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At other times, he has talked about rolling back regulations and named an industry-friendly former congressman, Tom Price, to head the Department of Health and Human Services, and a former pharmaceutical consultant, Scott Gottlieb , to lead the Food and Drug Administration. Members of Congress have put forward a grab-bag of options, each of which would help or hurt different industry players. Some address minor aspects, such as a bipartisan bill that would force brand-name drugmakers to hand over samples of their drugs to generic competitors. One would allow for the importing of cheaper drugs.

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Another would force pharmacy benefit managers to disclose more information about how they did business. The brand-name drug industry is the dominant player.

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It spends the most on campaign contributions, has the largest army of lobbyists and has the biggest pile of chits among lawmakers to try to protect its own interests. A second set of PhRMA ads point blame for price increases elsewhere, like benefit managers and health insurers.


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In doing so, PhRMA is seeking to rehabilitate a reputation that was damaged by the actions of companies like Turing Pharmaceuticals, which sharply hiked the price of a decades-old medicine. Though Turing was never a member of the group, PhRMA recently purged nearly two dozen companies from its membership after it voted to exclude investor-driven drug companies like Turing.

Nearly every week that Congress is in session, the industry holds fund-raisers at private clubs and restaurants to help bankroll the re-election campaigns of its allies. One former lobbyist for PhRMA recently boasted that he had once organized six fund-raising events in a two-day period. He asked that he not be named because the fund-raising efforts are supposed to be confidential. The industry had reason to thank Mr. He also co-sponsored legislation that threatened to block it, which became moot after the Obama administration backed down.

A spokesman for Mr. Shimkus said his actions were intended to protect cancer patients — pointing to a clinic in his district he said might close if the Medicare program had gone into effect — not the pharmaceutical industry.

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But other participants said industry influence — as drug companies attempted to preserve their bottom line — had played a decisive role. When you take on pharma, you take on this whole town. Stephen J. Brand Saftey.


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