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

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

Azar, 50, is likely to oversee GOP efforts to reshape the department’s priorities via executive action, ranging from scaling back the Medicaid health program for low-income and disabled people to pushing religious rights. He’ll also have to guide the administration’s approach to the Affordable Care Act, after efforts to repeal former President Barack Obama’s signature domestic policy failed 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 drug negotiation in Medicare Part B, the part of the government health program for the elderly that covers drugs administered by doctors. But he dismissed a similar move for Medicare’s larger prescription-drug benefit, known as Part D, saying private companies 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 succeed then-CEO John Lechleiter. He was previously a deputy secretary at HHS during the George W. Bush administration and clerked for Antonin Scalia on the Supreme Court.

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Senate confirms former drug executive Azar as health secretary

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