The U.S. Senate confirmed Alex Azar to head the Department of Health andHuman Services, setting a permanent replacement for Tom Price four months after he was ousted amida scandal over his travel.

The vote was 55-43 backing the former Eli Lilly & Co. executive to takethe nation’s top health post. HHS, with a budget of more than $1trillion, is responsible for the U.S. Medicare and Medicaid healthprograms, as well as agencies like the Centers for Disease Controland Prevention and the Food and Drug Administration.

Azar, 50, is likely to oversee GOP efforts to reshape thedepartment’s priorities via executive action, ranging from scalingback the Medicaid health program for low-income and disabled peopleto pushing religious rights. He’ll also have to guide theadministration’s approach to the Affordable Care Act, after effortsto repeal former President Barack Obama’s signature domestic policyfailed in the Senate.

Drug pricing is also likely to continue to draw scrutiny,especially given Azar’s industry ties.

Azar said at a nomination hearing that he would consider implementing some sort of drugnegotiation in Medicare Part B, the part of the government healthprogram for the elderly that covers drugs administered by doctors.But he dismissed a similar move for Medicare’s largerprescription-drug benefit, known as Part D, saying privatecompanies already bargain on the government’s behalf.

Azar left Lilly in January 2017 after a decade at the drugmaker,several months after another senior executive was named to succeedthen-CEO John Lechleiter. He was previously a deputy secretary atHHS during the George W. Bush administration and clerked forAntonin Scalia on the Supreme Court.

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