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WASHINGTON — In the coming weeks, Democrats will embark on an ambitious effort to change the way seniors, and maybe millions of other people, pay for prescription drugs in the United States — if they can get by the drug industry first.

The effort’s success depends on the calculations and sausage-making chops of a number of lawmakers and White House officials, as well as the effectiveness of industry lobbyists working to stop them. The path to the major drug pricing reform Democrats are eyeing will be a slog, if it happens at all.

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If Congress gives Medicare the power to negotiate drug prices or limit price hikes, it could move prescription drugs closer to the rate-setting model Medicare uses for nearly every other service, said Tricia Neuman, a senior vice president at the nonpartisan Kaiser Family Foundation.

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