读者文摘:你不知道的医药多余消费(2)

Most patients never realize that the cash price of the drug is cheaper than the co-pay.

大多数病人从来没有意识到这种药物的现金价格比购买保险后要便宜。

"There's this whole industry that most people don't know about,"

“大多数人都不知道，”

says Connecticut lawyer Craig Raabe, who represents people accusing two insurance companies and a PBM of defrauding¹ them.

康涅狄格州律师克雷格·拉比说道。克雷格·拉比代表人们指控两家保险公司和药品利益管理机构对消费者施行诈骗。

Clawbacks are possible because benefit managers take advantage of an opaque² market,

回扣是可能的，因为利益管理机构利用了市场的不透明，

says Susan Hayes, a consultant³ with Pharmacy⁴ Outcomes Specialists in Lake Zurich, Illinois.

苏珊·海斯——伊利诺伊州苏黎世湖的药学成果专家说道。

Only the PBMs know who pays what.

只有药品利益管理机构知道谁付多少钱。

For their part, benefit managers argue that they actually keep prices low, in part by negotiating rebates⁵ from drugmakers.

药品利益管理机构认为，他们实际上是通过与制药商商量回扣来保持低价。

That may be true in some cases,

在某些情况下这可能是真的，

but clawbacks have prompted at least 16 lawsuits⁷ since October 2016,

但自2016年10月以来，回扣已引发至少16起诉讼。

with accusations⁸ that include defrauding patients through racketeering, breach⁹ of contract, and violation¹⁰ of insurance laws.

指控包括诈骗病人，违反合同，违反保险法。

The three largest PBMs in the United States—OptumRx (owned by UnitedHealth Group, Inc.), CVS Caremark (owned by CVS Health Corp.), and Express Scripts Holding Co.

美国最大的三家利益管理机构- 药品福利管理公司（隶属于联合健康集团有限公司）， 西维斯公司(隶属于CVS Health Corp.)和快捷药方公司。

—process an estimated 70 to 85 percent of all the prescriptions¹¹ in the country.

全国约70%到85%的处方都是由这三家公司处理的。

A spokesperson for UnitedHealth Group, Inc., the target of a class action lawsuit⁶ alleging¹² that OptumRx required network pharmacies¹³ to charge excessive fees,

联合健康集团的发言人遭到群起指控——药品福利管理公司要求网络药店收取过高费用，

said, "We believe these lawsuits are without merit."

发言人表示：“我们认为这些诉讼毫无意义。”

1 defrauding   

v.诈取，骗取( defraud的现在分词 )

参考例句：

• Second is the actor regards defrauding of the wealth as object. 第二，行为人以骗取钱财为目的。 来自互联网
• Therefore, DELL has the motive and economic purpose of intentionally defrauding the Chinese consumers. 因此，戴尔公司存在故意欺诈中国消费者的动机和经济目的。 来自互联网

2 opaque   

adj.不透光的；不反光的，不传导的；晦涩的

参考例句：

• The windows are of opaque glass.这些窗户装着不透明玻璃。
• Their intentions remained opaque.他们的意图仍然令人费解。

3 consultant   

n.顾问；会诊医师，专科医生

参考例句：

• He is a consultant on law affairs to the mayor.他是市长的一个法律顾问。
• Originally,Gar had agreed to come up as a consultant.原来，加尔只答应来充当我们的顾问。

4 pharmacy   

n.药房，药剂学，制药业，配药业，一批备用药品

参考例句：

• She works at the pharmacy.她在药房工作。
• Modern pharmacy has solved the problem of sleeplessness.现代制药学已经解决了失眠问题。

5 rebates   

n.退还款( rebate的名词复数 )；回扣；返还（退还的部份货价）；折扣

参考例句：

• The VAT system offers advantages, such as rebates on exports. 增值税有其优点，如对出口商品实行回扣。 来自辞典例句
• In more recent years rate rebates have been introduced for households. 近年地方税的减免已适用于家庭。 来自辞典例句

6 lawsuit   

n.诉讼，控诉

参考例句：

• They threatened him with a lawsuit.他们以诉讼威逼他。
• He was perpetually involving himself in this long lawsuit.他使自己无休止地卷入这场长时间的诉讼。

7 lawsuits   

n.诉讼( lawsuit的名词复数 )

参考例句：

• Lawsuits involving property rights and farming and grazing rights increased markedly. 涉及财产权，耕作与放牧权的诉讼案件显著地增加。 来自辞典例句
• I've lost and won more lawsuits than any man in England. 全英国的人算我官司打得最多，赢的也多，输的也多。 来自辞典例句

8 accusations   

n.指责( accusation的名词复数 )；指控；控告；（被告发、控告的）罪名

参考例句：

• There were accusations of plagiarism. 曾有过关于剽窃的指控。
• He remained unruffled by their accusations. 对于他们的指控他处之泰然。

9 breach   

n.违反，不履行；破裂；vt.冲破，攻破

参考例句：

• We won't have any breach of discipline.我们不允许任何破坏纪律的现象。
• He was sued for breach of contract.他因不履行合同而被起诉。

10 violation   

n.违反(行为)，违背(行为)，侵犯

参考例句：

• He roared that was a violation of the rules.他大声说，那是违反规则的。
• He was fined 200 dollars for violation of traffic regulation.他因违反交通规则被罚款200美元。

11 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

12 alleging   

断言，宣称，辩解( allege的现在分词 )

参考例句：

• His reputation was blemished by a newspaper article alleging he'd evaded his taxes. 由于报上一篇文章声称他曾逃税，他的名誉受到损害。
• This our Peeress declined as unnecessary, alleging that her cousin Thornhill's recommendation would be sufficient. 那位贵人不肯，还说不必，只要有她老表唐希尔保荐就够了。

13 pharmacies   

药店

参考例句：

• Still, 32 percent of the pharmacies filled the prescriptions. 但仍然有32%的药剂师配发了这两张药方。 来自互联网
• Chinese herbal pharmacies, and traditional massage therapists in the Vancouver telephone book. 中药店，和传统的按摩师在温哥华的电话簿里。 来自互联网