It's expected that President Trump will give a speech early this month regarding the price of prescription drugs and that the lecture likely will include some harsh words for the pharmaceutical industry.
There has been no official word about when Trump will talk following the cancellation last month of the speech, but speculation in the capital is that May 8 could be the day.
If past Trump behavior is an indicator, his words will be the toughest thing that pharma companies will need to endure.
Drug companies are "getting away with murder," Trump said in January 2017. Later in the year, he told his cabinet that "prescription drug prices are out of control. The drug prices have gone through the roof."
In the State of the Union address earlier this year, he said he intended "to make fixing the injustice of high drug prices one of our top priorities for the year. And prices will come down substantially. Watch."
And last month the president promised Health and Human Services Secretary Alex Azar would unveil a host of proposals that would lower drug prices.
"You'll be seeing drug prices falling very substantially in the not-too-distant future, and it's going to be beautiful," Trump said.
Azar told the World Health Care Congress on Wednesday, May 2, that Trump is serious about taking action that will bring drug prices down: "I can assure you the president wants to go further. Much further. Action is desperately needed. There's little access for a sick patient between a miracle cure that hasn't been discovered and one that is too expensive to use."
Azar said Trump has given his administration "a very strong mandate" to fix an American healthcare industry that he feels is ailing.
The HHS secretary went on to say that his agency wanted to find ways for Medicaid and Medicare to bring drug prices down by creating more resources to negotiate with pharma companies.
Heights Capital Markets healthcare analyst Andrea Harris said she expected the president to give the drug companies a piece of his mind. But she doesn't expect Trump to propose any actions that would keep the companies from setting higher prices for drugs.
While there is no shortage of critics who don't expect much of Trump's speech beyond some sharp rhetoric, not everyone thinks his bark will be worse than his bite.
Wells Fargo Securities LLC's David Maris told clients in a note, "We believe that there is a high risk that healthcare and drug pricing will be a key part of the midterm elections as well as the next presidential election, and we expect that the current administration will try to blunt any criticism that it hasn't done enough with plans of its own before then."
It seems that everybody in the drug industry has wanted to put their best foot forward when it comes to what Trump might do. Pharmaceutical Research and Manufacturers of America, or PhRMA, the trade group that advocates for drug companies, spent almost $10 million on lobbying in the first quarter of 2018, according to the Center for Responsive Politics. For all of 2017, PhRMA spent $25.8 million.
That cash doesn't include the money PhRMA's spending on the ongoing "Go Boldly" campaign, a series of TV, print and radio ads designed to polish the drug industry's image by reminding the public that drug companies do world-class research that brings disease cures to market to save lives.
Drug companies also have been busy making sure that lawmakers know how they feel. In 2017, the first year of the Trump administration, the 10 largest drug companies spent a combined $74 million. So far this year, those same companies have spent $24.2 million, a pace that would easily top last year's lobbying spend.
Drug companies became a favorite villain during the presidential campaign when Democratic candidates Hillary Clinton and Bernie Sanders beat on "Pharma Bro" Martin Shkreli for raising a drug price 5,000%. (Shkreli was sentenced to seven years in prison in January for securities fraud and conspiracy to commit fraud, and a forfeiture order authorized the government to seize a Picasso painting and the sole copy of Wu Tang Clan's "Once Upon a Time in Shaolin.") Pharma companies, though, were unpopular before Shkreli as consumers watched their prescription prices rise.
Steve Ubl, the CEO of PhRMA, understands his industry is under fire, part of the reason his organization is spending so much money on lobbying and image work. In a recent interview with The Hill, Ubl said that he understands why Trump is pointing to pharma companies regarding high drug prices. He noted, however, that the president and others need to look at all the different influences that affect prices, not just drug companies. In other words, what about insurance companies and pharmacy benefit managers?
Those parties, of course, could point back at drug companies, illustrating the difficulty of tamping down prices.