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HHS nominee testifies on govt.'s role in lowering drug costs

The Washington Post
November 29. 2017 11:27PM
Alex Azar testifies during a Senate Health, Education, Labor and Pensions Committee hearing on his nomination to be Health and Human Services secretary on Capitol Hill in Washington, U.S., November 29, 2017. REUTERS/Yuri Gripas 

WASHINGTON — Alex Azar, in line to become the next health and human services secretary, testified Wednesday that prescription drug prices are too high and that the federal government has a role in trying to make medicine more affordable for consumers.

The focus on drug costs during Azar’s nomination hearing before the Senate Health, Education, Labor and Pensions Committee reflected an attempt to get ahead of criticism that the decade he just spent as a top executive at a major pharmaceutical company makes him ill-equipped to wrestle with one of the most vexing financial issues in the U.S. health-care system.

“I think there are constructive things we can do” to bring down the price of medicines, Azar said, sitting alone at the broad witness table in a paneled Senate hearing room.

He said he favors fostering competition between brand-name drugs and generic equivalents — an issue he worked on in the early 2000s while he was the HHS general counsel during the George W. Bush administration.

The HELP Committee’s ranking Democrat, Sen. Patty Murray, Wash., quickly retorted that the prospect of Azar presiding over federal policy on drug prices would be akin to “the fox guarding the henhouse.”

Drug prices were one of four central priorities that Azar said would guide him as HHS secretary if he is confirmed. The others, he testified, would be making health care more affordable and available, shifting Medicare further in the direction of creating incentives for good health outcomes rather than the volume of medical care, and fighting “the scourge of the opioid epidemic.”

He did not address how he would approach the other three priorities.

In response to questions from Democratic senators about his views on health coverage of contraceptives — an ideological flash point — Azar largely sidestepped. He said he had not studied a 2011 recommendation from the National Academy of Sciences’ Institute of Medicine that women should have access to free prescription birth control.

And he said the administration already has struck a balance between making affordable contraceptives available and respecting “the conscience objections” of people and organizations opposing that.

He indicated that he favors a goal of the president and many GOP conservatives to convert the Medicaid program for poor Americans from its half-century tradition as an entitlement system open to anyone eligible into a block grant that would allot states a fixed sum and more freedom from federal rules. ‘‘It can be an effective approach,” he said.

Azar was pressed on whether he agreed with steps President Donald Trump and administration officials have taken to undercut the Affordable Care Act.

“My understanding was that the choices made were about what’s working and what’s not working,” he said.

He gave a variant of that answer to questions about funding cuts for enrollment “navigators” who provide guidance to consumers, as well as on Trump’s decision to end payments to insurers to offset discounts the ACA requires them to give lower-income customers on deductibles and other out-of-pocket costs.

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