The comments came ahead of a blueprint President Donald Trump will unveil later Friday for lowering U.S. drug prices. The plan will target "foreign freeloading" in other countries that use "socialized healthcare to command unfairly low prices from U.S. drug makers," according to a White House summary released Thursday.
Some countries set price controls for prescription drugs. Several experts have questioned how the U.S. can make other governments pay more.
Azar said the administration will propose ideas aimed at lowering costs American patients pay.
"On the foreign side, we need to, through our trade negotiations and agreements, pressure them," Azar said on "Squawk Box." "And so we pay less, they pay more. It shouldn't be a one-way ratchet. We all have some skin in this game."