A Rolling Conflict of Interest

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Health Editor’s Note:  So it is possible that the nominee for Secretary for the Department of Health and Human Services (HHS) will be a former president of Eli Lilly’s U.S. business unit, Lilly USA, from January 2012 to January 2017.  I have a very bad/sick feeling about this.  How could we trust someone who has been employed by big pharma to make impartial decisions about factors that are vital to our healthcare?  While he was president of Eli Lily’s business unit, Forteo (a drug used to treat osteoporosis) developed a price hike from $947.20 (wholesale) in 2010 to $2,551.77 by 2016. This is exactly what has been happening with the price of drugs that are working to help people.  The prices go sky high and few can afford to stay on them, even when these drugs are vital for health and well-being. 

Azar shows his true partial colors as he also argued against the recommendations on containing drug costs issued in a recent National Academies of Sciences, Engineering, and Medicine (NASEM) report. I think we can see that the leopard has spots and those spots are not going to change just because he is put in charge of making more decisions of this ilk. He shows no signs of impartiality.

According to the Washington Post, “He suggested that he favors converting Medicaid, from its half-century history as an entitlement program open to anyone who is eligible, into a system of block grants with more freedom for states to set the rules. He acknowledged, however, that “the devil is in the details.” He would allow states to decrease or stop Medicaid for those who have already met the criteria for receiving Medicaid and CHIP which provide health coverage to nearly 60 million Americans, including children, pregnant women, parents, seniors and individuals with disabilities. 

The republicans see no problem with this irresponsible choice for this important healthcare position. The democrats are not such pushovers and are balking at this choice. Sure, let’s let the fox into the hen house and even give him the keys to it.  NO!  Bad Move! This is like sitting on the train tracks in a stalled car and watching that speeding train coming toward you and not bothering to get out of the car…….Carol   

Praise and Concern for Azar’s Pharma Background

HHS secretary nominee has GOP backers; Dems remain skeptical

by Shannon Firth, Washington Correspondent, MedPage Today  January 09, 2018

WASHINGTON — Having worked in the private healthcare sector seems to be a blessing and a curse for Alex Azar, JD, the nominee for Secretary of the Department of Health and Human Services (HHS) — at least according to members of the Senate Finance Committee.

During a hearing on Tuesday, several Democrats expressed reservations about, or blatant distrust of, Azar because of his time as a pharmaceutical executive.

Azar served as president of Eli Lilly’s U.S. business unit, Lilly USA, from January 2012 to January 2017, according to his LinkedIn profile. He is currently the chairman and founder of Seraphim Strategies, a consulting firm based in Indianapolis.

But Republican committee members said they considered Azar’s time in the private sector be an asset. Rather than disqualifying him, Azar’s years in pharma should be in his favor, according to chairman Orrin Hatch (R-Utah), who also asserted that concerns about Azar’s “nonexistent conflicts of interest” were simply “empty criticism” by Democrats.

Another Azar ally, Mike Leavitt, who served as HHS secretary under President George W. Bush, described him as “a man of good judgment… of compassion” and “a steady leader in crisis.” Azar worked as general counsel for HHS during Leavitt’s tenure. Leavitt is a former governor of Utah and the founder of Leavitt Partners, a healthcare consulting firm.

Democrats were having none of it. Ranking Member Ron Wyden (D-Ore.) brought out two large poster boards — one for the osteoporosis drug teriparatide (Forteo), and one for the attention deficit-hyperactivity disorder (ADHD) drug atomoxetine (Strattera). He pointed out that the price of both drugs shot up during Azar’s tenure.

For instance, in 2010, Forteo’s wholesale price was $947.20; that climbed to 2016 in $2,551.77, according to the New York Times. Wyden stressed that Azar had “direct responsibility for pricing strategy of the biomedicine unit.”

When Wyden asked whether Azar had ever lowered the price of any drug while serving as company president, Azar responded that “every incentive in the system is toward higher prices, and that is where we can do things together working with the government to get at this … That’s why I want to be here working with you.”

“Let the record show that when that specific question of Mr. Azar was asked… Mr. Azar said ‘No,'” Wyden responded.

When asked for more details on how he would lower drug prices, Azar mentioned “robust competition,” and value-based or outcomes-based pricing.

He also argued against the recommendations on containing drug costs issued in a recent National Academies of Sciences, Engineering, and Medicine (NASEM) report. To follow those suggestions would mean instituting a single national pharmacy and restricting access to certain drugs, Azar said. “I don’t think we want to go there.”

Sen. Bill Nelson (D-Fla.) highlighted Democrats’ concerns that Republicans would try to fill the $1 trillion hole in the budget made by the recent GOP-led tax reform bill with cuts to Social Security, Medicare, or Medicaid.

Azar said that President Trump had already announced he wouldn’t cut these programs, and that “I will live up to that if I’m confirmed.”

However, when Nelson asked Azar if he supported raising the Medicare eligibility age, Azar was noncommittal. “What we have to do is make sure that Medicare is going to be sustainable for our beneficiaries over the long run,” he said.

Sen. Maria Cantwell (D-Wash.) asked if Azar supported shifting Medicaid to a block grant, he responded, “The devil there is in the details … both in terms of the dollar amounts and what strings from the government are attached to it.”

He also reframed what Democrats call “cuts” to the Medicaid program as “slowing the rate of growth over the next 10 years in the interest of sustainability.”

In terms of potential repeal-and-replace efforts for the Affordable Care Act (ACA), Azar called elements of the Graham-Cassidy bill “very positive [for] empowering states to run their budgets.”

Currently federal dollars increase when state budgets increase, Azar said, and as a result, states are less inclined to manage those dollars as creatively or exercise “fiscal fraud waste and abuse stewardship.”

Senate Democrats aren’t alone in their concerns about Azar.

“At a time when our country is facing a crisis of access to affordable medicines, we need an untainted and credible advocate for patients and our healthcare system. A former prescription drug company executive with a history of spiking the prices of lifesaving medicines simply is unqualified to address the needs of our national healthcare system,” wrote Public Citizen in a statement signed by dozens of advocacy and medical organizations, including the American Medical Students Association, the National Physicians Alliance, and National Nurses United, urging Congress not to advance Azar’s nomination.

The letter spotlighted Azar’s criticism of the ACA — his “circling the drain” comment — his support for funding Medicaid block grants, and his reluctance to commit to no-cost sharing contraception.

But Azar has received endorsements from the American Hospital Association, the Federation of American Hospitals, the National Community Pharmacists Association, and America’s Health Insurance Plans.

Azar was nominated to the post of HHS secretary in November 2017, following the resignation of Tom Price, MD. He has until this Thursday to respond to senators’ questions left unanswered at the hearing. The committee’s vote on whether to send Azar’s nomination to the Senate floor will come sometime later; no date has yet been set.

3 COMMENTS

  1. The fox guarding us chickens will be watching over profits as well maybe to the chagrin of others in big pharma. Generic substitutes could even become cannon fodder. This trumps the pick for secretary of Education. Never has so much been spent on heath care and prevention where the population seems to get more ill. Our spastic system of healthcare is twisted top to bottom. Healthcare providers get great marks as a majority on a positive note. Every one needs to take an active approach towards their health.

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