Former executive Alex Azar appeared before the Senate on Wednesday, denouncing drug price hikes while touting his pharmaceutical industry experience

This article is more than 2 years old

This article is more than 2 years old

Donald Trump’s pick for health secretary, former drug company executive Alex Azar, said drug prices “are too high” and pitched himself as a proponent of reining in “abuse” by pharmaceutical companies, at his confirmation hearing.

Trump nominates ex-drug company executive as new health secretary Read more

The 50-year-old attorney and former drug company executive is an unusual nomination because most secretaries have come from academia or government – not industry.

The health and human Services agency has a $1tn budget, approves drugs from companies Azar once advised, and manages health programs that directly insure one in three Americans.

“Drug prices are too high. The president has made this clear, so have I,” said Azar, while touting his experience as a pharmaceutical executive. “I can bring the skills and experience to the table to help us address these issues while still encouraging discovery.”

The full Senate must approve Azar’s nomination before he is confirmed. If approved, Azar would be the second health secretary of the Trump administration. Former health secretary Dr Tom Price resigned after paying for private jets with taxpayer funds.

Azar worked at the US-affiliate of Eli Lilly for roughly a decade before founding his own consulting company in Indiana. During that time, Azar built a net worth of up to $20.6m, according to government ethics filings.

Azar previously worked at the health department under George W Bush, and was a law clerk under the deceased supreme court Justice Antonin Scalia, among his conservative credentials. However, senators in both parties expressed skepticism of Azar’s experience as a drug company executive.

Democratic Senator Elizabeth Warren said Azar’s résume, “reads like a how-to manual for profiting from government service”. Republican senator Rand Paul said that Azar would have to do “some convincing to make me believe you’re going to represent the American people and not big pharma”.

In addition, Azar was questioned about whether he intended to keep birth control accessible to American women. Health reforms by Barack Obama made contraception free in many health insurance plans, a requirement known as the “contraceptive mandate”, but the Trump administration has significantly eroded that provision. Azar appeared keen to continue Trump’s policies.

“I also will, as the president has done, try to balance the conscious objections of organizations and individuals there,” said Azar. He said requiring insurance cover birth control a “balance”, between women’s need for it and employer’s objection to paying for it, even indirectly.

However, the main focus of Azar’s testimony was drug prices, a topic that has scandalized Americans as the price of prescriptions for everything from dry eyes to allergic reactions to opioid overdose reversal medications has soared.

During Azar’s time at Eli Lilly, the company increased the price of insulin 450% above inflation over the last two decades, according to one analysis.

In one testy exchange with Democratic senator Tammy Baldwin, who asked Azar what she should tell her diabetic constituents, Azar implied no particular drug maker played a role in raising prices.

“The system makes it,” said Azar, before he was interrupted by Baldwin.

“So, I should just tell him it’s the system?” Baldwin asked.

“The system has to get fixed, that’s the problem,” said Azar, who said lack of insurance was the overarching problem with high-priced drugs.

“It’s a complicated system, and it’s this and that,” said Baldwin dismissively. “It starts with the manufacturers setting the list prices.”