Pharma was blindsided last weekby the plan to index certain expensive drugs paid for by Medicareto much lower international prices. (Photo: Getty)

Earnings are now in at most of the biggest pharmaceutical firms, and one thing is clearfrom their results: One of President Donald Trump's most visible efforts to strong-arm them onprices hasn't caused much pain.

Pfizer Inc. was called out by Trump in a July tweet overmid-year price increases the drug giant pushed through on a numberof its medicines, and the public shaming prompted the company toroll back the increases. That was followed by appeasement from other big pharmafirms including Merck & Co., Novartis AG and Roche HoldingAG.

Related: Reference-based pricing: a panacea for high drugprices?

It's been obvious from the start that these moves were cosmetic.Roche, for example, promised to forego further price increases thisyear only after it had already enacted hikes on some of its biggestsellers. But the earnings reports are further proof that effortsintended to mollify the president didn't involve much if anysacrifice.

Novartis, Merck, and Amgen all beat analysts' third-quarterearnings expectations and raised either their sales or EPS guidancefor the full year (Amgen raised both). Roche doesn't report EPS ona quarterly basis, but beat sales expectations on the back ofstrong U.S. results. Pfizer's earnings were messier, but its pricerollback wasn't to blame for its woes. In fact, the various pricingactions don't appear to have had any impact that couldn't beovercome by nudging a few levers elsewhere:

The fourth quarter will likely be similar. And Pfizer's outgoingCEO Ian Read said on Tuesday's earnings call that the end of theyear is likely to bring a return to a pricing policy of “businessas normal” for the company, and it probably won't be alone.

The issue has never really been any individual price hike, butinitial prices that are out of whack with the rest of the world andthe compounded effects of many years of increases across manydrugs.

In spite of its initial celebration, the Trump administrationappears to be wise to the fact that the industry's efforts atreform were pretty lazy. Pharma was blindsided last week by theplan to index certain expensive drugs paid for by Medicare to muchlower international prices. It went well beyond what it expectedfrom a Republican administration, and serves as a clear sign thatthe pricing issue won't go away easily.

Pricing reform that actually has an impact on patients andhealth-care spending is going to come at a cost to pharma. But theindustry has plenty of room to moderate while still remainingwildly profitable.

As long as pharma's self-discipline is so soft, policy makersare going to remain focused on this highly populist issue. The cutsthat eventually result won't be cosmetic and they won't bevoluntary.

Read more: 

• Pharma balks at proposal to list drug prices in TVads
• Pharma giants have pledged to lower prices before.Is this time different?
• The 'dark money' behind the latest pro-pharmaadvocates

Max Nisen is a Bloomberg Opinion columnistcovering biotech, pharma and health care. He previously wrote aboutmanagement and corporate strategy for Quartz and BusinessInsider.  This column does not necessarily reflect theopinion of the editorial board or Bloomberg LP and itsowners.

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