The nomination of Azar represents a shift for Trump, who in his Cabinet picks to date often has not selected candidates with experience in the department they would oversee. He served as deputy secretary of HHS under former President George W. Bush and has been considered a frontrunner for the secretary position since mid-October.
Like more than half of Trump's nominees, Azar has professional ties to the industry that he will be expected to regulate.
Democratic Senator Patty Murray, who has been working on bipartisan healthcare legislation, tweeted, "Given Alex Azar's professional background, there are concerns on whether he can fairly execute any significant effort to lower drug prices for patients & families".
Azar worked at Eli Lilly and Co for a decade, including five years as president of its Lilly USA unit, and left the company in January, according to his LinkedIn page.
Azar's Senate confirmation could be hard, with the chamber's 48 Democrats unlikely to approve a candidate who supports dismantling the Affordable Care Act.
Azar's nomination for HHS Secretary follows the ascendance of Seema Verma, who now leads the Centers for Medicare and Medicaid, and former State Health Commissioner Jerome Adams, who became Surgeon General this summer.
Currently, Azar is the chairman and founder of Seraphim Strategies, which provides strategic consulting and counsel on biopharmaceutical and health insurance industries. "I'm confident that he would like to see the way the law works change".
Trump made the announcement on Twitter, saying Azar "will be a star for better healthcare and lower drug prices". "Instead of draining the swamp, he has set the fox to guard the henhouse".