Former Eli Lilly exec Alex Azar, President Donald Trump’s nominee to replace the ousted U.S. Department of Health and Human Services’ Secretary Tom Price, told the Senate HELP confirmation hearing Wednesday morning that his top priority was to make prescription drugs more affordable.

“Drug prices are too high. The president has made that clear. And so have I,” said Azar. “I believe I can bring the skills and experiences to the table that can help address these issues.”

To Azar, the crux of the issue is drug manufacturers gaming the system and a need for competition that can be fueled by the use of generic drug offerings.

The point was continually reiterated and examined throughout the hearing on both sides of the aisle, and for most senators Azar’s answers were satisfactory.

Most Republicans touted Azar’s successful experience in both the government and private sectors. But Azar drew some skeptical questioning from many Democrats -- and even Sen. Rand Paul, R-Kentucky.

Rand laid into Azar about his opposition to consumers importing lower-cost drugs from other countries from the EU and other countries.

“You’d have to sit there and say the EU has unsafe drugs… It’s a canard,” said Paul. “That’s B.S. and the American people think it’s B.S.”

“We have this enormous drug problem, and nothing happens… It’s big pharma’s fault, but we’re letting them do it…. You’re going to have to prove that you’re working for the American people and not big pharma,” he continued. “You’ve got some convincing to make me believe you are going to represent the American people.”

Azar acknowledged the current system isn’t working, but didn’t get into detail on how he planned to change it. As one of his priorities, Azar said he would come down on drug companies that attempt to game the patent system, such as making superficial changes to insulin pens to ward 
off generic alternatives.

He also supports the use of drug rebates, but didn’t explain any possible constraints on list pricing set by pharmaceutical companies.

Drug pricing would be just one of Azar’s four priorities as secretary, also included were fighting the opioid epidemic, combating overpriced healthcare and ensuring all Americans have access to affordable, quality healthcare.

But Sen. Patty Murray, D-Washington expressed concerns over many of Azar’s comments and viewpoints. To Murray, it would be a “fox guarding the henhouse.”

Another recurring topic? Women’s healthcare.

Murray, Sen. Al Franken, D-Minnesota, and Sen. Elizabeth Warren, D-Massachusetts -- to name a few -- grilled Azar on his “conscience exemption” stance, which lets organizations opt out of some healthcare services for women -- including abortion and contraceptives.

Azar repeatedly sidestepped the issue. When Franken kept pressing the point, based on a 2011 recommendation from the National Academy of Sciences’ Institute of Medicine that access to free birth control had many benefits, Azar kept pointing to the need to respect the “conscience objections.”

As only “about 200 employers” fall into this category, Azar said the impact would be minimal. And the administration has created a balance between the ethical objections posed by some organizations and making sure women have access to affordable contraceptives.

But Warren felt Azar’s responses were far too similar to Tom Price -- who was pressured to resign in September during an investigation into his use of private planes for official business -- on the taxpayers’ dime.

“You can own up to the fact you want to cut Medicaid and gut the affordable care act, like every other member of the Trump administration,” said Warren. “But you want to smile and pretend otherwise until you get the job.”

“And yet, you say exactly the same things that would let you pick up right where Tom Price left off in trying to gut the Affordable Care Act,” she continued. “Tom Price lied through his confirmation hearing. And now you come in here and say the same things he said: No one should be fooled.”

Azar was general counsel for HHS from 2001 to 2005 and was deputy secretary for two years. The Senate confirmed these positions. He followed his tenures at Eli Lilly, and resigned from the position of President of Lilly USA in 2012.

If confirmed, Azar will be the first HHS Secretary to come from the pharmaceutical industry.

Twitter: @JessieFDavis
Email the writer: jessica.davis@himssmedia.com