The latest comparison of the two presidential candidates’ health plans offers a twist: a look at how they’d affect some of the biggest players feeding at America’s trillion-plus health care trough.

If Barack Obama wins Nov. 4, it’s the pharma industry that stands to take the biggest hit, according to Boston Consulting Group. Its analysis concludes that Obama’s plan to let the federal government negotiate Medicare drug prices could cut industry revenues by a whopping billion to billion.

That loss might be at least partly offset by Obama’s plan to reduce the number of uninsured, which would likely increase the number of people able to afford prescription drugs in the first place. On the other hand, private insurers might follow Medicare’s lead and insist on paying less for prescription drugs.