One TV ad accuses a Democrat of “supporting drug company greed over our needs”. Another accuses a Republican of “making a killing off cancer patients”. A third ad praises a Republican for “standing up to drug companies”. A fourth attacks a Republican for placing “drug company profits” ahead of kids with diabetes.

Taken one at a time, they look like average election ads. But as a group, they scramble all the usual rules for political messaging. The ads have aired in a scattershot of nine states in the run-up to the November elections, in both congressional and gubernatorial races. Some attack Republicans and others attack Democrats. Certain ads are even placed in races where the outcome does not appear to be in doubt, with the incumbent up by 30 points.

But it’s a coordinated campaign, and what unites the TV spots is a single objective: to promote lower pharmaceutical drug prices by supporting officials who have been allies in that cause and targeting officials who have not. If the ad campaign looks experimental otherwise, with its grab bag of races and partisan flexibility, that’s because it is, said advocate David Mitchell. He is the founder of the not-for-profit group, Patients for Affordable Drugs, whose political action committee spinoff is running the campaign.

“It’s very different than a classic electoral strategy,” said Mitchell. “The electoral work is a way of elevating the issue, creating a clear sense of the power of this issue and the demand out there for politicians to take action.”

Two years ago, Mitchell, a communications executive who had been diagnosed with multiple myeloma, decided to take on the drug pricing issue by building a national network of patients with stories about their personal struggles to afford life-saving medicine. For his cancer, Mitchell was prescribed a drug that costs $11,500 per year out-of-pocket for most Medicare beneficiaries, although he had private insurance.

Per capita spending on prescription drugs has more than tripled in the last 20 years, according to the Kaiser Family Foundation. As the midterm elections neared, Donald Trump sought to claim the issue, delivering a speech last Thursday in which he said: “Americans pay more so other countries can pay less. It’s wrong. It’s unfair.” But so far the Trump administration has not shown signs of pursuing in earnest new regulations or legislation that would address the problem.

The battle has been frustratingly protracted for patients, despite occasional flare-ups of public outrage over seemingly extortionist pricing for EpiPens or the kind of predatory drug company behavior embodied by Martin Shkreli. “I realized we needed to raise patient voices and stories and get them in the face of elected officials and policymakers,” Mitchell said.

The result is a collection of often heartwrenching personal stories drawn from a national network that now counts 85,000 patients and 110 patient-advocates who have testified before Congress or in courts, talked to media or visited Washington to lobby elected officials.

There are stories of stretching prescriptions by taking half-doses, facing bankruptcy to pay for drugs to save a child’s life, skipping other medications, fighting insurance companies, taking out loans, going without food, going to Canada where drugs are cheaper, or simply living with fear.

Mitchell’s group found a resourceful ally in the Houston-based Laura and John Arnold foundation, which made a $500,000 grant in November 2016 and has contributed millions since. In late 2017, Patients for Affordable Drugs sprouted a lobbying arm, and then a political action committee which by 30 September had spent $8.1m in midterm elections races.

“We have no illusions – ‘big pharma’ is spending half-a-billion in this election cycle,” said Mitchell. “Sometimes it’s daunting.”

Michael Franz, the codirector of the Wesleyan Media Project, which tracks political ads in federal elections, said plenty of outside groups have spent money on both sides of the aisle before, in the form of political contributions. Such bipartisan contributions are typically made to ensure a place at the policymaking table no matter who ends up controlling it, Franz said. But a genuinely bipartisan TV ad campaign around a single issue was rare, he said.

Mitchell said their first target was easy to pick: Republican Bob Hugin, a former pharmaceuticals CEO running for US Senate in New Jersey. Hugin’s company, Celgene, makes the drug, Revlimid, that Mitchell first took as a cancer patient. It cost him $250 a month out-of-pocket, Mitchell said, thanks to his good insurance. But for someone on Medicare, the drug can cost 50 times as much, out-of-pocket.

