WASHINGTON, Nov. 17  – At a Senate confirmation hearing today, Sen. Bernie Sanders (I-Vt.) said he opposes the nomination of Dr. Robert Califf to be commissioner of the Food and Drug Administration because of doubts that he would act to lower skyrocketing drug prices.

“At the end of the day people are dying and not buying the food they need because they have to pay outrageous prices for medicine,” Sanders said. “We have been extraordinarily weak at taking on the pharmaceutical industry that has been ripping off the American people. I believe we need a commissioner who is going to stand up to the pharmaceutical industry and protect American consumers. You are not that person.”

Last year, one in five Americans – 35 million people – were unable to afford to fill their prescriptions. Prices for some prescription drugs soared 1,000 percent or more in recent years. Since 2002, total spending on medicine in the United States went up by more than 90 percent.

Califf has deeper ties to the pharmaceutical industry than any FDA commissioner in recent history. He ran a multimillion-dollar clinical research center at Duke University that received more than 60 percent of its funding from the pharmaceutical and medical device industry. And his financial disclosure form last year listed seven drug companies and a device maker that paid him for consulting and six others –including Merck, Novartis and Eli Lilly – which supported his university salary.

In 2014, the pharmaceutical industry spent $250 million on lobbying and campaign contributions and employed some 1,400 lobbyists. “Do you think that type of expenditure has any impact on the fact that we pay the highest prices in the world for prescription drugs?” Sanders asked Califf.

The top three pharmaceutical companies made a combined $45 billion in profits last year and spent more on sales and marketing than they did on research and development.

Sanders has introduced comprehensive legislation that would lower soaring drug prices.