The U.S. Department of Health and Human Services has been awaiting a new secretary since Tom Price resigned in September, after it became public knowledge he had spent over $1 million in taxpayer money. President Trump announced the new nominee, Alex Azar, on November 13, and many people with diabetes felt impending doom.
To some, Alex Azar is a puzzling pick for President Trump, who has been quoted saying drug companies are getting “away with murder.”
Azar’s credentials look great; he received a law degree from Yale and has spent his career practicing within the healthcare field, including as Deputy Secretary of Health and Human Services. What has many concerned is where he went after that: to head Eli Lilly USA, one of the ‘big three’ insulin manufacturers that dominate approximately 90% of the insulin market.
What Azar’s Nomination Means for People with Diabetes
CNN reports, “Citing data from Bernstein Research, CNBC recently said that the prices of Lilly’s insulin drugs Humalog and Humulin N rose 20.81% in 2014 and 16.96% in 2015, under Azar’s watch. Since 1994, the company has raised the price of insulin over 1000%. Six million Americans depend on insulin to keep them alive, and high prices are already forcing a multitude to skip doses, putting their lives in danger.
Some worry that Azar may push for value-based pricing, which could mean that prices are set based on the perceived value of a drug or on patient health outcomes. Such a pricing system is worrying because it could restrict insulin affordability for those who do not have good control. It also leaves us with many questions. What defines control? Does this mean those forced to ration insulin and let their blood sugar run high do not have control? Does it mean that because insulin saves lives it’s ‘value’ will be set at a price so high that it costs even more than the current high rates?
We cannot know for certain how things would play out if Azar is confirmed. However, USA Today notes that the new HHS secretary can directly impact our health, so this is exactly why people with diabetes need to be concerned about this nomination. Many feel that Azar is unlikely to hold big pharma accountable for its prices. A statement by the patient advocacy organization Public Citizen said “Alex Azar has made clear that he is opposed to measures to restrain prescription companies’ profiteering and limit improper marketing, while favoring weaker safety approval standards.”
Emphasizing the control the department has over the system, Azar also said in a TV interview, “I’m not one to say many good things about Obamacare, but one of the nice things in it is it does give a tremendous amount authority to the secretary of HHS.” Since the Trump administration has already slashed some of the positive things Obamacare offers, it is reasonable to conclude Azar would continue the job.
“A vigorous and profitable drug industry is not a problem to be solved, but a goal to be encouraged” Azar said in 2006 speech.
It would be a great step backward for the drug pricing battle if Alex Azar takes the reigns at HHS. Sure, he seems intelligent, but does knowledge mean that a person has the compassion required to make humane healthcare decisions? People with diabetes have already died because they could not afford insulin. Now President Trump wants to merge the two powerhouses that are responsible for the inexplicably high cost of insulin: the government and insulin manufacturers.
If they were not already, people with diabetes should be very worried about the future of their health care and being able to afford the drugs they need to stay alive.