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“We needed 60 votes in the Senate; we got 60. We needed 218 votes in the House; we got 219,” said Ron Pollack, executive director of Families USA, a health care advocacy group and ally of the White House that worked to corral industry support for the bill. “Had structural changes to pharmaceutical pricing been in the bill, the Affordable Care Act would not have been enacted.”

PhRMA coughed up about $32 billion to help close a large gap in Medicare drug coverage known as the “doughnut hole” — which meant that once seniors got about $2,800 in drug coverage, they were on the hook for all the costs until they hit $6,400, when coverage kicked in again. The trade group also agreed to pay tens of billions in taxes and to increase drug discounts in Medicaid to help with the broader financing of the law.

The drug industry won two other victories as the law took shape that weren’t part of its initial deal with Democrats. And both are constraining policymakers today.

One involved a new quasi-government entity — the Patient Centered Outcomes Research Institute, known as PCORI. It was set up by the Affordable Care Act to test how different medical treatments stack up against one another — but PhRMA insisted that PCORI would not be able to take cost effectiveness into account — and it doesn't.

The Tea Party uprising against Obamacare in the summer of 2009 — and the outlandish claims that it would set up “death panels” — fed into PhRMA’s arguments. Politicians didn’t want to do anything that could fuel fears that the health bill, already controversial enough, would limit Americans’ access to treatment.

Critics say that restriction has hamstrung the independent expert group, making it hesitant to take on politically sensitive issues and unable to assess the true value of treatments. A Center for American Progress report in May found its “potential impact on the nation's health care system has not been fully realized” — which is exactly what PhRMA sought, to protect its turf.

Perhaps more significantly, the drugmakers won an unprecedented, guaranteed 12-year monopoly for biologic drugs — a costly class of new cell-based therapies that are more complicated to manufacture than more familiar chemical drugs.

Twelve years — as opposed to five that most other drugs get — means biologics get a much longer time to dictate prices on the market before they have to face generic-like completion.

The dozen-year market lock is still stirring controversy. One of PhRMA’s top demands for the 12-country Trans Pacific Partnership negotiations was that the monopoly be extended internationally, but other countries balked. The TPP deal set the target at eight years, and the drug industry’s ire is one shadow hanging over the sweeping, unfinished accord.

But the Obama administration’s repeated bid to cut the domestic market protections to seven years – what it had sought during the Obamacare negotiations — has gained no traction on the Hill.

Seven years later, Tauzin’s goal is intact. PhRMA’s not the meal; and everyone else is still picking up that tab.

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