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Robert F. Kennedy, Jr. was confirmed as the next Secretary of the Department of Health and Human Services (HHS) on Thursday morning.

Kennedy was confirmed by the Senate in a full floor vote.

The Senate advanced Kennedy following a key procedural vote of 53 to 47 on Wednesday afternoon.

The confirmation came weeks after a pair of Senate committee hearings in which Kennedy was interrogated by lawmakers on both sides of the aisle over his controversial views on vaccines, public health, Medicare and Medicaid, as well as drug pricing.

The votes were expected to be split along party lines and Sen. Bill Cassidy, (R-LA), ultimately tipped the scale in favor of Kennedy. 

Cassidy, who was initially skeptical of Kennedy’s anti-vaccine rhetoric, noted in a post on X shortly after the hearings that he would vote in the affirmative after several “intense conversations” with the nominee.

Later, Cassidy announced that he wanted Kennedy to succeed in “Make America Healthy Again” (MAHA).

It remains to be seen how Kennedy will handle the post, specifically whether he takes a more moderate approach or shakes things up like he has previously promised.

While Kennedy may not follow through on policy ambitions to ban direct-to-consumer (DTC) advertising, for example, he still has the power to be “extraordinarily influential” on pharma, according to experts.

Here are some of the main health policy areas that deserve renewed attention from industry leaders in light of Kennedy’s confirmation.

Drug pricing

At face value, Kennedy has appeared to align more closely with progressives on drug pricing issues than industry-friendly conservatives. 

He has repeated the argument common among drug pricing reform advocates that Americans shouldn’t be paying more than other countries for the same drugs. 

Additionally, he has singled out Big Pharma companies as being too closely intertwined with the federal agencies that regulate them.

However, Kennedy didn’t delve into too many details about his approach to drug pricing during the confirmation hearings. 

When asked about Medicare negotiations — which are now entering their second round — he simply noted that President Donald Trump was committed to negotiating lower prescription drug prices.

That pledge coincided with the Trump administration releasing its first statement on the future of the Medicare negotiation program, in which it noted lowering drug costs was a “top priority.” 

Still, the White House also made clear it planned to work with stakeholders to improve the program — hinting that Trump plans to keep drugmakers somewhat content.

Kennedy’s answers on Medicare negotiations during the hearing did not satisfy Democratic lawmakers, who sent him a letter afterwards.

“Contrary to what you suggested in today’s hearing, the Trump administration’s statement is far from an embrace of drug price negotiation and appears to be opening the door to changes that could undermine Medicare’s ability to get the best price possible on drugs,” Sen. Ron Wyden, (D-OR), wrote.

It’s likely that Medicare negotiations will go on as planned; though it’s also just as likely there will be some tweaks or adjustments to the program, according to Evan Seigerman, a biopharma analyst at BMO Capital Markets.

“The optics for negotiating against Big Pharma are good for [Trump],” Seigerman previously told MM+M. “It’s hard for the Trump administration to be super supportive of a Biden administration [accomplishment] — so he’s got to find his angle and to make it his own.”

Kennedy was also asked during a closed-door Senate Finance Committee meeting if he was open to the use of “march-in rights” to lower drug costs.

Politico first reported that Kennedy showed an openness to march-in rights, which would allow the government to seize the patents of certain high-cost drugs developed with federal funding, in order to drive down prices. 

STAT News later reported the opposite — that Kennedy in fact said lowering drug costs “would not be an appropriate use” of march-in rights.

An unwillingness to consider march-in rights for drug costs would be welcome news to the pharma industry, which opposes the option. It would also be a split from the Bidden administration, which announced its support of march-in rights in 2023.

Vaccine policy

During the confirmation hearings, Kennedy repeatedly emphasized that he would not deter Americans from taking the measles or polio vaccines — adding that he wasn’t anti-vaccine.

Yet when it came to other questions about whether he believed vaccines cause autism, he was more elusive with his responses.

His promises to safeguard access to well-established vaccines during the hearings were apparently enough to win Cassidy’s vote. 

Still, Democratic lawmakers have continued to voice concerns that Kennedy might jeopardize public health by stoking vaccine hesitancy among the general public.

It remains unclear whether Kennedy will maintain the federal government’s status quo on vaccines, or if he’ll lean more toward an anti-vaccine approach.

On the industry side, some major drugmakers have expressed a sense of confidence despite Kennedy’s checkered past on vaccines. 

During Pfizer’s recent earnings call, CEO Albert Bourla noted he had been to dinner with Kennedy and had discussed the path forward for the industry.

“I focus more not on the things that we clearly disagree [on], like the vaccines, but on the things that we can agree [on] and we can do things together,” Bourla said. “I’m cautiously optimistic.”

Potential DTC advertising ban

One of the most direct threats to pharma lies in a potential DTC advertising ban — something Kennedy has called for in the past.

The issue wasn’t brought up during his confirmation hearings, however, suggesting it might not be as big of a priority for Kennedy as some of his other MAHA goals. 

The extent of Kennedy’s power in enacting a ban legally may also be limited, experts have noted.

In the event regulatory action comes to pass, pharma companies are beginning to prepare for a possible ban or even a partial one, according to Sonam Dubey, a partner at life sciences consultancy Beghou Consulting.

“A large portion of marketing spend goes into DTC ads,” Dubey said. “So there would have to be a big transformation in the way pharma companies double down on more traditional marketing channels.”

Since the COVID-19 pandemic, pharma companies have reduced their investments in the traditional route of in-person meetings between sales reps and healthcare providers (HCPs). 

However, if DTC ads see restrictions thanks to Kennedy, there may need to be a reinforced effort on HCP marketing, including in-person sales reps, Dubey said.

She suggested drugmakers could also take another route — working with patient support programs and developing more “above-brand” strategies that don’t necessarily market a single product, but instead focus on disease awareness and education.

For pharma marketers who are preparing for potential DTC ad restrictions, the key is to view it as more of an opportunity rather than an obstacle, Dubey said.

“It’s an opportunity — whether [a ban] happens or not — to relook at the whole thing and see what else you can do to truly empower the patient,” she explained. “The main customer is still the physician; they’re the ones writing prescriptions for the patient at the end of the day. So that’s something that’s not going away anytime soon.”