President Donald Trump's Department of Health and Human Services (HHS) Secretary nominee Alex Azar told the Senate Finance Committee on Tuesday that drug prices "are too high" and he will work to bring them down, though, "There's no silver bullet."
Azar previously told the Senate Health, Education, Labor and Pensions Committee that drug prices will be his top priority.
The comments on Tuesday followed questions raised by Sen. Ron Wyden (D-OR) and others regarding Azar's past as an executive at Eli Lilly. Wyden noted multiple drugs that saw their prices double under Azar's watch.
As far as possible solutions to high drug prices, Azar pointed to generic drug and biosimilar competition and noted that he particularly wants to focus on drugs' list prices, which are set by manufacturers, though typically only patients without insurance are exposed to them.
Azar said he wants to work on creating incentives to pull down list prices, adding, "We have to make sure we go after any gaming of exclusivities or patents."
"No one company is going to fix this system," Azar said later, noting that he does not think there are any branded drugs that have seen decreased prices because the US system is incentivized for higher prices.
As far as value or outcome-based pricing deals that might be forged by the Centers for Medicare and Medicaid Services (CMS), Azar said they could be "an important part of how we think about prices."
But in terms of allowing CMS to further negotiate drug prices, Azar said the center already negotiates under its Part D program (though Pew Research has indicated ways to improve those negotiations) and that the only way to achieve more savings would be to create a formulary, noting, "I don't believe we want to go there and restrict patient access" to certain drugs. He also said that there could be room for negotiating prices under Medicare Part B.
Sen. Claire McCaskill (D-MO) brought up the influx of prescription drug advertisements in the US, noting, "I just do not understand why the American taxpayer is subsidizing this."
Azar said he shared her concerns and that he would be interested in working with US Food and Drug Administration Commissioner Scott Gottlieb to see if the agency's "approach on balance is working."