It should come as no shock that Donald Trump has nominated Alex Michael Azar II, a former Pharma executive and lobbyist, to head the Department of Health and Human Services. After all, Trump named Scott Gottlieb, a Pharma consultant and stock speculator FDA commissioner and EPA opponent Scott Pruitt to be head of the EPA.

Azar would replace Tom Price, who resigned amid a scandal over his use of taxpayer money for his personal and official travel.

While serving as president of Lilly USA, Azar presided over a tripling of the price of its insulin. But that is just the tip of the iceberg.

Azar was vice president of Lilly’s U.S. Managed Healthcare Services in 2009 when the company paid $1.415 billion to settle criminal charges for illegally promoting its antipsychotic Zyprexa for off-label uses. Only four years earlier, the company had pleaded guilty for similar illegal promotion of its hormone drug Evista.

"The company made hundreds of millions of dollars by trying to convince health care providers that Zyprexa was safe for unapproved uses," said Laurie Magid, U.S. Attorney for the Eastern District of Pennsylvania, "putting thousands and thousands of patients at risk." Specifically, Lilly promoted Zyprexa for the elderly despite an increased risk of death in those with dementia. In its own published data which it hid from doctors and regulators according to the New York Times 30 percent of patients on Zyprexa gained 22 pounds or more, 16 percent gained 66 pounds or more and some patients gained over 100 pounds. The drug also caused ever-rising blood sugar levels.

Court documents unsealed in South Carolina in 2009 show that Eli Lilly sales reps actually used golf bets to push Zyprexa sales. One doctor agreed to start new patients on Zyprexa “for each time a sales representative parred.”

Three months after its guilty plea for Zyprexa off-label marketing in 2009, the unrepetant Lilly sought FDA permission to sell Zyprexa to adolescents––and got it.

In 2007, when Azar served as Lilly's spokesman and top lobbyist the Times reported that Lilly had created a company, Comprehensive NeuroScience, to counsel states on how best to use its products. No conflict of interest there. At the time, Zyprexa was the "single biggest drug cost for state Medicaid budgets," selling for $300 for a monthly prescription, reported the Times.

"I’m skeptical of a drug company program that says, 'We’ll hold down use of our drug,'" said Stephen W. Schondelmeyer, a professor of health care economics at the University of Minnesota of the program.

Lilly admitted its counseling program was created to fight state efforts to cut use of its drugs and preserve tax dollars. Doctors who veered from the program guidelines received “Dear Doctor” admonishing letters. The program also tracked whether patients were renewing prescriptions and if not their doctors were notified.

Lilly's efforts coincided with Pharma's continuing campaign against "prescription abandonment"––patients leaving drugs at the pharmacy when they see the price. Pharma says it really cares about the wellbeing of patients but apparently not enough to lower its prices. Pharma cost-cutting programs for low-income patients are just PR window-dressing and cost shifting––Pharma still gets its high prices.

Lilly is known for inventing Prozac, which ushered in the era of serotonin-active antidepressants that as much as a quarter of the U.S. population now takes. It sought to reprise its success with Prozac with the antidepressant Cymbalta but things went terribly wrong. During Cymbalta clinical trials in 2004 in the Eli Lilly laboratory in Indianapolis the previously healthy volunteer Traci Johnson hung herself. A year after Cymbalta hit drug store shelves, it was indicted for causing more than twice the rate of suicide attempts in women prescribed the drug for stress urinary incontinence, a use not approved in the US, according to the FDA.

Carol Anne Gotbaum, daughter-in-law of New York City Public Advocate Betsy Gotbaum, was taking Cymbalta during her macabre death in police custody at the Phoenix’s Sky Harbor airport in 2007.

Does anyone believe an executive who enabled such profiteering, looting of tax dollars and unethical marketing of dangerous drugs should be health secretary?