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One of the most powerful players in health care is PhRMA, the Pharmaceutical Research and Manufacturers of America. It represents 32 brand-name drug companies, and has so much influence, that when Congress passes a bill, PhRMA almost always gets its way.

NPR's Dollar Politics team dug into the numbers and found one big reason why: PhRMA and its members have spent millions lobbying Congress.

Here's correspondent Andrea Seabrook.

ANDREA SEABROOK: Any firm that spends significant money lobbying Congress has to file a quarterly report. This Monday was the deadline for the second quarter, giving us a chance to peer into three critical months in the health care debate: April, May and June. That's when Congress really got down to business.

In those three months, PhRMA spent just over $6 million, breaks down to about $2 million a month. But then we looked up the reports of the companies that belong to PhRMA and it turns out that all but a few of them were running their own lobby shops, as well. Drug maker Pfizer alone spent $5.5 million. Amgen, Eli Lilly and GlaxoSmithKline spent about $3 million each.

Add it all up, and you get this: In those three critical months, PhRMA and its member companies spent $40 million lobbying Congress. That's $3 million and change each week. PhRMA declined to speak to us for this story. And four of its biggest members turned down or didn't respond to requests for interviews.

(Soundbite of TV advertisement)

Ms. LOUISE CAIRE CLARK (Actress): (As Louise) We need good coverage people can afford.

SEABROOK: But PhRMA is running ads.

(Soundbite of TV advertisement)

Ms. CLARK:(As Louise) A little more cooperation, a little less politics, and we can get the job done this time.

SEABROOK: And PhRMA's CEO, Billy Tauzin, has been out there touting its support for reform.

Mr. BILLY TAUZIN (CEO, Pharmaceutical Research and Manufacturers of America): We're working with groups we never worked with before: Families USA, the American Agenda. We're working with labor and health care providers that never stood together on the same platform together. We have every business reason to want to see this happen. And we have every moral reason to see it happen, because our patients are our first concern.

Dr. JERRY AVORN (Harvard Medical School, Author, "Powerful Medicines"): Of course they're supportive. They're getting from it exactly what they want.

SEABROOK: This is Dr. Jerry Avorn, a professor at Harvard Medical School. He, for one, is not shocked to hear that brand-name drug companies spent $40 million in three months.

Dr. AVORN: It's not surprising to learn this because the pharmaceutical industry has for many, many years, been one of the most effective and powerful and expensive lobbying outfits in Washington. And it explains why we have a lot of drug policies in the U.S. that don't look like drug policies in any other industrialized country.

SEABROOK: Avorn wrote a book about drugs and health care called "Powerful Medicines." Avorn compares the current fight to the last time Congress did a major health care change in 2003. It added prescription drug coverage to Medicare. He says PhRMA's lobbying efforts were so vast and so intense that the result is plain in the law.

The government is empowered to negotiate how much it pays doctors, hospitals, laboratories, almost anyone who does business with Medicare, anyone except pharmaceutical companies. Avorn points out, negotiating drug prices is made illegal by the law.

If you want to know what PhRMA is getting this time, Avorn says, just look at what's not on the table during the debate: Drug re-importation from Canada -off the table, government-negotiated drug prices - off the table.

Dr. AVORN: A lot of those seem to have been already resolved even before the public discussion begins. And usually, as with the other interest groups involved, they seem to have been resolved in favor of the interest groups rather than in favor of the public.

SEABROOK: There's something else drug companies bought with that $40 million: People. PhRMA alone has 29 people lobbying for it. Dig into the reports and you'll find that it also hired 45 different D.C. lobbying firms to represent it in those three months. Check out a graphic of this at npr.org.

Most of the drug companies that belong to PhRMA are running their own lobby shops, as well. Plus, the biggest ones have also hired dozens of D.C. lobbying firms.

So think about it this way: There are far more people in Washington representing one party of the debate, the big drug companies, than there are members of Congress working on the health care bill. This is not to pass judgment on the merits of PhRMA's arguments, but to show just how much money and lobbying it uses to back them up, and the winning streak in Congress that follows.

Andrea Seabrook, NPR News, Washington.

MADELEINE BRAND, host:

We want to hear your questions about fixing health care. We'll find some answers and put them on the air. Send them to us at our Web site, go to npr.org. Click on Contact Us. And please put, health, in the subject line.

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