PBS高端访谈:制药公司Mylan推出肾上腺素笔EpiPen

 　　GWEN IFILL: Drugmaker Mylan has been under heavy fire for its soaring price hikes for EpiPens, the lifesaving necessity for those with serious allergic¹ reactions.

　　Its price has skyrocketed to as much as $600 for a set of two. At first, Mylan offered financial assistance to customers, but after mounting pressure, the company said it now will release a generic² version for half the price.

　　To give us some perspective on how this case is different, Stephen Schondelmeyer studies this closely at the University of Minnesota, and Andrew Pollack covers pharmaceuticals⁴ for The New York Times.

　　Gentlemen, welcome.

　　Andrew Pollack, I want to start with you and ask you to explain just basically, what's the difference here? What's the big deal between a generic EpiPen and the kind that this company has been producing and selling at such a markup⁵?

　　ANDREW POLLACK, The New York Times: Well, it's actually quite a bit confusing. The products are exactly the same. It's the same product.

　　However, they are calling one version now a generic. It will have a different package on it. It won't say EpiPen, and they will be selling it for half the list price of the branded product.

　　GWEN IFILL: Has that ever happened before?

　　ANDREW POLLACK: Well, pharmaceutical³ companies, brand-name pharmaceutical companies often do introduce their own generic version of their own drug. It's called an authorized⁶ generic.

　　This is done once an outside generic company comes into the market. This allows them to keep some of the sales, rather than having all their sales being lost to the outside generic company. What is unusual here is that Mylan does not have an immediate⁷ generic competitor for the EpiPen.

　　GWEN IFILL: So they're basically competing against public relations at this point.

　　Stephen Schondelmeyer, how did a product that cost as little as $100 in 2007 rise to $600 today?

　　制药公司Mylan推出肾上腺素笔EpiPen

　　STEPHEN SCHONDELMEYER, University of Minnesota: Well, it did that because the marketplace doesn't have any regulation, either government regulation or market regulation, that holds that down.

　　And, in fact, this product that — at a self-insured employer I work with, it cost them $100 for this product in 2011, and today is costing them $730. That dramatic increase just isn't seen.

　　And now they're calling it a generic in name. But it's not a generic, meaning an independent economic decision-maker choosing to compete with the price of the brand name. So we won't see this behave like a normal generic in the market either.

　　GWEN IFILL: And even if it's half the price, it will be still around $300, which is still more than it was just a short time ago, right?

　　STEPHEN SCHONDELMEYER: Sure, it's more than $200 than it was not too long ago.

　　This is sort of like if your child happens to get kidnapped, and the kidnappers⁸ call you and say we will cut the ransom⁹ in half, so you're going to save half the money. I'm not sure you would call that a savings¹⁰.

　　GWEN IFILL: Andrew Pollack, how did this study get so much attention? It feels like we weren't talking about this at all a couple of weeks ago, and the numbers were just as high then.

　　ANDREW POLLACK: Yes, I think it's partly the back-to-school season is the peak buying season for these products.

　　This year, you had many parents buy more than in the past, having high deductible insurance plans, where, having not met their deductibles, they had to pay the entire price. This started spreading on social media, and a big furor¹¹ arose.

　　GWEN IFILL: So, social media was the driving force behind this furor, this uprising, as it were?

　　ANDREW POLLACK: Yes, we — my colleague Tara had an article on this a couple of days ago.

　　GWEN IFILL: Tara Parker-Pope, right.

　　Stephen Schondelmeyer, I want to ask you a little bit about how this could have been avoided. Could this, for instance — the first thing that Mylan did was offer coupons¹² to reduce the price. Now, today, they have talked about making available a generic version.

　　Is there anything other thing they could have done to bring this price down, or was this simply a force of the markets?

　　STEPHEN SCHONDELMEYER: Well, I think Mylan could have avoided raising it so dramatically in the first place.

　　This is a product they have been raising 9.9 percent at a time for two or three times a year. And then in the last two years, they started raising it 14.9 percent at a time for one or two or three times a year. The marketplace isn't going up that rapidly in terms of inflation, and most people and their resources don't go up that much.

　　And then they come back and say, well, this is covered by insurance, so what are people worried about? Well, nobody — the insurance company doesn't pay for this drug. The insurance company bills somebody for the drug and pays pharmacies¹³ for it, but the insurance company just processes transactions.

　　So, premiums¹⁴ for insurance are out-of-pocket costs also, and they seem to have ignored that.

　　GWEN IFILL: Well, you mentioned the insurance companies and the high deductibles.

　　Andrew Pollack, you mentioned it as well.

　　How much is this driven — the company says this is driven in part by the high-deductible health care plans and that is where the problem lies, not the pricing structure they create for the drug.

　　ANDREW POLLACK: Well, this has been sort of a perennial¹⁵ battle between the pharmaceutical companies, not just Mylan, and the insurers, each blaming the other.

　　But, in defense¹⁶ of the insurance companies, I mean, they say they have to take some measures because the price keeps going up. And it's part of the playbook of all the drug companies, especially those with high-priced drugs, to try to cushion the consumer and, you know, bill the insurance company.

　　GWEN IFILL: This does seem like we're kind of chasing our tails here. There is one — there is the price, which drives the insurance, which drives the price, and caught in the middle of all this is the person who's trying to make use of the drug.

　　So, Stephen Schondelmeyer, let me ask you something about why this one. We have heard lots of talk before, and on this program, we have talked about the high cost of pharmaceuticals. Is it because this is something which is used for children, and that has gotten people angry in a different way?

