President Trump’s first week in office has been a wildcard to outsiders — with the Republican putting America’s health corps on ice, crashing Medicaid, and pushing forward with his nomination of Robert F. Kennedy Jr. to run the Department of Health and Human Services. But despite that, investors are clinging to hopes that Republicans could reignite the pharmaceutical industry.

Republicans have the Rx pad: Under President Joe Biden, the stocks of pharma firms fell from their COVID-19 good graces, with the SPDR S&P Biotech ETFXBI

down 39% during the Democrat’s term. It came as Dems passed legislation that capped prices of prescription drugs and created new regulations while giants hurdled patent cliffs. But with new leadership on Capitol Hill, the pharma industry is enthusiastic about Trump’s “pro-business” bent — and is hoping he’ll commit to cutting down on middlemen, repealing his predecessor’s regulations, and opening up the floodgates for dealmaking.

• At a presidential debate, Trump said that he had “concepts of a plan” for replacing America’s current health system, vaguely detailing a focus on deregulation, competition, and care choice.
• In addition, drugmakers are looking to reignite M&A under Trump, with changes at the FTC likely to reduce antitrust enforcement.

Ones to Watch

Besides great unknowns, the sector is also looking forward to a year of new approvals — with drugs from Vertex PharmaceuticalsVRTX

, GSKGSK

, and others rolling out highly-anticipated launches which are forecast to generate up to $29B in annual sales by 2030.

• Vertex’s cystic fibrosis drug Vanza Triple and its acute and neuropathic pain drug Suzetrigine rank as the #1 and #3 drugs on Evaluate’s top 10 drugs “slated to earn approvals in 2025.”
• Other drugs from Daiichi Sankyo/AstraZenecaAZN
  , CytokineticsCYTK
  , and InsmedINSM
  also made the list — targeting lung/breast cancers, hypertrophic cardiomyopathy and neutrophil-mediated diseases.

Big f’n deal: In recent years, smaller pharmaceutical companies have produced a larger number of treatments — many for a wider array of rare diseases like myasthenia gravis, cystic fibrosis, and others. But after a big 2024 for small firms and diseases, 2025 could be the year that larger pharma enterprises put their ample cash to work in pursuit of big deals.