medicaid to a block-grant program, saying such a move could "be an effective approach."

    When asked about actions the administration has taken that Democratic lawmakers said undermine the Affordable Care Act (ACA), Azar said, "My understanding was that the choices made were about what's working and what's not working." According to the Associated Press, Azar said the federal government must work to curb rising health insurance premiums. "Under the status quo, premiums have been skyrocketing year after year, and choices have been dwindling," he said, adding, "We must address these challenges for those who have insurance coverage and for those who have been pushed out or left out of the insurance market by the [ACA]."

    Next steps

    According to the Post, the Senate HELP Committee hearing was a so-called "courtesy hearing," because the committee does not vote on Azar's nomination. The Senate Finance Committee, which must vote on the nomination, has not yet scheduled a hearing for Azar (Goldstein/Eiplerin, Washington Post, 11/29; Mershon, STAT News, 11/29; AP/Chicago Sun-Times, 11/29; Edney, Bloomberg, 11/29; Mongan, McNight's Long-Term Care News, 11/30).

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