Opioid painkillers that have led to thousandsof deaths and new drug addicts should be the highest priority ofthe U.S. Food and Drug Administration, said Scott Gottlieb,President Donald Trump’s pick to lead the agency.

“The opioid epidemic in this country has staggeringhuman consequences,” Gottlieb said Wednesday in a hearingbefore the Senate Committee on Health, Education, Labor andPensions. “I think this is the biggest crisis facing theagency.”

Likening the widespread abuse of opioids to the outbreak ofEbola virus that ran rampant in West Africa, Gottlieb said that theagency would have to pursue a number of paths, such as working withdrugmakers seeking approval for alternatives and abuse-deterrentversions of the drugs. More than 33,000 people died from opioidoverdoses in 2015, according to the U.S. Centers for DiseaseControl and Prevention.

The agency would “push the policy boundaries” for approval ofsafer opioids and other alternatives if he’s confirmed,Gottlieb said. “It’s going to be an all-of-the-above approach.”

Gottlieb is likely to be confirmed by the full Senate when heeventually gets a vote. His comments to the committee Wednesdayseemed to assuage concerns by some senators on the drug crisis aswell as other issues, including potential conflicts of interestthat come from his work as a consultant and investor.

Number of hats

A former FDA staffer who left the agency to work in the businessworld, Gottlieb also faced questions on his ties to health-carecompanies. Financial disclosure forms show he earned millions ofdollars from various investment banks and pharmaceutical firms lastyear and in the first part of this year, including $1.85 millionfor his work as a managing director at T.R. Winston &Co., an investment bank that raised money for a number ofpublic companies.

“You do wear an extraordinary number of hats,” said SenatorPatty Murray, a Democrat from Washington.

Gottlieb replied that at the FDA, he would be guided by science.If confirmed, he would resign from T.R. Winston, divest interestsin more than a dozen companies and temporarily recuse himself frommaking decisions on at least 20 more where he has financialinterests or was paid consulting fees, including GlaxoSmithKlinePlc and Bristol-Myers Squibb Co.

“The lives and the futures of families like mine are affected bythe decisions made by the FDA,” Gottlieb, whose wife, children andparents were at the hearing, said in his opening statement. Hepledged to make sure “the FDA puts their interests first ineverything we do.”

Drug prices

Gottlieb has previously spoken about lowering drug prices, a Trump priority, byspeeding approval of generic drugs. He’s particularly focused oncomplex medications that combine old drugs with newer deliverydevices, as well as those with unusually complicatedformulations.

In his prepared remarks, Gottlieb urged rejection of what hecalled a “false dichotomy that it all boils down to a choicebetween speed and safety.” Instead, he wrote, if the FDA leveragesnew technology and better science it can improve efficiency andsafety “and also remain faithful to FDA’s gold standard forregulatory conduct.”

Gottlieb, 44, served as a deputy FDA commissioner from 2005 to2007. He hasn’t faced the same criticism from Democrats that otherTrump administration choices have, such as Health and HumanServices Secretary Tom Price and Supreme Court justice nominee NeilGorsuch.

In addition to his consulting and investment work since leavingthe agency, Gottlieb has also been a fellow at the AmericanEnterprise Institute, a conservative-leaning Washington thinktank. He was trained as a physician and completed his residency ininternal medicine at Mount Sinai Medical Center in New York aftergraduating from the Mount Sinai School of Medicine in 1999. Heearned a degree in economics from Wesleyan University in 1994.

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