# Alex Azar Alex M. Azar II is the former pharmaceutical executive who served as the 24th Secretary of [[Department of Health and Human Services]] (2018–2021) under [[Donald Trump]]. He is the cleanest single illustration of the pharmaceutical [[Revolving Door]] in modern American politics: a government lawyer who left for industry, ran the U.S. arm of a major drugmaker through years of steep price hikes, and then returned to run the department that regulates that industry — tasked, explicitly, with lowering the drug prices he had helped raise. ## The Revolving Door, Personified Azar's career is a near-perfect loop between government and industry. Born in Johnstown, Pennsylvania in 1967, he went from Dartmouth to Yale Law, clerked for Justice [[Antonin Scalia]], and worked on Ken Starr's Whitewater investigation. He first entered HHS in the George W. Bush administration as General Counsel (2001–2005) and then Deputy Secretary (2005–2007), where he helped roll out the Medicare Part D prescription-drug benefit — a program structured to prohibit Medicare from negotiating drug prices, a long-standing industry priority. He then cashed the credential in. In 2007 he joined [[Eli Lilly]] as senior vice president for corporate affairs and communications, and from 2012 to 2017 served as president of Lilly USA, the company's largest affiliate. In 2018 he walked back through the door at the top, as Trump's HHS Secretary. His federal-government and lobbying-side ties are extensive enough that OpenSecrets maintains a dedicated revolving-door profile for him. ## The Insulin Record The defining knock against Azar is insulin pricing. During his years running Lilly USA, the list price of the company's flagship insulin, Humalog, roughly doubled — from around $123 per vial in early 2012 to roughly $255 by early 2017 — part of a broader pattern in which the three dominant insulin makers (Lilly, Novo Nordisk, Sanofi) raised list prices in close parallel, a dynamic critics describe as an insulin cartel. When Trump nominated him in 2017 to *lower* drug prices, the contradiction was immediate and widely noted: the Washington Post headlined him as "Trump's pick to lower drug prices" who "raised them," and one outlet branded him "the worst pharma bro of all." As Secretary he later promoted importing cheaper drugs from Canada — the very price gap his prior employer's pricing had helped create. ## HHS Secretary and COVID-19 As Secretary, Azar oversaw an ~85,000-person department and a budget exceeding $1.4 trillion, with authority over the [[FDA]], [[CDC]], [[NIH]], and [[CMS]]. His tenure was dominated by the COVID-19 pandemic. He chaired the White House Coronavirus Task Force in its early phase before being supplanted by [[Vice President Pence]], and was a principal architect of [[Operation Warp Speed]], the crash vaccine-development program he cites as his signature achievement. His pandemic record is contested: he is credited with the speed of the vaccine push but criticized for the early testing failures and the friction between HHS, the CDC, and the White House. Azar resigned effective January 20, 2021. In his resignation letter, written after the [[January 6 Capitol Attack]], he urged a peaceful transfer of power and warned that the assault on the Capitol threatened to tarnish the administration's accomplishments — stopping short of resigning outright in protest as some other officials did. ## After HHS: Boards and Conflicts Out of office, Azar reassembled a dense portfolio of health-industry positions: chairman of LifeScience Logistics, board seats at AbsoluteCare and Interwell Health, an advisory role at Foresite Capital, a trusteeship at the [[Aspen Institute]], and an adjunct professorship at the University of Miami business school. He also chaired the board of a company involved in Florida's Canadian drug-importation plan — the policy he had greenlit as Secretary, flagged by KFF Health News as a conflict. The most current example is [[Guardant Health]]. Azar joined its board in September 2025 for compensation valued around $725,000 a year. In June 2026, reporting noted that a proposed [[CMS]] national-coverage rule for blood-based colorectal cancer screening stood to benefit Guardant's Shield test — which runs roughly $1,500 versus about $500 for stool-based tests — reviving the same pattern that has shadowed his entire career: a former regulator positioned to profit from the decisions of the agency he used to run. ## Why He Matters in This KB Azar is less interesting as an ideologue than as **infrastructure**. He is a connective node linking [[Big Pharma]] to the Republican health-policy apparatus and the Bush-to-Trump establishment continuity. As a Scalia clerk and [[Federalist Society]] figure, he sits inside the conservative legal pipeline; as a career drug-industry executive, he embodies the [[Regulatory Capture]] that [[Project 2025]] and the broader right's health agenda both rely on and obscure. His repeated trips through the [[Revolving Door]] make him a recurring case study in how industry interests are laundered into "public service" and back. ## Connections - [[Donald Trump]] — Appointed Azar HHS Secretary; Azar served 2018–2021 - [[Robert F. Kennedy Jr]] — Later HHS Secretary; useful contrast in how the department's leadership shifted under the second Trump term - [[Antonin Scalia]] — Azar clerked for him; entry point to the conservative legal pipeline - [[Eli Lilly]] — Ran its U.S. affiliate during the insulin price-hike years - [[Guardant Health]] — Current board seat and live 2026 conflict-of-interest story - [[Operation Warp Speed]] — His signature HHS achievement - [[Revolving Door]] — The pattern his career most cleanly illustrates