Stat Plus: Republicans’ surprising Becerra attack: He’s not sympathetic enough to pharma

WASHINGTON — Republican senators on Tuesday blasted President Biden's health secretary nominee using an unexpected argument: He's not sympathetic enough to the pharmaceutical industry.

The attack on Xavier Becerra, California's attorney general, is a surprising twist following years of agitation on Capitol Hill and from the Trump administration over high drug prices. But it also highlights the credibility that pharmaceutical companies may have earned after developing several Covid-19 vaccines in record time, and the challenge Becerra could face in balancing pricing frustrations with the industry's central role in pandemic response.

During a hearing before the Senate Health, Education, Labor, and Pensions Committee, Sen. Richard Burr (N.C.), the panel's top Republican and a longtime drug industry ally, attacked Becerra's credentials, comparing his track record to Trump health secretary Alex Azar's "extensive career in the pharmaceutical sector" prior to leading the Department of Health and Human Services. Sen. Ted Cruz (Texas), who does not hold a seat on either committee overseeing Becerra's confirmation, told Fox News that Becerra was an "extreme" nominee, in part because "he's never worked at a pharmaceutical company."

Republicans' surprising line of attack runs counter to most Americans' starkly negative view of the pharmaceutical sector, and the fact that before Azar, no health and human services secretary had ever previously worked for a drug company.

Separately, Sen. Bill Cassidy (R-La.), a physician, attacked Becerra for not being a doctor, arguing that nominating a lawyer to lead HHS was akin to nominating a doctor to serve as attorney general. But Azar, too, is a lawyer, and most modern health secretaries also have not held medical or nursing degrees, though there are a few exceptions.

Becerra, who would become the nation's highest-ranking health official if confirmed, brings at least some experience in health care policy and regulation, which he highlighted during his testimony.

"I helped write and pass the Affordable Care Act from the Ways and Means Committee," he said. "I fought to strengthen and modernize Medicare. …. I've worked to hold opioid manufacturers accountable for the addiction crisis. I've taken on hospital and drug makers who unfairly jack up prices on patients. I've protected patients' privacy."

Becerra also pledged to immediately focus on the ongoing Covid-19 pandemic, which has killed 500,000 Americans to date. Early priorities, he said, would include administering millions of vaccines, ensuring government scientists play a central role in crafting policy, and scaling up genomic sequencing of the virus so that U.S. officials can better detect and respond to new variants.

During the hearing, Sen. Patty Murray (D-Wash.), the committee chair, highlighted Becerra's experience as California attorney general, including a nearly $70 million settlement he secured from several generic drug manufacturers over "pay-for-delay" agreements that prevented cheaper generic medicines from entering the market.

Becerra's other noteworthy health care experience includes founding a drug pricing task force in Congress and extracting a $575 million antitrust settlement from Sutter Health, a major California hospital system. Becerra has also supported "Medicare for All" proposals in the past, a progressive position that puts him out of step with the Biden administration.

Sen. Mitch McConnell (Ky.), the Senate's top Republican, said in a statement that he was "hard-pressed to see any way such a radical and underqualified nominee should fill such a critical post at this crucial time." The Senate is currently split 50-50 between Democrats and Republicans, but unanimous Democratic support would be sufficient to confirm Becerra after a tie-breaking vote from Vice President Kamala Harris.

Burr, in particular, used Becerra's record on drug pricing as a central line of attack, particularly his interpretation of Bayh-Dole, the intellectual property law that grants the government "march-in" authority. That drug pricing policy, which Becerra has supported in the past, allows the federal government to effectively invalidate a drug company's monopoly power if it determines a medication is priced unfairly. It has never been put to use.

The successful development of at least two effective Covid-19 vaccines in record time, Burr argued, shows that aggressive pricing interventions could prevent the development of lifesaving pharmaceuticals.

"American innovation and ingenuity are rescuing us from the devastation of a global pandemic," he said. "Your actions as attorney general for California and your tenure in Congress reveal somewhat of a disregard for the value of this ingenuity, calling for policies that undo decades of investment in and support of Americans' biomedical research."

Even in the face of GOP criticism, Becerra touted his drug pricing work, pledging to Sen. Bernie Sanders (I-Vt.) that the issue would be a priority.