Which pharma advertising did President Trump lambaste on Twitter? Good question

President Donald Trump slammed “Big Pharma” TV ads on Twitter, the morning after pharma executives turned down his White House invite. But the ad that sparked his ire might not be a pharma commercial after all.

While the president may have been upset by the pharma executives' rejection, a TV ad created by the Pharmaceutical Care Management Association—not Big Pharma—might well have set off the Tuesday morning tirade.

PCMA launched a TV and digital ad campaign Tuesday, and the subject matter seems to fall right in line with the president's complaints.

The TV ad opens with a voiceover announcing: “The Trump administration just announced a new plan to raise Medicare premiums.” An older man in his kitchen looks up at the camera and asks “During a pandemic?” while another senior looks up from his newspaper and asks “When drug costs are already so high?”

A PCMA spokesperson confirmed that the commercial ran this morning on Fox—a channel the president is known to watch.

Trump’s complaints came around 10 a.m., just after the Fox and Friends morning TV show, starting with this opening shot: “Big Pharma is taking television ads trying to make the case that I am raising prescription drug prices on seniors.”

The president then claimed, with no evidence, that he has reduced drug prices by 50% "at least" before continuing in a second tweet to call the ads "nasty."

In referring to Prescription D, the president likely meant Medicare Part D, the prescription drug benefit for seniors which went into effect in 2006.

But PCMA, the group running the costs criticisms from seniors, doesn’t speak for Big Pharma. It represents pharmacy benefit managers (PBM) who handle drug benefit programs for insurance companies and large employers. PBMs, in fact, are often at odds with Big Pharma and its pricing moves.

PhRMA, the trade group that does represent Big Pharma companies, is currently running a more feel-good we're-all-in-this-fight-together COVID-19 TV ad campaign, but it did openly criticize Trump's recent executive orders. The group’s CEO Stephen Ubl called the orders a “reckless distraction that impedes our ability to respond to the current pandemic—and those we could face in the future." 

The executive orders, signed Friday, seem to have pulled several typically disparate healthcare groups onto the same page to rally against them. The orders mandate discounts for insulin and epinephrine, eliminates drug rebates, allows importation of drugs from other countries and creates an index linking U.S. prices to those elsewhere. In practice, the changes will take months to launch at best, and some may require congressional action, analysts say.

RELATED: Trump's flipped his view on pharma companies thanks to COVID-19. Will the public?

Along with the PCMA ad and PhRMA's condemnation, the National Association of Manufacturers debuted a reported $10 million ad campaign that criticizes the price control part of the executive orders. In a TV ad, NAM's voiceover criticizes Washington D.C. maneuvers, noting: “Politicians shouldn’t force bad ideas from overseas on Americans that harm manufacturers' ability to develop innovative cures for diseases."