揭露药医利益关系的新招

 　　TWO drug executives walked into a bar. No, this is not the start of a joke. The workers for Roche, a Swiss drugs firm, had been dining with doctors after a medical conference. At the bar, alleged¹ an anonymous² complaint in a recent report by a British industry watchdog, they bought the doctors drinks (“shots of varying colours flowed like hot lava”). One executive danced on stage, prompting bar staff to throw him out. Roche maintains its managers ran into the doctors and did not buy them drinks. But the evening hardly seems like the finest moment in the history of ties between doctors and drug companies.

　　两名制药公司的高管走进一家酒吧。别理解错了，这可不是在讲笑话。瑞士制药企业罗氏公司（Roche）的员工开完医学会议后，此时正和医生们共进晚餐。在一家英国行业监督机构最近发表的报告中，一位匿名人士指控这两名员工在酒吧请医生喝酒（“照片上的酒颜色各异，像喷涌而出的火热岩浆”）。一名高管登台起舞，结果被酒吧服务人员赶了出去。瑞士公司则坚持认为，其负责人是偶然碰到几位医生的，而且也没有请他们喝酒。但这个夜晚怎么看也不像是医生与制药企业的关系史上最美好的时刻。

　　That relationship is a poorly regulated muddle³. At one (beneficial) extreme, firms work with doctors to create new treatments. At the other end of the spectrum⁴, firms bribe⁵ doctors to prescribe their drugs. America’s justice department has wrung⁶ huge settlements from companies over such charges. Between these poles is a lot of activity deemed standard by some, repugnant by others—and which is increasingly subject to new laws.

　　二者关系疏于监管，可谓一团糟。一个（有益的）极端是，企业为创造新的治疗方案与医生合作。另一个极端则是企业向医生行贿，以便让医生在开药时选择他们厂家的产品。美国司法部门从此类官司涉及的公司中榨取了大量罚金。两个极端之间可以有种种行事，有些人视之为标准，有些人则嗤之以鼻，而新法律对这些管得越来越严了。

　　This month American regulators released rules to implement⁷ a so-called Sunshine law designed to improve transparency. France passed a similar law in 2011. Firms in Britain are planning voluntary disclosures. By 2015 more than 70% of drug sales will be in countries with such measures, according to Deloitte, a consultancy.

　　本月，美国监管机构公布了新规定，旨在贯彻实施一部所谓的“阳光法案”，以提高企业透明度。法国在2011年通过了一部类似的法案。英国的企业正计划着主动公示信息。据咨询公司德勤（Deloitte）显示，在2015年前，70%以上的药品会在采取此类措施的国家中销售。

　　America’s health-care market, the world’s biggest, is particularly busy. In 2012 pharmaceutical⁸ companies spent more than $24 billion marketing⁹ drugs to doctors, according to Cegedim Strategic Data, a research firm; 35% of doctors accept food, entertainment or travel from the pharmaceutical industry, said a survey by Deloitte last year, while 16% accept consulting or speaking fees. In most states, doctors take regular courses to maintain their licences. In 2011 drug and device companies sponsored nearly a third of the medical training tracked by the Accreditation¹⁰ Council for Continuing Medical Education.

　　美国拥有世界上最大的医疗市场。如今，该市场相当热闹。据调查公司Cegedim Strategic Data 称，2012年制药企业为了向医生推销药品，所花费用超过240亿美元；根据德勤去年做的一份调查显示，35%的医生接受了制药行业的宴请或其提供的免费旅游，而16%的医生收受了咨询费，或者说演讲费。大部分州的医生为维持医师资格证，需要定期接受培训。2011年美国继续医学教育认证委员会（Accreditation Council for Continuing Medical Education）发现，其追踪调查的医学培训机构中有近1/3是由医药和器械公司赞助。

　　Such chumminess has long raised fears about undue¹¹ influence. In 2008 two health-industry groups set tighter, voluntary standards for companies. In 2009 America’s Institute of Medicine, an advisory¹² body, urged much stricter regulation to prevent conflicts of interest.

　　一直以来，人们都担心医商之间的这种亲密无间会带来不好的影响。2008年，两家医疗健康产业集团为企业制定了更严格的自愿性质标准。2009年，美国顾问团医院研究所（America’s Institute of Medicine）敦促要加强监管力度，防止利益纠纷。

　　Legislative¹³ action, though, has been slow, especially at the federal level. The Sunshine law, passed as part of Barack Obama’s health reform, is the first national requirement for transparency. Each year drug and device firms must disclose payments and other “transfers of value” to doctors. They must also report research fees and doctors’ investment interests. The first filing will appear on a public database by September 30th, 2014.

　　不过美国在立法方面行动一直很慢，尤其是联邦层级的立法。“阳光法案”是作为巴拉克??奥巴马医疗改革项目的一部分通过的，它是第一部为提高透明度的国家级法案。每年，医药和器械公司必须公开支付信息，以及其他用在医生身上的开销。他们也必须汇报研究经费、医生在医疗公司投资股权。第一批申报文案将于2014年9月30日前上传至公共数据库中。

　　The rule’s broader effects are uncertain. It does not limit firms’ interactions with doctors; it merely requires them to be reported. Certain marketing techniques, such as providing free drug samples, are exempt¹⁴. And in some ways the law is already out of date. It regulates only doctors and some hospitals, not nurses, pharmacists or hospital bureaucrats¹⁵ who have a growing role in patients’ treatment.

