Drug industry treads carefully after stunning RFK Jr. nomination

The selection of Robert F. Kennedy Jr. to lead the Department of Health and Human Services (HHS) sent shock waves through the pharmaceutical industry.

But many of the industry sources and outside lobbyists who spoke to The Hill said they are not prepared to outright oppose Kennedy, at least for now.

Lobbyists said they anticipated Kennedy would get some kind of role in the administration but were surprised at his being picked for HHS secretary. They are now scrambling to figure out what kind of damage Kennedy could inflict were he to be confirmed.

“Striking at the heart of a science-based industry like this by saying nonsensical stuff and actually having power to do something about it is bad news,” said a lobbyist who works for drug companies. “I think right now they're in sort of like 'holy s--- mode.'"

Kennedy argues the rise of chronic diseases in America can be traced to ultraprocessed foods, environmental toxins and chemical additives. He wants to ban fluoridated water and increase access to raw milk.

Even before Kennedy was officially tapped to lead the nation’s top health agency, public health experts were worried that he could amplify vaccine hesitancy and direct agency funding to favor his preferred views.

Still, lobbyists said they are advising clients to let the nomination play out among Senate Republicans. They are preaching patience, as they don't want to risk expending political capital to wind up on President-elect Trump's bad side before he even takes office.

“A lot of companies are going to be reluctant to engage in politics,” said Richard Hughes IV, an attorney at Epstein Becker Green.

Hughes said it wasn’t necessarily a given that Trump would be friendly to the industry, but Kennedy’s confirmation would add a completely different element that could make the government outright hostile toward innovative drugs, especially vaccines.

"The way that President Trump has set it up for him, you know, he's basically said that [Kennedy’s] going to have carte blanche. So, will he check himself? Will members of President Trump's party in Congress check him?” Hughes said.

Another lobbyist who represents drug companies said the Kennedy pick was unexpected, but the reactions from their clients haven’t been uniformly negative.

"We have some clients that are differently positioned, who are like, 'Hey, this could be good for us because you said things that are supportive to our position years ago. So let's hold our fire,'" said the lobbyist.

“And then you have others that are looking at whip counts to say, 'Will we have votes on Senate Finance to kill this in committee?' So I think it's putting together a menu of options ... and then waiting to see how things play out.”

One source said the common consensus was that Kennedy would likely not be confirmed, so he’d be put in the White House as an adviser or “czar.” But that didn’t happen, and it clearly shook up the notion that a second Trump administration would hew toward traditional Republican choices as nominees.

Now lobbyists are rereading the tea leaves.

“There are some [GOP senators] out there that are noting some skepticism. I think most of them are leaving the pathway for them to vote yes for his confirmation, which would be ... surprising,” said one source.

Pharmaceutical Research and Manufacturers of America, the powerful industry group that represents drugmakers, didn’t mention Kennedy by name in a statement after he was officially tapped by Trump as the nominee.

It referenced the importance of the industry as part of the American economy, and emphasized how the group and industry could work with the Trump administration “to further strengthen our innovation ecosystem and improve health care for patients.”

It's not clear what Kennedy’s priorities as secretary would be, but he is a vocal vaccine skeptic who has also called into question the legitimacy of the entire regulatory process.

First as an independent candidate for president and then as a surrogate for Trump, Kennedy has said federal health regulators are “sock puppets” held captive by industry special interests.

In a social media post prior to the election, Kennedy said the Food and Drug Administration's (FDA) "war on public health is about to end,” and told anyone who was involved in blocking access to things like raw milk, “peptides,” sunshine, ivermectin and other controversial treatments should “pack your bags.”

He’s also spoken negatively about the industry-paid fees that fund the staffing needed for relatively quick FDA drug and medical device reviews, saying it makes the agency too reliant on industry. Nearly half of the agency’s budget this year came from user fees.

Multiple sources said one of the top concerns among pharmaceutical companies is that a Kennedy-run HHS would try to somehow change the user fee system.

But while there are bipartisan concerns about the role of user fees and undue industry influence — current FDA Commissioner Robert Califf has previously said he wished FDA was completely funded by taxpayers — radically altering or ending the agreements would take an act of Congress.

Still, if Senate Republicans are unwilling to stop Kennedy’s nomination from moving forward, there is not a lot of optimism among industry lobbyists that the party will be a check on the agency once he takes over.

“I think to have a big disruptive impact, he needs support from Congress, and then it's a matter of how much lease does he get from Trump? If he gets some cover there and the White House is willing to go to bat and twist arms, then perhaps he's able to have a bigger impact than what we hope,” said one drug company lobbyist.

“If not, if he's kind of left as a free-floating electron on his own, we might be able to buttress any of his ideas and actions with some congressional resistance.”

Trump is testing the loyalty of GOP senators from the get-go with his choice of controversial Cabinet nominees. They will have to decide where to draw the line for opposing someone.

"RFK Jr., I'm almost inclined to say unless something crazy comes out in his disclosures ... are his stances in and of itself enough to prevent him from getting the spot? I'm not sure, with this list, right?” said another source.