Few industries are getting the Trump Treatment quite like Big Pharma. Drug stocks initially jumped after Donald Trump was elected, on the bet the new president would support the industry’s profits. Then they stumbled, as Trump publicly criticized high drug prices and the debate on the future of healthcare shifted by the day, or even the hour.

And now?

“You really cannot predict the unpredictable,” AstraZeneca Plc Chief Executive Officer Pascal Soriot said on Thursday in London on a conference call with reporters. And Soriot’s competitors at Novo Nordisk A/S cut their annual forecast Thursday, citing political risk in the U.S.

Healthcare isn’t the only industry that’s been whipsawed by Trump’s sometimes improvised pronouncements. Retailers were hit by the proposal to tax Mexican imports to pay for a border wall. Airlines declined amid the chaos created by his executive order on immigration.

Daily Uncertainty

But healthcare, responsible for 17 percent of the U.S. economy, is unique. The government spends more than $1 trillion a year on the Medicare program for the elderly and disabled and the Medicaid program for the poor. And the U.S. plays a controlling role in the market, both in financing care and in setting rules for everything from how hospitals operate to which drugs can be sold.

So the industry, a behemoth accustomed to a slower pace of change, has found itself buffeted by daily uncertainty.

Trump’s Tuesday White House meeting with drugmakers shows what executives and investors are facing. They were relieved that Trump appeared to back off government-set pricing for drugs after he slammed the industry in a pre-inauguration press conference. But after the meeting, Trump’s press secretary, Sean Spicer, called Trump “a top notch negotiator,” and appeared to put the pricing issue back on the table.

Merck & Co. CEO Ken Frazier said he came away from the meeting with Trump thinking the government wouldn’t be using its purchasing power to negotiate down drug prices.

“We did not have a conversation that led you to believe that they think the solution to that problem is secretarial negotiations,” he said today in an earnings call. “That is not perceived to be the solution to the problem.”

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