Mr. Grogan, who was appointed when Mick Mulvaney was the acting White House chief of staff, said two weeks ago that he planned to step down in May 2020. In a remarkable two-year span, Joe Grogan has vaulted from lobbyist for the pharmaceutical giant Gilead Sciences to White House budget adviser to director of the president’s Domestic Policy Council. Grogan’s chaotic ascent to the White House’s highest ranks, described to STAT in interviews with eight current and former Trump administration health officials and an array of conservative lobbyists, is defined more by feud than by policy triumph — and on drug pricing in particular, his track record consists more of blocking others’ policies than advancing new ones. In one of his first personnel moves, Mick Mulvaney plucked Grogan from his perch as Gilead’s head of federal affairs. in 1995, when Grogan worked alongside his roommate, Sean Spicer, as a junior researcher at the National Republican Senatorial Committee, Grogan cared little about the chain of command. Grogan, a recent SUNY-Albany graduate, spent a single election cycle working at NRSC before beginning law school at the College of William and Mary. From basement-level desks at NRSC’s Capitol Hill offices, they spent their days archiving comments from the Congressional Record for use in future advertisements and fundraising campaigns. Grogan went on to craft some of the most lucrative direct-mail fundraising campaigns in NRSC history. Grogan has long sympathized more with a populist, nonconformist brand of conservatism that Trump has come to personify.