President Trump’s nominee for Secretary of Health and Human Services, Alex Azar, was approved by the Senate Finance Committee yesterday, taking him one step closer to confirmation.

Though a former president of Eli Lilly, Azar has stated that lowering drug prices is his foremost priority, saying that abuses of the patent system by pharmaceutical innovators need to be curbed and competition from generics and biosimilars increased. While he is unlikely to push for radical changes if he is confirmed, his comments reflect the atmosphere of political disgruntlement in the US over the high cost of medical care – an atmosphere which looks set to keep pharma patents under the spotlight for the foreseeable future.

Given his experiences as the former president of a branded pharmaceuticals company, Azar is thought by many to favour a strongly pro-patent agenda. Some argue (see here and here) that he displayed a hawkish approach to IP while at Eli Lilly, which they expect to see reflected in his new role, if he is confirmed.

But so far Azar has departed from the message one might expect to hear from a conservative former pharmaceuticals chief. Addressing a Senate Finance Committee hearing last week, he reiterated his previous statement that there is a need to clamp down on the “gaming or exploitation of exclusivities or patents by branded drug companies”. He identified lowering drug prices as the first of his four core priorities, which he said also required greater competition from generic and biosimilar products.

To that extent, Azar has echoed critics of the US patent system, who see the length of exclusivity conferred on innovative pharma products as the key factor underlying high US drug prices (see here and here). And given President Trump’s previous remark that pharmaceuticals companies have been “getting away with murder”, some will wonder whether regulatory or legal reforms pertaining to exclusivity are on the cards.

But perhaps not too much should be read into Azar’s comments, though; after all, they were made during a confirmation hearing involving senators from across the political spectrum. And even then his tone was decidedly moderate: he cautioned the committee that there is “no silver bullet” for the problems faced by the US healthcare system and that any changes needed to be balanced against the need to encourage new drug discoveries. Moreover, Azar did not make any detailed criticisms of the patent system, or propose any specific changes.

But, even if Azar is unlikely to push for radical reforms, his words – coming as they do from a former branded pharmaceuticals chief – reflect the extent to which drug prices, and especially market exclusivity for pharmaceuticals, are under the political spotlight in the US at present. Whether or not Azar clears the final hurdle to become Health and Human Services Secretary, that seems unlikely to change – and one day, perhaps not too far into the distance, that might mean we see developments that could have a significant impact on the market where many big pharma patent owners tend to make most of their money.