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Steve Ubl, who leads the nation’s top industry group for drugmakers, is offering a final salvo to Congress as Democratic lawmakers inch closer to passing their sweeping reconciliation package that includes drug pricing measures — and threatening swift retaliation if they don’t listen, he told POLITICO.

Ubl’s group, the Pharmaceutical Research and Manufacturers of America, or PhRMA, and its 31 board members sent a letter to every member of Congress on Thursday afternoon, urging them to vote against the package.

PhRMA, not accustomed to losing legislative fights, has waged a multimillion-dollar advocacy campaign against the drug pricing measures, and is crafting contingency plans if they fail. In addition to hinting at running campaign ads against Democrats in tough races this fall, the industry is assessing its legal options and pondering future regulatory or legislative fixes.

“Regardless of the outcome in the coming weeks, this fight isn’t over,” Ubl said in an interview. “Few associations have all the tools of modern political advocacy at their disposal in the way that PhRMA does.”

Thursday’s letter largely reiterates arguments the industry has made throughout the process, with the executives from companies including Pfizer and Merck saying that passing the legislation would lead to fewer treatments and cures — particularly for tough illnesses like cancer and Alzheimer’s disease that can be difficult and costly to develop.

Ubl said that one of PhRMA’s member companies has 15 drugs in the pipeline that would be nixed if the bill becomes law.

“This is a very consequential vote. Those members who vote for this bill will not get a free pass. We’ll do whatever we can to hold them accountable,” he said.

It’s unclear when Senate Majority Leader Chuck Schumer will bring the $740 billion reconciliation package to the floor, and senators anticipate having to stay over the weekend as they move to work out any kinks and pass it as quickly as possible.

The stakes are high for the drug industry: allowing Medicare to negotiate the cost of high-price drugs is expected to save the federal government more than $100 billion. The move would “put the U.S. system on a course toward broad government control, setting the stage for our country to fall behind,” reads the letter sent to Congress on Thursday.

PhRMA has spent millions of dollars lobbying on Democrats’ drug pricing reform measures over the past two years, and millions more on TV and digital advertisements trying to sway public opinion. In the first six months of 2022, the group’s overall lobbying operation spent more than $14.4 million, according to disclosure filings.

Ubl declined to talk more about what kinds of legal arguments would be on the table — “for fear that tipping our hand would foreclose future options” — or what changes could come from future regulations or legislation.

“From my experience, when a bill like this is pursued on a hyperpartisan basis, with slim margins and deficiencies in due process, it rarely sticks,” he said, pointing to all the changes that have been made to the Affordable Care Act since its passage. “I would expect there’ll be opportunities to further mitigate the harms of this legislation going forward.”

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