RFK Jr. vs. Vivek: Trump world's two paths for pharma regulation
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Between Robert F. Kennedy Jr. and Vivek Ramaswamy, the incoming Trump administration has divergent views on regulating the pharmaceutical industry.
Why it matters: Both influential MAGA allies say there are deep problems with America's drug development system. But RFK Jr., the Health and Human Services secretary designee, is calling for more oversight of drugs and vaccines and diminished federal funding for R&D.
- Ramaswamy, a biotech entrepreneur who will lead a new "Department of Government Efficiency" with Elon Musk, is a small government aficionado who's called for fewer barriers to bringing drugs to market.
Their differences add another layer of uncertainty for pharmaceutical companies trying to navigate what could be dizzying changes in the new administration.
Where it stands: Kennedy's priorities include a crackdown on direct-to-consumer drug ads and diverting half of the National Institutes of Health's research budget from infectious diseases to alternative cures and preventive health.
- The vaccine critic wants to see more safety data on shots already on the market. And before Trump selected him for the top health care post, Kennedy also pledged to end the Food and Drug Administration's "war" on "anything that can't be patented by Pharma."
Ramaswamy, in contrast, wrote on social media last week that his biggest problem with the FDA is the agency's layers of bureaucracy, which he said stifle innovation.
- "This stops patients from accessing promising therapies & raises prescription drug costs by impeding competition. The agency's staff have callous disregard for the impact of their daily decisions on the cost of developing new therapies, which inevitably gets passed on to the healthcare system," Ramaswamy posted on X.
Zoom out: The differences between Ramaswamy and Kennedy create more confusion for the pharmaceutical industry, said Dave Latshaw, CEO of BioPhy, which analyzes clinical trial data and helps companies with drug development.
- Prior to Trump's selection of Kennedy to lead HHS, life sciences companies were focused on how the next administration's economic policy, including tariffs, would affect their business.
- But the nearly simultaneous selections of Kennedy and Ramaswamy last week created "so many unknown variables in there that you can't really solve for them all at the same time," Latshaw told Axios.
- "The default for most people — the vast majority of companies and operators — is going to be, well, we have to plan for the worst," he said, adding that he thinks the risk to companies is overstated.
- For example, companies might end some high-risk research programs. And there's already speculation that venture capital will stop funding new biotechs because of the uncertainty.
The pharmaceutical industry has been tight-lipped in its public statements about what it's expecting from the Trump administration.
- "This industry is a crown jewel of the American economy. ... We want to work with the Trump administration to further strengthen our innovation ecosystem and improve health care for patients," PhRMA CEO Steve Ubl said in a statement last week.
Yes, but: Ramaswamy and Kennedy are aligned on some issues. Both have said they want to root out corruption in the FDA. They've also both advocated for restructuring federal departments and firing career civil service employees.
- Ramaswamy said last year that he regrets getting vaccinated against COVID. He also praised Kennedy and elements of his health care agenda on Fox News in August. "I think RFK Jr. has been thoughtful on a number of issues, particularly on COVID policies," he said.
- They spoke together in September at a Tucker Carlson live tour stop, and this past weekend they attended an Ultimate Fighting Championship card with Trump and other influential Republican figures.
President-elect Trump doesn't see an inherent contradiction in his personnel choices.
- "President Trump has chosen highly-respected and accomplished individuals to serve in his Administration, including RFK Jr., Elon Musk, and Vivek Ramaswamy, all of whom are brilliant minds with bold ideas to Make America Great and Healthy Again," Brian Hughes, spokesperson for the administration's transition team, said in an email to Axios.
- Kennedy's and Ramaswamy's representatives didn't respond to requests for comment.
Reality check: There are still a lot of unknowns that could color the Trump administration's views on drug policy or tip it in a specific direction.
- For instance, the Senate could decide not to confirm Kennedy as HHS secretary.
- The Department of Government Efficiency is an advisory body. Its recommendations will need to be adopted and implemented by the White House or Congress, and its mission of slashing federal spending is much easier said than done.
