How Donald Trump broke the ice between Robert F. Kennedy Jr. and drug company CEOs

President-elect Donald Trump set two tables for a dinner party this month with his choice for Health and Human Services secretary, Robert F. Kennedy Jr., and drug company executives like the ones Kennedy once accused of belonging to a “criminal enterprise” that knowingly killed patients for profit.

They gathered first in a side dining room at his Mar-a-Lago estate, until Trump made clear that he wanted the meal to proceed as something less formal.

He proposed that the diners - which included the CEOs of Pfizer, Eli Lilly and the trade group PhRMA - relocate to a second round table on the patio, where music was playing, to better enjoy the winter Palm Beach evening, according to three people familiar with the dinner’s discussion, who spoke on the condition of anonymity to describe the private event.

Trump directed the conversation to the role pharmacy benefit managers play in the costs of prescription drugs - a major sore point for drug manufacturers who have launched a lobbying crusade accusing the middlemen of driving up prices.

The incoming president made clear that he wanted to do something to help drugmakers, and they discussed recent efforts to increase US-based manufacturing of pharmaceutical drugs, according to two of the people familiar with the meeting. Another person said the comments were focused on helping patients save money.

When the topic turned to vaccines, the discussion was not about banning the products, the three people said. Kennedy spoke about the need for better study of the vaccine dosing schedule for newborns and the rise in chronic disease, while also rattling off statistics about the increase in autism rates despite multiple studies that have shown no link between vaccines and the disorder and World Health Organization estimates that immunizations have saved 154 million lives, according to two of the people.

Here Trump redirected the conversation again, while backing up Kennedy’s desire for more research, two people said. He suggested to the drug company executives that they had nothing to fear from further investigation of the causes of autism, saying Kennedy could help put to rest vaccine hesitancy if no connection was found.

The aftermath of the dinner, which ended by all accounts with surprising warmth on all sides, has become the stuff of mini-legend in the week that has followed. Trump called it “a little unusual” in a recent NBC News interview.

“At a point I thought, I can’t believe I am doing this,” another participant said, expressing a sentiment echoed by others.

“Probably shouldn’t say too much about it, but it was all you can imagine, and a little bit more,” Eli Lilly CEO David Ricks said Tuesday during an appearance at the Economic Club of Washington. “There’s often more common ground than you’d think just reading the newspapers.”

Spokespeople for PhRMA, Pfizer and Eli Lilly declined to comment.

Kennedy did not respond to a request for comment. The Trump transition team also declined to comment.

There is no certainty that the congeniality will hold between Kennedy and the industry he has long demonized and has promised to challenge by conducting new research into their products. He has vowed to “review” drug companies’ ability to directly advertise to consumers; revisit the ability of the industry to fund Food and Drug Administration reviews of pharmaceuticals; and increase conflict-of-interest prohibitions for researchers getting funds from the National Institutes of Health.

But as Kennedy prepares to head to Washington this coming week to begin meetings with Republican senators, he has so far avoided the snags that quickly greeted Trump’s first attorney general pick, Matt Gaetz, who withdrew, and his defense secretary choice, Pete Hegseth, who continues to fight on. PhRMA has yet to issue any clear declaration of opposition to Kennedy, despite a recent warning from more than 75 Nobel laureates that Kennedy would “put the public’s health in jeopardy.”

The selection of Kennedy to lead HHS poses a major test of how far Republicans will go to support Trump. The former Democrat has championed issues that challenge GOP orthodoxy, such as his support of abortion rights, contempt for the drug industry and ideas to change U.S. agriculture.

He’s unlikely to get much support from Democrats, some of whom have expressed deep alarm at putting Kennedy in a position to shape health policy given his views on vaccines. If the party unites in opposition, then Kennedy can afford only three defections from Republican senators to be confirmed. Some Republican senators have said they will seek to have Kennedy explain his criticism of vaccines.

Aaron Siri, an ally of Kennedy, petitioned the government in 2022 to reconsider its approval of a widely used polio vaccine that is credited with staving off a debilitating virus that can result in permanent paralysis.

In response to reporting about Siri’s petition, Senate Republican leader Mitch McConnell (Kentucky), who battled polio as a child, forcefully denounced attempts to cast doubt on the polio vaccine. “Anyone seeking the Senate’s consent to serve in the incoming Administration would do well to steer clear of even the appearance of association with such efforts,” McConnell said in a statement Friday.

Ahead of Kennedy’s meetings on Capitol Hill, some leading antiabortion groups have met with at least half a dozen senators or their staff, according to an antiabortion strategist who spoke on the condition of anonymity to detail private discussions. Those conversations are aimed at ensuring senators will ask him questions of concern to the antiabortion community. Former vice president Mike Pence has called the choice of Kennedy “an abrupt departure from the pro-life record” of the first Trump term.

“I think there’s an impression [Kennedy] is not a zealot on this and that if he has good people around him that they’ll handle it right,” said the strategist. “In all honesty, I think the pro-life community is probably more concerned about what President Trump says about abortion than what RFK Jr. is saying about it.”