　　这项规定会产生怎样更大范围的影响还不得而知。它并没有限制企业与医生之间的往来；仅仅只是要求他们上报相关信息。某些营销方案不在监管之列，比如为医生提供免费的药物样品。法律在某些方面已经过时了，它所监管的只有医生和某些医院，却不包括护士、药剂师或者医院的行政人员，而这些人在病人的治疗中发挥的作用越来越大。

　　Nevertheless, the Sunshine law is likely to lead to at least one change. Firms already have data on each doctor’s prescriptions¹⁶, points out Chris Wright of ZS Associates, a consultancy. The Sunshine law will also provide them with exhaustive data on how much they and their competitors spend to market drugs to that doctor. This will let firms track which type of marketing spurs the most prescriptions. Companies will not stop wooing doctors. They may simply get better at it.

　　尽管如此，阳光法案至少可能带来一个转变。咨询公司Chris Wright of ZS Associates指出，制药企业已经掌握了每个医生的处方内容。阳光法案还将为这些企业提供详细数据，让他们了解自己和竞争对手在向医生推销药品时的花销情况。这将有利于企业追踪调查，找出最利于销售的推销方案。将来，企业还是会向医生献殷勤。但或许他们只是更擅长罢了。

1 alleged   

a.被指控的，嫌疑的

参考例句：

• It was alleged that he had taken bribes while in office. 他被指称在任时收受贿赂。
• alleged irregularities in the election campaign 被指称竞选运动中的不正当行为

2 anonymous   

adj.无名的；匿名的；无特色的

参考例句：

• Sending anonymous letters is a cowardly act.寄匿名信是懦夫的行为。
• The author wishes to remain anonymous.作者希望姓名不公开。

3 muddle   

n.困惑，混浊状态；vt.使混乱，使糊涂，使惊呆；vi.胡乱应付，混乱

参考例句：

• Everything in the room was in a muddle.房间里每一件东西都是乱七八糟的。
• Don't work in a rush and get into a muddle.克服忙乱现象。

4 spectrum   

n.谱，光谱，频谱；范围，幅度，系列

参考例句：

• This is a kind of atomic spectrum.这是一种原子光谱。
• We have known much of the constitution of the solar spectrum.关于太阳光谱的构成，我们已了解不少。

5 bribe   

n.贿赂；v.向…行贿，买通

参考例句：

• He tried to bribe the policeman not to arrest him.他企图贿赂警察不逮捕他。
• He resolutely refused their bribe.他坚决不接受他们的贿赂。

6 wrung   

绞( wring的过去式和过去分词 )； 握紧（尤指别人的手）； 把（湿衣服）拧干； 绞掉（水）

参考例句：

• He has wrung the words from their true meaning. 他曲解这些字的真正意义。
• He wrung my hand warmly. 他热情地紧握我的手。

7 implement   

n.(pl.)工具，器具；vt.实行，实施，执行

参考例句：

• Don't undertake a project unless you can implement it.不要承担一项计划，除非你能完成这项计划。
• The best implement for digging a garden is a spade.在花园里挖土的最好工具是铁锹。

8 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。

9 marketing   

n.行销，在市场的买卖，买东西

参考例句：

• They are developing marketing network.他们正在发展销售网络。
• He often goes marketing.他经常去市场做生意。

10 accreditation   

n.委派，信赖，鉴定合格

参考例句：

• a letter of accreditation 一份合格证明书
• This paper gives an overview of the Verification, Validation and Accreditation (VV&A) in High Level Architecture(HLA). 对基于高层体系结构(High Level Architecture,简称HLA)的仿真系统的校核、验证与确认(Verification, Validation and Accreditation,简称VV&A)问题进行了详细的介绍及分析。 来自互联网

11 undue   

adj.过分的；不适当的；未到期的

参考例句：

• Don't treat the matter with undue haste.不要过急地处理此事。
• It would be wise not to give undue importance to his criticisms.最好不要过分看重他的批评。

12 advisory   

adj.劝告的，忠告的，顾问的，提供咨询

参考例句：

• I have worked in an advisory capacity with many hospitals.我曾在多家医院做过顾问工作。
• He was appointed to the advisory committee last month.他上个月获任命为顾问委员会委员。

13 legislative   

n.立法机构，立法权；adj.立法的，有立法权的

参考例句：

• Congress is the legislative branch of the U.S. government.国会是美国政府的立法部门。
• Today's hearing was just the first step in the legislative process.今天的听证会只是展开立法程序的第一步。

14 exempt   

adj.免除的；v.使免除；n.免税者，被免除义务者

参考例句：

• These goods are exempt from customs duties.这些货物免征关税。
• He is exempt from punishment about this thing.关于此事对他已免于处分。

15 bureaucrats   

n.官僚( bureaucrat的名词复数 )；官僚主义；官僚主义者；官僚语言

参考例句：

• That is the fate of the bureaucrats, not the inspiration of statesmen. 那是官僚主义者的命运，而不是政治家的灵感。 来自辞典例句
• Big business and dozens of anonymous bureaucrats have as much power as Japan's top elected leaders. 大企业和许多不知名的官僚同日本选举出来的最高层领导者们的权力一样大。 来自辞典例句

16 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。