WASHINGTON — Facing resistance from its Pacific trading partners, the Obama administration is no longer demanding protection for pharmaceutical prices under the 12-nation Trans-Pacific Partnership, according to a newly leaked “transparency” annex of the proposed trade accord.

But American negotiators are still pressing participating governments to open the process that sets reimbursement rates for drugs and medical devices. Public health professionals, generic drugmakers and activists opposed to the trade deal, which is still being negotiated, contend that it will empower big pharmaceutical firms to command higher reimbursement rates in the United States and abroad, at the expense of consumers.

They also say it could expose international markets to the direct consumer appeals that Americans have experienced.

“It was very clear to everyone except the U.S. that the initial proposal wasn’t about transparency; it was about getting market access for the pharmaceutical industry by giving them greater access to and influence over decision-making processes around pricing and reimbursement,” said Deborah Gleeson, a lecturer at the School of Psychology and Public Health at La Trobe University in Australia, who has seen the leaked document. And even though it has been toned down, she said, “I think it’s a shame that the annex is still being considered at all for the T.P.P.”

The pharmaceutical and medical device annex is the latest document obtained by The New York Times in collaboration with the watchdog group WikiLeaks, and it was released ahead of the House vote on whether to give President Obama expanded powers to complete the Trans-Pacific Partnership. The Senate has already approved legislation giving the president “trade promotion authority,” or fast-track power to complete trade deals that cannot be amended or filibustered by Congress. A House vote on final passage of the bill, which could come as early as Friday, appears extremely close.

The Pacific accord, the largest since the North American Free Trade Agreement two decades ago, would link countries stretching from Canada and Chile to Japan and Australia into a new regimen of trade rules that would cover 40 percent of the global economy.

Opponents of both the Pacific deal and the legislation to grant trade promotion authority have long targeted the pharmaceutical issue. Foreign governments and health care activists have accused pharmaceutical giants, mostly based in the United States, of protecting profits over public health, especially in poor countries where neither the government nor consumers can afford to pay rates anywhere close to those charged in the West.

That fight re-emerged in the Pacific trade negotiations, which involve countries with strong cost-containment policies, like New Zealand, as well as poor countries like Peru and Vietnam.