Long-time industry critic Representative John Dingell has been ousted as chairman of the powerful US House Energy and Commerce Committee, but his replacement, Henry Waxman, is unlikely to be any easier on the sector, and his appointment will fast-track health care - plus energy and climate change - to the top of the agenda for reform in the new administration of President-elect Barack Obama.

After 28 years, Rep Dingell lost his chairmanship of the House committee - which is regarded as the most influential in Congress and has particular jurisdiction over health care - in a 137-122 vote last Thursday in favour of Rep Waxman, currently chairman of the House Oversight and Government Reform Committee. In his announcement earlier this month that he would be seeking the Commerce post, Rep Waxman said that some of the most important issues being faced by the USA are under the panel’s jurisdiction and that: “in large measure, our success as Congress will depend on how the Commerce Committee performs.”

Back in 1984, Rep Waxman co-sponsored, with Senator Orrin Hatch, the Drug Price Competition and Patent Term Restoration Act (the “Hatch-Waxman Act”), which sought to promote the availability of generic drugs while also maintaining incentives for R&D. In 2008, his activities have included co-sponsoring legislation to enable health care professionals to received “unbiased” information on prescription drugs and create a regulatory pathway for biogenerics. He has also been a highly vocal critic of plans by the FDA to allow drugmakers to promote off-label uses of their products, the multi-billion-dollar “windfall” created for drugmakers by the Medicare prescription drug benefit and the government’s position in the Wyeth “pre-emption” case currently being heard in the Supreme Court.

Rep Dingell has advocated universal health care throughout his 53-year career in Congress and has been an outspoken critic of the both Food and Drug Administration (FDA) - particularly this year on its record of overseas inspections - and the industry, notably in the areas of sales practices and use of direct-to-consumer (DTC) advertising. Earlier this year, he pressed the FDA to release the results of a study looking at potential links to cancer with use of Merck & Co/Schering-Plough’s cholesterol-lowerer Vytorin (ezetimibe and simvastatin).

Commenting on the change of leadership at the Committee, Billy Tauzin, chief executive of the Pharmaceutical Research and Manufacturers of America (PhRMA) said: “with health care foremost on the minds of many Americans - especially those who have recently lost their jobs and health insurance because of the economic downturn - we look forward to working with incoming Energy and Commerce Committee Chairman Henry Waxman on a wide range of issues that impact American patients.”

“At the same time, we commend Chairman John Dingell for his 50 years of tireless service and dedication, and the work he has done to improve the lives of generations of Americans. Unquestionably, he will continue to be a positive force in Congress on issues affecting the day-to-day lives of people everywhere,” Mr Tauzin added.