　　STEPHEN SCHONDELMEYER: Well, I think partly because it's used for children and also because this is literally¹⁷ a drug about life and death.

　　If you don't have it, there's a high probability a patient could die without access to this drug. Also, this is a drug that you have to have on hand to prevent a problem, so the patient may have to have one or two doses at home, one at their cabin up north, one or two doses at school, and a school may have 40 or 50 EpiPens.

　　And, technically¹⁸, right now, the nurse can't use one patient's EpiPen for another patient. So we may need to look at some alternative policies of how these are used at schools, much like we have with the Naloxone, that these become readily available, and they could have a supply at the school on hand, and use it for whoever needs it at the time, rather than each patient having to have one.

　　GWEN IFILL: So, this is about so much more than price.

　　Professor Stephen Schondelmeyer at the University of Minnesota and Andrew Pollack of The New York Times, thank you both very much.

1 allergic   

adj.过敏的，变态的

参考例句：

• Alice is allergic to the fur of cats.艾丽斯对猫的皮毛过敏。
• Many people are allergic to airborne pollutants such as pollen.许多人对空气传播的污染物过敏，比如花粉。

2 generic   

adj.一般的，普通的，共有的

参考例句：

• I usually buy generic clothes instead of name brands.我通常买普通的衣服，不买名牌。
• The generic woman appears to have an extraordinary faculty for swallowing the individual.一般妇女在婚后似乎有特别突出的抑制个性的能力。

3 pharmaceutical   

adj.药学的，药物的；药用的，药剂师的

参考例句：

• She has donated money to establish a pharmaceutical laboratory.她捐款成立了一个药剂实验室。
• We are engaged in a legal tussle with a large pharmaceutical company.我们正同一家大制药公司闹法律纠纷。

4 pharmaceuticals   

n.医药品；药物( pharmaceutical的名词复数 )

参考例句：

• the development of new pharmaceuticals 新药的开发
• The companies are pouring trillions of yen into biotechnology research,especially for pharmaceuticals and new seeds. 这些公司将大量资金投入生物工艺学研究，尤其是药品和新种子方面。 来自《简明英汉词典》

5 markup   

n.加价，涨价，利润

参考例句：

• This mean that international delivery will line markup from today.这意味着国际快递将从今天起全线涨价。
• Our products are expensive,and distributors and retailers always want a large markup.我们的产品很贵，经销商和零售商总是要求高额利差。

6 authorized   

a.委任的，许可的

参考例句：

• An administrative order is valid if authorized by a statute.如果一个行政命令得到一个法规的认可那么这个命令就是有效的。

7 immediate   

adj.立即的；直接的，最接近的；紧靠的

参考例句：

• His immediate neighbours felt it their duty to call.他的近邻认为他们有责任去拜访。
• We declared ourselves for the immediate convocation of the meeting.我们主张立即召开这个会议。

8 kidnappers   

n.拐子，绑匪( kidnapper的名词复数 )

参考例句：

• They were freed yesterday by their kidnappers unharmed. 他们昨天被绑架者释放了，没有受到伤害。 来自《简明英汉词典》
• The kidnappers had threatened to behead all four unless their jailed comrades were released. 帮匪们曾经威胁说如果印度方面不释放他们的同伙，他们就要将这四名人质全部斩首。 来自《简明英汉词典》

9 ransom   

n.赎金，赎身；v.赎回，解救

参考例句：

• We'd better arrange the ransom right away.我们最好马上把索取赎金的事安排好。
• The kidnappers exacted a ransom of 10000 from the family.绑架者向这家人家勒索10000英镑的赎金。

10 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。

11 furor   

n.狂热；大骚动

参考例句：

• His choice of words created quite a furor.他的措辞引起了相当大的轰动。
• The half hour lecture caused an enormous furor.那半小时的演讲引起了极大的轰动。

12 coupons   

n.礼券( coupon的名词复数 )；优惠券；订货单；参赛表

参考例句：

• The company gives away free coupons for drinks or other items. 公司为饮料或其它项目发放免费赠券。 来自辞典例句
• Do you have any coupons? 你们有优惠卡吗？ 来自英汉 - 翻译样例 - 口语

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

14 premiums   

n.费用( premium的名词复数 )；保险费；额外费用；（商品定价、贷款利息等以外的）加价

参考例句：

• He paid premiums on his life insurance last year. 他去年付了人寿保险费。 来自《现代英汉综合大词典》
• Moves are afoot to increase car insurance premiums. 现正在酝酿提高汽车的保险费。 来自《简明英汉词典》

15 perennial   

adj.终年的；长久的

参考例句：

• I wonder at her perennial youthfulness.我对她青春常驻感到惊讶。
• There's a perennial shortage of teachers with science qualifications.有理科教学资格的老师一直都很短缺。

16 defense   

n.防御，保卫；[pl.]防务工事；辩护，答辩

参考例句：

• The accused has the right to defense.被告人有权获得辩护。
• The war has impacted the area with military and defense workers.战争使那个地区挤满了军队和防御工程人员。

17 literally   

adv.照字面意义，逐字地；确实

参考例句：

• He translated the passage literally.他逐字逐句地翻译这段文字。
• Sometimes she would not sit down till she was literally faint.有时候，她不走到真正要昏厥了，决不肯坐下来。

18 technically   

adv.专门地，技术上地

参考例句：

• Technically it is the most advanced equipment ever.从技术上说，这是最先进的设备。
• The tomato is technically a fruit,although it is eaten as a vegetable.严格地说，西红柿是一种水果，尽管它是当作蔬菜吃的。