Don't expect too much in the way of drug stock-moving details from President Trump when he gives a much-anticipated speech on the price of prescription drugs on Friday afternoon. 

Jefferies Research says the speech is likely to consist of some typical Trump rhetoric, an appeal to voters prior to the mid-terms and a nod to pharmacy benefit manager reform in terms of rebates.

In a note May 10, Cowen and Co. analysts told investors they don't expect the president to break any new ground and that the address is likely to be "relatively benign."

Wells Fargo analyst David Maris has been sounding the alarm bell lately for pharmaceutical companies, warning them of a growing public chorus calling for lower drug prices. Maris reiterated that theme May 10 ahead of the speech, noting that the dissatisfaction with prescription drug transparency has "never been louder."

However, Evercore ISI may be an outlier as its analysts anticipate that recent speeches by officials from the Food and Drug Administration, Health and Human Services and Centers for Medicare & Medicaid Services may have telegraphed the Trump administration's willingness to move beyond loud talk and tweets into policy discussions.

In those tweets and in talks with his cabinet, Trump has been critical of the pharmaceutical sector and its pricing of prescription drugs, famously saying on at least two occasions that companies are "getting away with murder."

But since taking office in January 2017, the president has been longer on talk than action, and the drug industry has spent lavishly on lobbying federal lawmakers to be sure they understood what the companies wanted. In 2017, the ten largest companies paid lobbyists a collective $74 million. This year they are on a pace to reach $100 million.

What the future of healthcare looks like, according to Cigna's (CI) CEO.

In the short term, pharmacy benefit managers (PBMs) such as  ExpressScripts Holding Co. (ESRX) , CVS Health Corp. (CVS) and United Health Group Inc.'s OptumRx (UNH) may feel a pinch after the president puts away the teleprompter tomorrow. The healthcare middlemen have been drawing more attention for the less-than-transparent way they operate in the drug pricing process.

The Trump administration has been a little schizophrenic when it comes to PBMs. On the one hand, they support them because under Part D using rebates and head-to-head negotiations, they lower prices. But the White House has expressed frustration that PBMs boost their own bottom lines by retaining some of the rebate cash.

As complicated as the drug pricing matrix is between PBMs, insurance companies and drug companies, it becomes even more muddled when dropped into the middle of election season. Since the White House has been less than effective in bringing drug prices down, the Democrats have been eyeing the issue for the midterms. This is especially true given how it polls. Kaiser Health Foundation found in a March 2018 survey that 80% of the country feels that prescription drugs cost too much.

Though Trump dedicated a speech to the opioid crisis in March it was overshadowed by his call for giving drug dealers the death penalty. Given his habit of going off-script, it wouldn't be unusual for him to freelance some thoughts on how drug companies making or distributing those drugs need to do more to battle abuse.

If that happens, drug companies like Endo International PLC (ENDP) , Depomed Inc. (DEPO) and Mallinckrodt PLC (MNK) could see their shares get knocked. Likewise, distributors like McKesson Corp. (MCK) , AmerisourceBergen (ABC) and Cardinal Health (CAH) would have to weather a news cycle or two.

Lastly, a popular idea with the GOP, Right to Try, may get some love from Trump. Under Right to Try, patients with life-threatening diseases who have exhausted their options could be given access to experimental drugs. And if that happens, drug companies active in the orphan sector like Celgene Corporation (CELG) , Biogen Inc. (BIIB) , BioMarin Pharmaceutical Inc. (BMRN) , and Ultragenyx Pharmaceutical Inc. (RARE) may garner more attention following the speech.

United Health is a holding in Jim Cramer's Action Alerts PLUS Charitable Trust Portfolio. Want to be alerted before Cramer buys or sells UNH? Learn more now.

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