Trump's Rx for confusion: How a push for tariffs complicated his pharma plan

"But the road to that decision was rocky, and showed how Trump's uneven management style - particularly surrounding tariffs - shadows a White House in which policies can be made on the fly, change suddenly at the president's whim, and then be fine-tuned as conflicts are resolved in real time. Trump Cabinet secretaries sometimes operate with such independence that they encroach on each other's turf."

"Behind the scenes: Within the White House, the conflict came to a head on Sept. 25, during a going-away party for departing senior adviser Taylor Budowich. About the same time that evening, Lutnick was in the Oval Office after a previously scheduled meeting about tariffs on heavy trucks and furniture. Trump and Lutnick then began talking about pharmaceuticals tariffs, a source said. And at 7:24 p.m., Trump posted that he'd impose the 100% tariff on prescription drugs produced outside the country."

"The fallout: Trump's post caught everyone off guard: Kennedy, Medicare and Medicaid Administrator Mehmet Oz, senior White House officials and drug companies negotiating with them. None had been consulted about the announcement. It prompted White House Chief of Staff Susie Wiles to have a one-on-one meeting with Lutnick to convey their concerns. Wiles - who has tried to prevent the chaos and drama that defined Trump's White House in his first term - reiterated to senior officials that they must work within established processes."

Affordability drove the president's decision on drug pricing, but competing priorities and impulsive interventions created internal conflict. Cabinet secretaries sometimes acted independently, with Commerce Secretary Howard Lutnick advocating tariffs and HHS Secretary Robert F. Kennedy Jr. negotiating a most-favored-nation drug pricing plan. The dispute intensified Sept. 25 when Lutnick discussed pharmaceutical tariffs with the president and the president announced a 100% tariff at 7:24 p.m., surprising negotiators and officials. The announcement prompted Chief of Staff Susie Wiles to confront Lutnick and demand adherence to established processes to reduce chaos and interagency turf battles.

Read at Axios