BioPharma, Policy

Trump adviser described as ‘key architect’ of drug-pricing blueprint to step down

John O’Brien, a former insurance industry executive, will step down less than one year after his appointment as senior advisory to HHS Secretary Alex Azar on drug-pricing reform. He had worked for HHS since March 2017 and also previously worked for CMS.

A Trump administration staffer described as playing a significant role in its drug pricing plan is leaving his current advisory role after less than a year.

In a statement Monday, Health and Human Services Secretary Alex Azar said that John O’Brien would be stepping down as senior adviser to the secretary on drug pricing reform, a position to which he was appointed in December 2018. Current Principal Deputy Director of the Center for Medicare John Brooks will take over the role.

O’Brien has served in HHS since March 2017, having most recently worked as vice president for public policy at CareFirst BlueCross BlueShield.

It was not immediately clear what O’Brien’s reason for leaving was, or what his next role will be. Reached via social media, O’Brien directed inquiries to an HHS public information officer. The spokesperson sent a statement from O’Brien that he was going to Florida to serve as a caregiver for his parents.

Azar described O’Brien as a “key architect” of the administration’s drug-pricing plan, a collection of policy proposals released last year that it said would reduce drug costs, and said O’Brien’s efforts had reduced out-of-pocket drug costs and would continue to do so.

“John O’Brien’s time at HHS will leave a legacy of lasting improvements to American healthcare, including the way that Americans pay for prescription drugs,” Azar said in the statement. From the beginning of President Trump’s administration, John led policy research, analysis and development on a number of important issues, including strengthening the Medicare program for our seniors and addressing the effects of the Affordable Care Act.”

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

Despite Azar’s praise for the blueprint, however, administration policies derived from it have encountered setbacks. Last month, a federal judge in Washington struck down a rule that HHS had implemented in May that would have required drugmakers to include list prices of medications in drug ads, setting up a potential battle in the Supreme Court. A few days later, it was reported that the administration had withdrawn a proposal to crack down on rebates that drugmakers offer to pharmacy benefit managers by removing their safe-harbor protection under anti-kickback laws.

Meanwhile, in addition to opposition from the pharmaceutical industry, experts have expressed skepticism about how much the administration would be able to accomplish on its own without congressional action, while also stating that its proposals did not go to the heart of factors that actually drive drug costs.

Photo: Mark Wilson, Getty Images

UPDATE: Subsequent to publication, an HHS spokesperson sent a statement that O’Brien would be returning home to Florida to care for his parents. The story has been updated to reflect the new information.