WASHINGTON — President Trump, who has repeatedly assailed pharmaceutical companies for the high cost of prescription medications in the United States, nominated on Monday a former executive of one of the nation’s largest drug companies to be secretary of health and human services, which has responsibility for regulating the pharmaceutical industry.
Mr. Trump announced his choice of Alex M. Azar II, a former president of the American division of Eli Lilly and a health official in the George W. Bush administration, on Twitter while traveling in Asia. If confirmed, Mr. Azar would succeed Tom Price, who resigned from the post after revelations that he repeatedly used chartered jets for routine government travel.
In contrast to Mr. Price, an orthopedic surgeon and former Republican congressman, Mr. Azar is a lawyer and health care expert who allies predicted would use his deep knowledge of the federal bureaucracy to advance Mr. Trump’s agenda of undermining President Barack Obama’s health care law. Mr. Azar recently called the Affordable Care Act a “fundamentally broken system.”
“Much of the focus will likely be changing the ideology under which the existing law will be administered,” said Mike Leavitt, a former secretary of health and human services who was Mr. Azar’s boss during the Bush administration. “I’m confident that he would like to see the way the law works change.”
Mr. Trump said that Mr. Azar “will be a star for better health care and lower drug prices!” But the choice immediately raised new doubts among some lawmakers and industry observers about the president’s stated commitment to rein in drug companies.
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Critics mocked the selection by a president who promised to drain the Washington “swamp” of lobbyists and has complained about “RIPOFF DRUG PRICES” on Twitter. Representative Peter Welch, Democrat of Vermont, said that “instead of draining the swamp, he has set the fox to guard the henhouse.”
Senate Democrats vowed to scrutinize Mr. Azar’s record in the Bush administration and as a drug company executive.
“I am also interested in how, given Mr. Azar’s professional background, he believes he can fairly execute any significant effort to lower drug prices for patients,” said Senator Patty Murray, Democrat of Washington.
Senator Lamar Alexander, Republican of Tennessee and the chairman of the Health, Education, Labor and Pensions Committee, said Mr. Azar had “the qualifications and experience to get results” and promised to promptly schedule a hearing on his nomination.
In addition to his experience as a pharmaceutical executive, Mr. Azar brings to the job impeccable credentials as a conservative lawyer. A graduate of Yale Law School, he was a clerk for Justice Antonin Scalia on the Supreme Court in the early 1990s and spent two years as a young lawyer working for Kenneth W. Starr, the independent counsel who investigated President Bill Clinton.
If he is confirmed by the Senate, Mr. Azar would be returning to a sprawling agency where he served as general counsel and deputy secretary before spending a decade in the pharmaceutical industry. He resigned from Eli Lilly, which makes Cialis, Humulin and Trulicity among other popular and profitable drugs, in January.
Mr. Leavitt dismissed concerns that Mr. Azar’s work at Eli Lilly would interfere with his ability to seek lower drug prices.
“To solve the problems within the pharmaceutical industry, you have to understand the way the distribution system works,” Mr. Leavitt said. “Alex understands that as well as any person in the country.” If he were to be confirmed, Mr. Leavitt added, “Alex doesn’t work for the drug industry — he works for the president of the United States.”
Kathleen Sebelius, who succeeded Mr. Leavitt as health and human services secretary under Mr. Obama, said Mr. Azar’s knowledge of how the department worked would be a valuable asset if he was confirmed. But she said she had no doubt Mr. Azar would use that expertise to reverse the health care changes that she helped put in place.
“He may be the only secretary in modern history other than Tom Price to be given the job to take away people’s health care,” Ms. Sebelius said. “Alex is a smart guy. He clearly has watched the last year or so. I assume his agreement to come in means that he’s O.K. with enforcing or trying to promote the president’s agenda.”
Mr. Trump’s choice of Mr. Azar continues a pattern in which the president has put former industry officials in charge of regulating their former colleagues. At the Department of Health and Human Services, it would fall to Mr. Azar to follow through on the president’s threats to confront drug prices, many of which are manufactured by Mr. Azar’s former company.
Eli Lilly, where Mr. Azar worked for almost a decade, is one of three manufacturers of insulin whose prices have skyrocketed in recent years. The price increases by the three drug makers — Lilly, Novo Nordisk and Sanofi — have happened in near lock step and prompted outcries from patient groups. This year, a lawsuit filed by patients accused the companies of fixing prices.
Lilly again raised prices on two of its insulin products, Humalog and Humulin, by nearly 8 percent in May. The company has previously noted that many patients do not pay the list price for insulin because they benefit from rebates negotiated with insurers, and it offers discounts of about 45 percent off the list price for people without insurance.
When Mr. Trump nominated Dr. Scott Gottlieb to be the commissioner of the Food and Drug Administration in March, Democrats sharply criticized the selection, saying he could not be objective because he had earned hundreds of thousands of dollars as an investor in and consultant to pharmaceutical and biotechnology companies.
But since taking office in May, Dr. Gottlieb has put pressure on drug companies to hold down prices and has taken steps to increase competition in the prescription drug market by speeding the approval of lower-cost generic products.
“No patient should be priced out of the medicines they need,” Dr. Gottlieb said in June. And he followed up with several steps last month. “If consumers are priced out of the drugs they need,” he said, “that’s a public health concern that F.D.A. should address, within the scope of its mandate and authorities.”
John C. Rother, the executive director of the Campaign for Sustainable Rx Pricing, a coalition of consumer, labor and physician groups concerned about high drug prices, said Mr. Azar “is competent and knows a lot about health policy and the operations of the Department of Health and Human Services.”
“Even with his drug background, it’s hard to say anything negative” about him, Mr. Rother said, adding, “We sincerely hope that he will follow through on the president’s commitment to achieve lower drug prices.”/nytimes.com