If you haven’t heard of Joe Grogan, don’t worry—even White House staff told The Atlantic that he’s someone “Trump likely couldn’t pick out of a lineup.” But you should know about what he’s pushing behind the scenes.

Grogan is a former pharma lobbyist who has quietly risen through the ranks of the Trump administration.

Before joining the Trump administration, Joe Grogan was the top in-house lobbyist for one of the country’s largest pharmaceutical firms, Gilead Sciences. He left Gilead to join the Trump administration early on, first spending nearly two years at the Office of Management and Budget, coordinating President Trump’s health care policies. Now, he is the head of the White House Domestic Policy Council, the main hub for Trump’s domestic policy agenda.

Grogan has been and is now working on issues where Big Pharma stands to benefit.

Grogan’s work as a Trump official on issues that matter to Gilead—including at least one on which he directly lobbied for Gilead immediately before joining the Trump administration—raises important conflict of interest questions.

From 2015 through the time Grogan left the company, Gilead was evaluating a purchase of Kite Pharma, a company racing to receive FDA approval to market CAR-T cancer therapies, a potentially lucrative treatment. In Grogan’s final months at Gilead before joining the Trump administration, Gilead’s efforts to enter the CAR-T market hit a fever pitch, as the company hired a prominent oncology expert away from a competitor and entered into a formal confidentiality agreement with Kite to negotiate the details of their potential merger.

According to documents we uncovered, soon after Grogan left Gilead for OMB, he began working on a demonstration project focused on CAR-T with HHS, and only recused himself from the project after Gilead publicly announced its $11.9 billion acquisition of Kite on August 28, 2017.

Also, during his time at Gilead, right up until he left, Grogan lobbied HHS about the 340B drug discount program, which sets price ceilings for certain drugs at hospitals that serve poor and vulnerable populations. Big pharma companies have long been critics of the program. Then once he joined the Trump administration, Grogan led the White House’s “Drug Pricing and Innovation Working Group,” an internal administration group focused on pharmaceutical regulatory reform, including proposals concerning the 340B program.

Here’s what we do know: the pharmaceutical industry and Grogan’s former employer have secured serious policy victories since Grogan joined the administration.

In October 2017, Gilead received FDA approval for CAR-T therapies. In April 2019, the federal government proposed raising the reimbursement rate for CAR-T therapy by $56,000, which would generate an approximately $110 million increase in payments for CAR-T therapies in 2020, a major windfall for Gilead. The next day, Gilead announced a new facility to scale up CAR-T therapy production.

The week that Grogan joined the administration, HHS delayed an Obama-era 340B rule from going into effect. The result of a seven year negotiation that included pharma companies, the rule imposed penalties on manufacturers that intentionally overcharged hospitals. Ultimately the rule was delayed for two years, during which time the government did not set civil penalties for pharma companies illegally overcharging vulnerable patients.

The issues don’t stop at ethics.

Grogan has also been identified as one of the primary architects of the Trump administration’s litigation efforts to strike down the entirety of the Affordable Care Act, including its crucial protections for patients with pre-existing conditions.

What we still want to know:

• How much did Joe Grogan know about Gilead’s impending purchase of Kite during the period between March and August 2017 when he was working on the CAR-T demonstration effort from within the federal government? Was his work during this period a violation of his federal ethics pledge?
• Did Grogan seek ethics advice about his participation in CAR-T matters before Gilead’s purchase of Kite went public?
• What sorts of communications has Grogan been having with Gilead since joining the Trump administration?
• What was Grogan’s involvement in the Trump administration’s two-year delay of the 340B Rule?

Today we sued for answers to these questions, and we’ve also asked the Office of Government Ethics to open a formal investigation into whether Grogan is complying with his ethics obligations. When we know more, we’ll update our case page.