
By Ambrose O’Callaghan, Harvest ETFs
(Sponsor Blog)
The U.S. healthcare sector has faced unique challenges in late 2024 and the first half of 2025. Last year, we provided an in-depth look at global healthcare as a long-term opportunity and examined some of the catalysts and innovations that were impacting the sector. Today, the U.S. and global healthcare space continues to evolve while combatting headwinds in some key areas.
The state of U.S. healthcare equities
Healthcare performed relatively well in the early part of 2025, despite broader trade uncertainty and macroeconomic headwinds. The medical technology and tools sub-sector experienced some short-term volatility that was driven by the uncertainty surrounding tariffs. That comes as little surprise, considering companies in the space reliance on oversees manufacturing and revenue generation.
Domestic names, like those in Managed care and select Biopharmaceuticals, remained relatively insulated during this period. This stemmed from an easing in the tariff narrative, which was triggered by a sharp drop in several macroeconomic indicators that included manufacturing activity and consumer confidence. As we progressed further into 2025, a cloud of uncertainty crept into healthcare. That contributed to some recent volatility across several sub-sectors. In this article, we have provided some recent catalysts to help investors make sense of the current situation in healthcare.
Drug pricing in 2025
On May 12, 2025, President Donald Trump signed an Executive Order (EO) titled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients.” This EO proclaimed that the Trump administration “will take immediate steps to end global freeloading and, should drug manufacturers fail to offer American consumers, the most-favoured-nation lowest price, my Administration will take additional aggressive action.”
Ultimately, the aim is to align U.S. drug prices more closely with lower prices paid internationally. This EO echoes a summer 2020 Trump-era EO that was blocked in court and failed to be implemented. The current version faces similar hurdles. There is no bipartisan backing for the policy, the legality surrounding it is dubious, and there is opposition among both Democrat and Republican lawmakers.
All of these make the implementation of this EO unlikely. However, we could see pilot programs within the Department of Health and Humans Services (HHS), making attempts to fold the current EO’s proclamations into future IRA negotiations, or more comprehensive legislative proposals.
In addition, there are those who have predicted the policy could reduce the research and development (R&D) budgets further. That could potentially impact innovation and companies that have been propelled due to strong R&D spending. However, the risk may truly lie in the negative sentiment that continues to emerge in the news cycle.
Vaccine market uncertainty
The appointment of Robert F. Kennedy Jr. as the United States Secretary of Health has damaged sentiment for healthcare companies that manufacture vaccines. RFK Jr. is a vocal “vaccine sceptic.” Moreover, the Trump administration has pursued leadership changes at the Food and Drug Administration (FDA), which raises questions about stricter vaccine approval processes going forward.
Merck & Co, the U.S.–based pharmaceutical giant, with its vaccine-related businesses, has felt the pressure. In addition to the political uncertainty, a recent CMS technical document has added to the complexity in the vaccine arena. The report suggested that reformulated drugs may no longer be classified as “new” for Medicare negotiations. This development could impact companies with operations in the “combination therapy” space like Johnson & Johnson’s Darzalex Faspro, or Bristol Myers’ subcutaneous version of Opdivo. That could affect future patent projections as well. Continue Reading…