Trump’s call for Medicare to negotiate drug prices marks a rare area where the incoming president finds common ground with Democrats on health policy.

“You know, I’m sure you can imagine, I was encouraged,” Burwell said of Trump’s comments, in her final conversation with reporters before leaving office Friday.

She added that getting Medicare to negotiate drug prices is “something we’ve been talking about, working on for an extended period of time.”

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“It’s been in the president’s budget for a number of years, is an issue of import and one that drives overall costs,” she said.

Trump set his sights on pharmaceutical companies at his press conference last week, breaking with most Republicans on the issue, as he did during the campaign as well.

"The other thing we have to do is create new bidding procedures for the drug industry, because they’re getting away with murder," Trump said.

"PhRMA, PhRMA has a lot of lobbyists and a lot of power and there’s very little bidding on drugs," he added, calling out the drug companies.

Actually getting a bill allowing Medicare negotiation on drug prices through a Republican Congress would be an uphill task, though.

More broadly on the ObamaCare repeal fight, Burwell expressed hope that the conversation is shifting now that Republicans are coming to power and can actually enact many of their ideas.

“We are starting to see that movement from rhetoric to reality,” Burwell said.

She pointed to a new Congressional Budget Office report finding that 18 million people would lose coverage under repeal in the first year, and premiums would spike 20-25 percent.

“I am an optimist,” Burwell said. “It’s why I came here, it’s why I do the work I do, and I believe that when faced with this kind of impact that that’s not what people came here to do, and so that there will be a different trajectory.”

She said she has not had any extended conversations with the nominee to be her successor, Rep. Tom Price (R-Ga.), beyond an initial phone call after he was nominated.

The transition work has been with career staff at the department, she said, not political appointees like her.