The Senate approved Mark McClellan's nomination early Friday to head the government's mammoth Medicare program, despite his rankling of many in Congress by opposing the importation of prescription drugs.

Senators confirmed President Bush's choice by voice vote and no debate.

At a Senate committee hearing Thursday, McClellan seemingly did little to satisfy lawmakers who want the administration to reverse itself and let Americans buy prescription drugs entering the country from Canada and elsewhere.

Sen. Byron Dorgan (search), D-N.D., who had delayed the nomination, said he decided to let it go after becoming convinced that Senate Majority Leader Bill Frist (search), R-Tenn., had the votes needed for approval.

Dorgan also said Frist had agreed to commit to a process that could eventually allow the importation of drugs. In an interview, Frist said he, Dorgan and other senators agreed to develop proposals for the safe importation of drugs, though no timetable was specified.

"We're trying to move the ball forward here, to make progress" toward the use of imported drugs, Dorgan said in a brief interview.

Frist later issued a statement praising McClellan as "an extremely bright and capable public servant" who would be "providing strong leadership at this critical time."

McClellan, who is commissioner of the Food and Drug Administration (search), has argued that lifting the ban could result in patients receiving unsafe drugs.

Drug importation has broad support in Congress and among the public. Anger about rising drug prices in the United States is outweighing concerns about the safety of drugs purchased abroad, especially over the Internet.

During debate last year on Medicare prescription drug legislation, Republican congressional leaders and the White House blocked inclusion of a plan that would have allowed drug imports. Bush signed legislation in December adding drug benefits to the huge health insurance program for the elderly and disabled.

At a Senate hearing, McClellan did not commit to supporting legalized importation of drugs. But he pledged to work with senators who are developing legislation to address safety issues, such as giving the FDA more money for drug inspections, that McClellan and other government officials have identified.

"We're going to be working hard with help from the public to answer these questions about whether and how imported drugs would be safe," McClellan told members of the Senate Commerce, Science and Transportation Committee.

Dorgan said in response, "There's no evidence you've been interested in that at all."

McClellan is part of a government task force to study drug importation, as required by the Medicare law. Health and Human Services Secretary Tommy Thompson said Wednesday that he decided not to have McClellan lead the study, reversing course after lawmakers complained that it would be one-sided under McClellan's direction. The panel is to have its first public meeting next week.

Dorgan and the Senate committee chairman, Republican John McCain of Arizona, as well as other lawmakers had been upset with McClellan's refusal to testify about imported drugs before his confirmation. McClellan agreed to testify Thursday, after Dorgan said he would block confirmation.

Senators quickly made their displeasure known. When McClellan did not, in McCain's view, respond adequately to his first question, McCain said, "You come to this committee after having stiffed us, having stiffed the House of Representatives and my first question ... you won't answer."

Nearly two hours later, McCain was advising the 40-year-old physician and economist that the administration would be politically wise to recognize the widespread support for importing drugs and giving Medicare the power to negotiate directly with pharmaceutical companies, which the new law expressly prohibits.

One indication of the shifting political winds came from Sen. Trent Lott, R-Miss., who until now has backed the administration's position.

"I cannot explain to my mother any longer why she should pay twice or two-thirds more than what is paid in Canada and Mexico," Lott said, while also urging the Senate to confirm McClellan promptly.