The Trump transition team is also confident that Trump’s own relationship to the antiabortion community will more than make up for Kennedy’s history on the issue. But health-care advocacy groups on the left have signaled an intense effort to dissuade Republicans from supporting Kennedy in part by pointing to his past statements on abortion.

“The only health-care issue we could possibly agree with RFK Jr. on is he is fiercely pro-choice - so it will be quite a feat of political gymnastics for Republicans to confirm him ignoring both his views on vaccines and abortion,” said Brad Woodhouse, a strategist for Protect Our Care, a group that has organized an anti-Kennedy war room aimed at sinking his nomination.

Before becoming Trump’s champion, Kennedy, the scion of the most famous Democratic family, built his career as a trial lawyer suing chemical companies and other powerful industries. He launched his recent presidential campaign declaring that executives like those at the dinner with Trump had corruptly captured U.S. regulatory agencies while benefiting from an Orwellian censorship campaign to cover up the harmfulness of their products.

The confirmation of Kennedy by the Senate would place a fierce critic of the pharmaceutical industry who has accused drugmakers of corruption and “mass poisoning” in charge of the nation’s health department. He has falsely called the coronavirus shots, one of which Pfizer manufactures, the “deadliest vaccine ever made.” A group he founded, Children’s Health Defense, has raised doubts about the safety of vaccines despite assurances from federal regulators. The group along with others has sued The Washington Post and other news organizations on antitrust grounds alleging suppression of what it claims is “wholly accurate and legitimate reporting” about vaccine danger.

Shares of Moderna and Pfizer, which make coronavirus vaccines, dropped shortly after the announcement of his impending nomination, while some drugmakers reached out to their lobbyists pleading for help in understanding the potential impact of the selection.

Trump’s pick of Kennedy “fosters a mood of doubt in science and skepticism in science, and I think that’s a disaster,” said John LaMattina, a former president of Pfizer Global Research and Development and a senior partner at PureTech Health, a firm that creates biotech start-ups.

“But part of the challenge right now for pharmaceutical companies [is] they don’t necessarily want to rock the boat,” he said, adding that it was “smart” for pharmaceutical executives to establish a dialogue with the incoming administration.

The drug industry has had a complex relationship with Trump throughout the years. In 2017, during his first news conference as president-elect, he accused companies of “getting away with murder.” While in office, he pursued several policies the industry despised, including tying government payments for medicines to lower prices paid overseas - an idea that got tied up in court and which Trump has since abandoned. But he also pursued a rule beloved by the industry that was aimed at ending the widespread practice of drugmakers giving rebates to pharmacy middlemen in government programs like Medicare.

Kennedy has said that he opposes government vaccine mandates, believes vaccine injuries may be greater than reported, and wants more research into vaccines and the causes of increased chronic disease. Kennedy has also called for a reduction in subsidies for less healthy food and a new public health campaign to educate the country.

“We’re not going to take vaccines away from anybody,” Kennedy told NPR shortly after the election. “The science on vaccine safety, particularly, has huge deficits, and we’re going to make sure those scientific studies are done and that people can make informed choices about their vaccinations and their children’s vaccinations.”

Trump has also been open to the idea that vaccines could be causing undetected harm, despite a lack of evidence. In an interview published Thursday in Time, Trump suggested he could get rid of some vaccines if they are “dangerous” and “not beneficial.”

“There’s just not a connection,” Robert Califf, the commissioner of the Food and Drug Administration, said in an interview about the question of autism and vaccines. “It’s so well-documented that vaccines have saved millions of lives. Vaccines in general, particularly childhood vaccines, are critical to public health. If we back away from that, we’re putting our children at risk.”

Vaccines go through several stages of clinical trials and are studied in thousands of people to determine their safety and effectiveness before they are allowed to come to the market.

Drugmakers would be pleased to see Kennedy and Trump tag-team policies aimed at pharmacy middlemen.

Pharmacy benefit managers (PBMs) have faced bipartisan scrutiny in Congress, with some lawmakers arguing that industry middlemen are contributing to the high cost of medicines. Some lawmakers are racing to include measures taking aim at PBMs in an upcoming bill to fund the government, some of which has the support of the pharmaceutical industry. A top PBM trade group has maintained that the middlemen help lower costs for patients.

Trump alluded to Kennedy’s long-standing criticism of powerful interests when announcing his former rival as his pick to lead HHS. Some of the food policy ideas Kennedy has pushed - such as cracking down on food dyes and stripping ultra-processed foods from school menus - have found support on both the right and the left.

“For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health,” Trump wrote in a post on X.

That rhetoric has attracted the attention of one veteran public interest advocate, Ralph Nader, who has urged Democrats to support Kennedy’s nomination even as the leaders of the group Nader founded, Public Citizen, have called Kennedy a “science-denying, morally bankrupt conspiracy theorist.”

“You can have a list of quotes five pages long of nutty things he said. But don’t stereotype him,” Nader said.

“Put that aside. He is very good on chronic disease, junk food and obesity and pollution, and we have never had an HHS secretary who was very good on those points.”

Daniel Gilbert contributed to this report.

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