美国国家公共电台 NPR A Search For New Ways To Pay For Drugs That Cost A Mint

 

RACHEL MARTIN, HOST:

New, astronomically¹ expensive drugs are expected on the market in the next few years. And they could drive up the cost of medicine and health insurance for everyone. NPR's Richard Harris reports.

RICHARD HARRIS, BYLINE²: These new treatments are gene³ therapies, which target certain cancers and rare diseases. Take, for example, hemophilia, an inherited disorder⁴ that prevents a person's blood from clotting⁵ properly. Mark Skinner is one of about 20,000 Americans with the condition.

MARK SKINNER: So when I was born, treatment did not exist for hemophilia. So within my lifetime - I'm 58 years old - there have been remarkable⁶ advances.

HARRIS: He now gives himself daily injections of expensive medication to prevent the painful and potentially dangerous bleeding episodes. Skinner says eight or nine companies are now working on treatments that could actually cure his underlying⁷ condition.

SKINNER: I think we could see a gene therapy in the clinics and available to patients within a couple years.

HARRIS: One infusion⁸ might be enough to correct the genetic⁹ flaw and give him many years - maybe even a lifetime - free from bleeding episodes and daily medication - drugs that often cost hundreds of thousands of dollars per year.

SKINNER: And so a gene therapy that costs a million dollars or even $2 million, you could see it becoming economically viable¹⁰ over a couple years in terms of return of investment for a health system and certainly significant savings¹¹ over a lifetime.

HARRIS: But it could also be a big shock to the system. Gene therapy for every American with hemophilia could cost tens of billions of dollars. Mark Trusheim at MIT says a few years ago, insurance companies balked¹² at the new, high-priced drugs to cure hepatitis C and ended up rationing¹³ treatment. Would that happen for hemophilia?

MARK TRUSHEIM: If a gene therapy came through and was reasonably expensive, it would be terrible if we could only treat a thousand patients a year and it took us 10 or 15 years to treat all those people.

HARRIS: Trusheim's effort at MIT, called the NEWDIGS program, is trying to dream up better ways to pay for expensive, new, long-term treatments. We're used to paying as we go for drugs, with monthly bills for monthly pills. Trusheim says it's like paying rent on an apartment.

TRUSHEIM: But now, with these new gene therapies, we get to take the treatment once. And it can last for years - perhaps a lifetime, perhaps 10 years, but certainly for many years.

HARRIS: He says it makes more sense, then, to think of these drugs in terms of paying a mortgage over time for a condo rather than paying monthly rent.

TRUSHEIM: Plus, we have the option here not just to turn it into a mortgage payment, but make that mortgage payment contingent¹⁴ on whether the apartment's really a good apartment or not. If the roof begins to leak, maybe we won't pay so much on the future payments.

HARRIS: This strategy has already been put to use for one gene therapy which treats an inherited form of blindness at a cost of $850,000. The company that produces that has agreed to give health insurers some money back if a patient's vision doesn't improve enough.

Trusheim is eager to get funding schemes like this instituted now because he expects to see another three dozen new expensive therapies coming online in just the next four years. Those include treatments called CAR-T for cancer and gene therapies for diseases that, up till now, have had no treatment at all.

TRUSHEIM: It could be really exciting. But it could also be really expensive as we're treating conditions we never used to be able to treat.

HARRIS: The technology seems poised¹⁵ to take off, with hundreds of potential treatments in the pipeline¹⁶ - good for health, tough on the nation's health care budget. At a recent conference in Washington, D.C., Joe Grogan from the White House Office of Management and Budget warned that it could push health care spending over the edge.

JOE GROGAN: If we get a cure for Alzheimer's priced at a hundred thousand dollars or a million dollars a pop, we're toast.

HARRIS: That could add trillions to the cost of health care. Even if politicians step in to control drug prices, these products cost a lot to develop. So they will still be expensive. Mark Skinner says we will need creative ways to manage that.

SKINNER: At the pace at which gene therapy's coming, I think we have no choice. I don't think the public would tolerate cures sitting on the shelf that people don't have access to.

HARRIS: A solution will require not only new ways of thinking but new rules and regulations that govern how insurance companies and government programs pay for medical care. Richard Harris, NPR News.

1 astronomically   

天文学上

参考例句：

• The bill was astronomically high. 账单上的金额高得没谱儿。
• They have only been read as the multitude read the stars, at most astrologically, not astronomically. 它们之被群众阅读，有如群众之阅览繁星，至多是从星象学而不是从天文学的角度阅览的。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 gene   

n.遗传因子，基因

参考例句：

• A single gene may have many effects.单一基因可能具有很多种效应。
• The targeting of gene therapy has been paid close attention.其中基因治疗的靶向性是值得密切关注的问题之一。

4 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

5 clotting   

v.凝固( clot的现在分词 )；烧结

参考例句：

• The study was also based only on the one anti-clotting drug. 所用抗血栓药物也仅限于一种。 来自互联网
• A plasma protein that is converted into thrombin during blood clotting. 凝血原酶一种血浆蛋白质，在血液凝聚时转化成凝血''。'酵'。''''。'素'。''。 来自互联网

6 remarkable   

adj.显著的，异常的，非凡的，值得注意的

参考例句：

• She has made remarkable headway in her writing skills.她在写作技巧方面有了长足进步。
• These cars are remarkable for the quietness of their engines.这些汽车因发动机没有噪音而不同凡响。

7 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

8 infusion   

n.灌输

参考例句：

• Old families need an infusion of new blood from time to time.古老的家族需要不时地注入新鲜血液。
• Careful observation of the infusion site is necessary.必须仔细观察输液部位。

9 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。

10 viable   

adj.可行的，切实可行的，能活下去的

参考例句：

• The scheme is economically viable.这个计划从经济效益来看是可行的。
• The economy of the country is not viable.这个国家经济是难以维持的。

11 savings   

n.存款，储蓄

参考例句：

• I can't afford the vacation,for it would eat up my savings.我度不起假，那样会把我的积蓄用光的。
• By this time he had used up all his savings.到这时，他的存款已全部用完。

12 balked   

v.畏缩不前，犹豫( balk的过去式和过去分词 )；（指马）不肯跑

参考例句：

• He balked in his speech. 他忽然中断讲演。 来自《现代英汉综合大词典》
• They balked the robber's plan. 他们使强盗的计划受到挫败。 来自《现代英汉综合大词典》

13 rationing   

n.定量供应

参考例句：

• Wartime austerities included food rationing and shortage of fuel. 战时的艰苦包括食物配给和燃料短缺。
• Food rationing was abolished in that country long ago. 那个国家早就取消了粮食配给制。

14 contingent   

adj.视条件而定的；n.一组，代表团，分遣队

参考例句：

• The contingent marched in the direction of the Western Hills.队伍朝西山的方向前进。
• Whether or not we arrive on time is contingent on the weather.我们是否按时到达要视天气情况而定。

15 poised   

a.摆好姿势不动的

参考例句：

• The hawk poised in mid-air ready to swoop. 老鹰在半空中盘旋，准备俯冲。
• Tina was tense, her hand poised over the telephone. 蒂娜心情紧张，手悬在电话机上。

16 pipeline   

n.管道，管线

参考例句：

• The pipeline supplies Jordan with 15 per cent of its crude oil.该管道供给约旦15%的原油。
• A single pipeline serves all the houses with water.一条单管路给所有的房子供水。