But a series of criminal cases, multibillion-dollar fines and other scandals has diminished its reputation, and its prices — the last 10 cancer drugs approved before July 2015 have an average annual price of $190,217 — are again becoming a major political issue. Even with discounts and insurance coverage, a growing number of Americans find themselves choosing between their lives and lifetime savings.

“We’re on the wane. There’s just too much obvious greed,” said another veteran lobbyist for a major drug maker, citing Turing Pharmaceuticals’ overnight price increase on a 62-year-old drug to $750 a tablet from $13.50. “Everybody in the industry is talking about this.”

The White House has begun building a political case for reining in drug costs, and the administration recently agreed in the Trans-Pacific Partnership trade accord to intellectual property protections for advanced pharmaceuticals that was about half of what the industry demanded and United States law provides. Worse, a 2011 patent law has resulted in a wave of lawsuits funded by hedge funds against the industry’s most valuable property — drug patents.

In years past, according to interviews with longtime industry lobbyists, such problems could have been fixed by a vigorous lobbying push. No more.

The last time the industry’s prices and other practices raised significant concerns in Washington, drug makers decided that the solution was to increase the share of patients who had health insurance so that more people had help buying drugs. So in 2009, the industry rallied around President Obama’s push for the Affordable Care Act, striking an $80 billion deal with the administration that even led the industry to fund an advertising campaign supporting the law.

For decades, drug makers had overwhelmingly supported Republican lawmakers with campaign contributions. But the alliance with the Obama administration changed that, and Pfizer led the way. The company appointed Jeff Kindler, a lawyer and a longtime Democrat, as its chief executive in 2006, and Mr. Kindler became chairman of the Pharmaceutical Research and Manufacturers of America, the industry’s main lobbying arm, on the eve of the Affordable Care Act’s passage in Congress in 2010.

Mr. Kindler for the first time in memory not only directed a majority of the company’s political donations toward Democrats but also hired top Democrats to lead the company’s lobbying efforts. His most important hire was plucking Ms. Susman from beauty brand Estée Lauder Companies.