Authorities investigating mysterious death of the nation’s first drug ‘tsar’– a high-level federal official tasked with lowering drug prices have determined he took his own life but questions remain.
Daniel Best was the senior adviser to Alex Azar, secretary of Health and Human Services (HHS), for drug pricing reform.
Best was found “unresponsive” near the garage door exit of an apartment building in Navy Yard, a neighborhood about a mile south of the Capitol at 5:25 a.m. on Nov. 1, Cleveland.com reported, quoting the District of Columbia Metropolitan Police Department. Best was pronounced dead on the scene.
On Nov. 15, the D.C. Office of the Chief Medical Examiner declared the death a suicide, saying Best succumbed to “multiple blunt force injuries” without providing further details, according to Cleveland.com.
Best was a drug industry insider. He worked for more than a decade in various executive roles for the drugmaker Pfizer, Universal American, MemberHealth, and CVS Caremark Corporation.
His March appointment to HSS sparked criticism from some opponents of President Donald Trump, who accused the administration of cozying up to the drug industry. Azar is also a former pharma executive as well as lobbyist.
But Best’s experience could swing the other way, too.
Pharma ‘Shake Up’
Azar and Best will “know where the bodies are buried,” a health insurance lobbyist told Stat in May, though he added the two would also know how far they could go against the industry. “You can only shake up so much.”
Best apparently wanted to shake up quite a bit.
Two days before his death, HHS published a question-and-answer article where Best explained one of the initiatives he led was expected to save the government more than $50 billion in its first eight years on Medicare and Medicaid expenses—at the expense of drugmakers and/or other developed countries.
As Best explained, Americans often pay much higher prices than people in other developed countries for some expensive drugs. The plan was to attempt to level the playing field by tying how much Medicare pays for some drugs to a selection of international prices, instead of the average U.S. price.
Many European countries, for instance, exercise broad control over health care and dictate how much companies can charge for drugs. Conservative pundits have long complained over the oversized chunk of pharmaceutical research paid by Americans through higher drug prices.
“The world reaps the benefits of American genius and innovation, while American citizens—and especially our great seniors, who are hit the hardest—pick up the tab,” Trump said on Oct. 25 when announcing the plan.
Other initiatives of Best included opening the market to generics and biosimilar drugs, and restructuring drug rebate programs that are blamed by some for driving up prices.
The rebates have been on his mind for years, Best’s brother Tim told GoErie.com.
“It was a concept he started on in 2005 to be able to take the rebates from the drug companies and give them back to the consumer,” Tim Best said. “I think that’s what he is really looking to do.”
People who came into professional contact with Best described him as a congenial person and tough negotiator.
“He’s got a real nice personality,” said Chuck Spinelli, former team member of Best’s at MemberHealth. “He’s not a jerk, he’s not overbearing. He’s approachable, and pharma liked him. They appreciated working with him. He was very transparent. He was very honest. He didn’t play any games.”
Spinelli recalled a story of another of Best’s former coworkers who tried to get Best to include a new drug he was selling onto an insurance plan Best managed. But Best disregarded the longtime personal connection and refused the drug as it wasn’t a good fit for his customers.
Best grew up in the Erie, Pennsylvania, area and graduated from the University of Dayton. He leaves behind a wife and three sons.
“He brought his deep expertise and passion to this task with great humility and collegiality,” Azar said in a statement after news of Best’s death, The Associated Press reported. “All of us who served with Dan at HHS and in the administration mourn his passing and extend our thoughts and prayers to his wife Lisa and the entire Best family at this difficult time.”
The HHS, D.C. police, and the Office of the Chief Medical Examiner didn’t respond to requests for comment.