“Bob Hugin was a no-brainer because he is the embodiment of everything that’s wrong with our drug-pricing system and could help lead that work,” Mitchell said. “I took his drug for five-and-a-half years. And we could not let an abusive drug company CEO become a US senator.”

Patients for Affordable Drug Action, also known as P4AD, has spent $3.5m in the New Jersey race. The resulting ads are brutal, branding Hugin as: “The guy who made a killing off cancer patients like me”.

In a statement, a spokesman for the Hugin campaign attacked Mitchell as a “career Democrat operative”.

“David Mitchell and P4AD say they want to ‘defeat politicians who are in the pockets of Big Pharma and to help elect candidates who will stand up for patients and fight for lower drug prices’,” said spokesman Nick Iacovella. “But then they turn around and spend millions to try to save corrupt, career politician Bob Menendez.”

The campaign of incumbent Menendez, a Democrat who was admonished by the congressional ethics committee this year for accepting unapproved gifts, referred the Guardian to previous statements in which Menendez has accused Hugin of being a “fraud” and a “greedy pharmaceutical executive”.

The pharmaceutical industry argues that drugs are not overpriced. Given research and development and regulatory costs, it takes $2.5bn on average to bring a new drug to market, the industry has claimed – and if companies didn’t charge a lot for drugs they would go broke, new drugs would cease to emerge and patients would suffer.

Mitchell said the pharmaceutical industry lies about its profit-making and pointed out that Hugin made more than $20m a year as Celgene CEO.

“We decided we would highlight people who were really good and really bad,” Mitchell said.

The group supports the reelection bid of embattled Democratic senator Claire McCaskill, whom Mitchell called “a standout – a real leader who has passed bills and been a true opponent to big pharma”. The resulting ad is called “Fighting for the rest of us.”

One devastating spot targets Republican representative Bruce Poliquin of Maine, who has taken large donations from the insurance industry while voting against the Affordable Care Act and in favor of tax cuts for pharmaceutical companies. Poliquin’s campaign did not reply to a request for comment.

“My son has diabetes,” a woman in the ad says. “I wish we had a congressman who cared more about him than drug company profits.”

Mitchell said the group has heard some blowback for attacking targets such as Democratic senator Tom Carper of Delaware. An ad cut by the group says that Carper, whose campaign did not reply to a request for comment, “sides with drug corporations at the expense of people who need life-saving medications”.

“When we announced against Carper, the Democratic Senate caucus took note and wanted to know what the hell we were doing,” Mitchell said. “It’s easier to be partisan, because then at least your friends don’t yell at you.”

Another Democratic target is Anna Eshoo, whose 25 years in Congress have left her as the top cumulative recipient of donations from pharmaceutical interests. Eshoo does not appear to be in any earthly danger of losing her race; the 18th district in Silicon Valley, California, which boasts the highest median household income of any district in the country, went for Clinton by 53 points. Patients for Affordable Drugs Action is the only outside group spending in the race, which hasn’t seen much spending at all – and they’ve sunk hundreds of thousands of dollars.

In reply to a request for comment, Eshoo’s campaign highlighted what it said was her years of work on behalf of patients. “Over the past 25 years, Congresswoman Anna Eshoo has consistently championed affordability, innovation and patient protections for prescription drugs,” a statement said.

Healthcare is the top theme for political ads in 2018, said Franz, especially on the Democratic side. But as approval of the Barack Obama healthcare law has crept back to 50%, Republicans have stopped talking about healthcare so much, and the fight over the signature legislation has, for the moment, faded.

As Mitchell and his group see it, the truce in the Obamacare wars has created an opportunity to finally strike a blow against a problem that patients of all political persuasions agree on: runaway drug prices.

“There is energy and political will in many states around the country,” Mitchell said. “Depending on the outcome of the midterms, it may be that we have arrived at the right place at the right time to bring an authentic patient voice to the debate in Congress.”