2019年经济学人 抗生素生产商的困境(3)（在线收听）

Federal programmes like Medicare, which provides health care for the elderly,

联邦项目，比如为老年人提供健康医疗的Medicare，

often pay hospitals for antibiotics as part of bundled payments for hospitalisation, not as reimbursement for a particular treatment, as in the case of cancer.

通常向医院支付抗生素的费用作为住院费用捆绑支付的一部分，而非某种特定治疗（如癌症）的补助。

Aleks Engel of Novo Holdings, another asset manager, cites this model as a perennial gripe among fellow investors in antibiotics.

另一名资产经理，Novo Holdings的亚历克斯·恩格尔把这种模式看做是抗生素投资者常年的抱怨。

Antibiotics which fall flat in the first few years can eventually become profitable,

在最初几年中反响平平的抗生素最终可以盈利，

notes Bibhash Mukhopadhyay of New Enterprise Associates,an American venture-capital firm.

美国风险投资公司New Enterprise Associates的Bibhash Mukhopadhyay说到。

Until tests pinpoint the specific bug causing an infection (which may take days),

直到测试确定了导致感染的某种病菌（可能需要几天时间），

doctors try several common antibiotics that usually work for the microbial culprit they suspect.

医生才会尝试其他抗生素，这些抗生素通常对那些疑似微生物元凶有效。

For example, when a first-line antibiotic stops working for most cases of pneumonia caused by bacteria

例如，当一线抗生素对大多数细菌引起的肺炎不起作用时

that grow in hospital patients' breathing tubes, the third-line antibiotic starts selling briskly.

（这些细菌生长于住院病人的呼吸管中）第三线抗生素才开始销售火爆。

Many investors are too impatient to wait that long. Lacking other products on the market to turn a profit,

很多投资者都没耐心等那么久。由于市场上没有其他可盈利产品，

firms like Achaogen struggle to raise capital to cover their costs.

像Achaogen这样的公司难以筹集资本来支付他们的成本。

Higher prices might help, but the debate in America is about how to lower the cost of drugs, not raise it.

更高的价格可能有所帮助，但美国的争论是关于如何降低药品成本，而不是增加它的成本。

Even if new antibiotics were paid for separately,

即便新抗生素的费用另付，

many investors think that patients for drugs like plazomicin are too few to make these drugs commercially viable in the near term.

很多投资者认为服用plazomicin这样药物的病人太少了，所以短期内，这些药物不可能创造商业价值。

Making them profitable for firms will take ingenuity.

让它们为公司盈利将需要独创性。

This week a UN commission mused about granting large cash prizes for companies that create such drugs,

本周，一联合国委员会考虑为研发这种药物的公司提供大量现金奖项，

or paying them a subscription that guarantees fixed revenues regardless of use.

或是向他们支付一笔资金以保证，无论使用与否，他们都能获得固定收益。

Given the x Prize and Netflix, these are at least familiar to venture capitalists.

鉴于x大奖和Netflix，这些至少对风险资本家来说并不陌生。