This article explores the intricate relationship between Big Pharma and healthcare policies in the United States, unraveling the historical context, lobbying tactics, and policy impact. It delves into specific examples, such as the opioid crisis, and examines reform efforts amid public backlash. The influence on drug approval, pricing, and the role of patient advocacy groups are scrutinized, emphasizing the need for transparency and accountability. The article concludes by highlighting the complex challenges policymakers face in balancing innovation with public health.