### Trump's Health Policy Picks Stir Concerns Among Pharmaceutical Executives

In a twist that has unsettled the pharmaceutical industry, President-elect Donald Trump's nominations for key health policy positions have raised alarm rather than the anticipated relief. Drug company leaders, who had hoped for reduced regulation under a second Trump administration, are now facing the reality of navigating decisions made by individuals with controversial stances and limited experience in public health.

One of the most troubling appointments for the industry is Robert F. Kennedy Jr., nominated by Trump for the role of health secretary. Kennedy, a well-known vaccine skeptic with no medical or public health background, has previously accused drug companies of "mass poisoning" Americans. His appointment has sent shivers through the pharmaceutical sector, impacting stock prices and stirring uncertainty.

Similarly contentious is the nomination of Dr. Dave Weldon to head the Centers for Disease Control and Prevention (CDC). Weldon, a former congressman from Florida, has a track record of questioning vaccine safety and advocating for moving research out of the CDC. His appointment, alongside that of Dr. Mehmet Oz to run the Centers for Medicare and Medicaid Services, who lacks significant bureaucratic management experience, has added to the industry's concerns.

During Trump's first term, pharmaceutical executives were generally supportive of his nominees, who had ties to moderate Republicans and substantial experience in the industry. John LaMattina, once Pfizer's top scientist, expressed concern over the new picks, citing a lack of relevant background and thoughtful consideration of health issues.

For American patients and the pharmaceutical market, the implications are significant. There are fears that drug approvals may be expedited without ensuring their effectiveness, which could flood the market with questionable drugs. Robert F. Kennedy Jr.'s stance on vaccines—though he has recently softened his rhetoric—still poses a threat to widespread immunity and the industry's revenue from vaccines, illustrated by a temporary drop in vaccine and biotechnology stocks following his nomination.

Furthermore, Kennedy's challenge to the legal protections for vaccine makers could open the industry to costly lawsuits, fundamentally altering established compensation programs. Companies like Merck, which derive significant revenue from vaccines such as those for human papillomavirus (HPV) and measles, mumps, and rubella (MMR), face considerable risk.

Pharmaceutical officials, though publicly cordial, have expressed significant discomfort behind the scenes. Derek Lowe, a pharmaceutical researcher, has condemned Kennedy's views on vaccine safety as disastrous. The FDA also faces potential upheaval under Kennedy, who has described the agency as corrupt and overly aligned with the drug industry.

The sector's relief with Trump's choice of Dr. Martin Makary for FDA head is tempered by the broader concerns over Kennedy's influence. With Vivek Ramaswamy and Jim O'Neill, both critical of regulatory processes, taking senior roles, the industry braces for potential disruptions to its operations and profitability.

In anticipation of his administration, drug companies are mobilizing their lobbying efforts, hoping to mitigate adverse impacts. They are also considering strategies to defend their interests against potential government actions they see as harmful.

As Trump prepares to replace key officials and potentially overturn significant policies like Medicare's drug price negotiations established under the Inflation Reduction Act, pharmaceutical executives are strategizing for an uncertain future under leadership that promises to shake up the status quo.