While Bertagnolli won confirmation with ease, her road there was rocky. After President Joe Biden tapped her to lead NIH in May, Sen. Bernie Sanders (I-Vt.)
held up her nomination for months in an effort to extract a comprehensive plan to lower drug prices from the White House.

He and Pennsylvania Sen. John Fetterman were the only members of the Democratic caucus to vote against confirmation. Thirty-four Republicans also voted no.

In a speech preceding the vote, Sanders called Bertagnolli, who most recently led the National Cancer Institute, “an intelligent and caring person,” but said he was not convinced that “she is prepared to take on the greed and power of the drug companies.”

Fetterman echoed Sanders’ concerns.

As chair of the Senate committee with jurisdiction over health care nominees, Sanders refused to hold a panel vote until last month when he relented after the Biden administration struck a deal with biotech company Regeneron that included a reasonable pricing clause for a Covid therapy it’s developing with federal assistance.

Then five Republicans joined Democrats to advance Bertagnolli’s nomination out of the Health, Education, Labor and Pensions Committee.

During her confirmation hearing last month, Sanders and ranking member Bill Cassidy (R-La.) pressed Bertagnolli on her approach to drug pricing and whether she’d add reasonable pricing clauses to NIH contracts. She told both members that she couldn’t commit to any particular drug pricing policy.

Bertagnolli did offer insight into her priorities as NIH director, including improving clinical trials.

“One of the other commitments I want to make is for clinical trials — since it’s been one of my core expertise — that are faster, more inclusive, more responsive to the needs of people,” she told the HELP committee last month. “It’s one of the major initiatives that I’d like to see happen at NIH.”