Pharma fears Washington after a couple of surprising defeats on Capitol Hill have shown the industry may not be as bulletproof as it seems.

• What to watch: The Trump administration is eager to show progress on drug prices, and its early efforts have largely steered clear of drug companies themselves. But Health and Human Services secretary Alex Azar is open to reining in some of the industry’s patent tricks — a move that could cost drugmakers billions of dollars.

Everyone fears Amazon. Just the possibility that it might enter the pharmacy business has accelerated a trend of health care mega-mergers, as the old guard looks to lock in as much market power as it can.

And the public fears the cost of health care. That’s part of the reason the industry, which profits from those costs, is right to worry about what’s ahead.

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