Washington Editor

WASHINGTON - Another federal health care agency has lost its head.

Tommy Thompson resigned as secretary of the Department of Health and Human Services, leaving vacant the post atop a 60,000-employee government bureau with a $500 million budget. In a press conference Friday, he said he would stay on board until Feb. 4, or until a successor receives congressional approval. As for his next move, the 63-year-old said he planned to give the private sector a try.

"I do not tender my resignation easily," Thompson said. "While these years have been challenging, they have been greatly rewarding."

In terms of the direct impact of the departure on companies in the drug development industry, Carl Feldbaum, president of the Biotechnology Industry Organization (BIO) in Washington, said it was too early to tell. But he was quick to note the arduous tasks taken on by Thompson during his term.

"I've been in Washington for three decades," Feldbaum told BioWorld Today, "and it's increasingly apparent to me that cabinet positions are tougher and tougher. They really do increasingly burn out after four years, and I think that's due to the pace of life in Washington and the pace of politics these days."

During his tenure, Thompson presided over efforts to strengthen the nation's preparedness for a bioterrorism attack, increased funding for the National Institutes of Health and reorganized the Centers for Medicare and Medicaid Services to provide prescription drug coverage. Feldbaum also lauded Thompson's efforts to focus public health attention on obesity, diabetes and health disparities.

"I am so proud of so many things, but when you look back, the complete overhaul of Medicare is at the top of the list," Thompson said. "Second, that we started making America more cognizant of their public health conditions and the need for lifestyle changes. Third would be the rebuilding of federal and state public health work. They were really in disarray when I came out here. Now, after 9/11, the money has gone back to rebuilding the public health infrastructure at local, state and federal levels."

Thompson previously was a four-term governor in Wisconsin. He began his career in public service in 1966 as a representative in that state's assembly, and was sworn into the federal-level position just after President George Bush began his first term.

His departure marks the eighth cabinet-level exit from 15 positions as Bush heads into his second term. But before he leaves, Thompson hinted at changes he plans to make at the FDA, an agency that falls under HHS that recently has been criticized for drug safety lapses.

"I would like to find ways to get drugs to the market faster, but I'd also like to find ways to review on a more regular basis to look for adverse events, so that we can monitor more and respond quicker," he said. "We may need to have an independent office of safety, but we will discuss more about that later."

Feldbaum noted that Thompson always availed himself to biotech companies and BIO itself, attending industry conferences and speaking to the organization's board.

"This is an enormous position and these are very big institutional shoes to fill," Feldbaum said. "The industry is going to be watching very closely . . . it is not clear who the president will pick."

While a replacement has not yet been named, early speculation is centering on Mark McClellan. He heads the Centers for Medicare and Medicaid Services, which also falls under HHS, a position he vaulted to after a stint as head of the FDA. Since his departure from that agency, the FDA has relied on Lester Crawford as its acting commissioner. Crawford formerly served as its official commissioner, as well.

For his part, Thompson mentioned McClellan as a potential successor, along with former Congressman Newt Gingrich, Louisiana Sen. John Breaux, deputy HHS Secretary Claude Allen, Elias Zerhouni of the NIH and Julie Gerberding of the Centers for Disease Control and Prevention.

Whoever succeeds Thompson will inherit a full plate.

"There are global public health challenges with HIV/AIDS and how the administration addresses that," Feldbaum said. "Domestically, how do you deal with the whole issue of creating an infrastructure for vaccine development and distribution . . . how to implement the vast Medicare bill, and in the health and human services area, there is always the unexpected."

- Staff Writer Chris Delporte contributed to this article.