* STOXX drops 0.3 pct, down for fourth straight day
* Trump tweet hits drugmakers
* M&A chatter lifts Italy tower firms
* Aggreko plunges on weak outlook
* But well-received results lift Just Eat, Iliad (Adds details, closing prices)
By Kit Rees and Danilo Masoni
LONDON/MILAN, March 7 (Reuters) - European shares fell on Tuesday as shares in big international drugmakers were hit after U.S. President Donald Trump tweeted about lowering drug prices.
Also weighing were companies such as Casino and Aggreko which reported disappointing results, but merger talk boosted shares in Italian TV tower firms.
The STOXX 600 fell 0.3 percent, setting its fourth straight session of losses. The pan-European index however remains close to its 15 month peak hit last week on the back of a rally fuelled by a brighter economic outlook and a strong earnings season.
The region's healthcare index was the top drag to the STOXX, down 1 percent, after Trump said he was working on a new system to increase competition and bring down drugs prices.
Sector heavyweights such as Novartis, Roche , Shire and Sanofi all fell between 0.8 and 2.3 percent.
The three biggest fallers on the STOXX all reported results, with Aggreko tumbling 12.9 percent after the British temporary power provider reported lower revenues and gave a gloomy outlook for this year.
French retailer Casino Guichard and bookmaker Paddy Power Betfair both fell more than 5 percent following poor earnings updates.
Data from Germany added to the downcast mood on Tuesday as figures showed that Europe's largest economy saw industrial orders fall 7.4 percent in January, their biggest monthly fall in eight years due to a slump in domestic and euro zone demand. Europe's industrial goods and services index ended down 0.1 percent.
Italian TV towers companies EI Towers and Rai Way both rose 5.3 percent after local newspaper Il Messaggero said Rai Way had mandated Citi to examine a possible takeover of its rival after a failed attempt to merge in 2014.
EI Towers, which is controlled by broadcaster Mediaset , said it was not aware of any offer.
Other company updates drove gains, with Just Eat rising 4.6 percent after the online food delivery company posted nearly doubled its earnings, while French telecoms group Iliad gained more than 1 percent after a core earnings rose.
The earnings season in Europe has so far been relatively strong, with 55 percent of companies in major regional markets posting earnings beats, according to Eikon data.
Traders said market participants were also looking ahead to the U.S. Federal Reserve's interest rate decision later in the month.
"We are still quite confident in European markets ... There's further scope for a bit of a push but we think there's a bit of a lack of a volume and market participation just because everybody's sitting on the sidelines waiting for the imminent announcement from the U.S.," said Berkeley Capital trader John Moore. (Editing by Hugh Lawson)