美國藥價爲何居高不下
Here's why the bipartisan push to lower drug prices never works
美國藥價爲何居高不下
The United States spends far more on prescription drugs compared to other high-income countries, despite having similar prescription drug usage — a phenomenon that is often explained by the sky-high prices at which drugs are sold across the nation and the enormous cost of high-risk research and innovation.
儘管與其它高收入國家相比，美國的處方藥用量相差無幾，但其處方藥開支卻更加高昂——全美藥品的高價售賣以及研發藥品的高成本通常可以爲這一現象作出解釋。
The battle over how to lower drug prices in the U.S. — and how to revamp the nation's health care system, more generally — has moved to the center stage of the 2020 presidential race, as President Donald Trump has repeatedly vowed to "bring down drug prices" and as several Democratic presidential candidates have unveiled proposals that would target the rising costs of prescription drugs. Polls have indicated that a majority of voters — across the political spectrum — support a range of federal policies aimed at curbing prescription drug costs.
關於如何降低美國藥價的爭論——以及如何更全面地改革美國的醫療保健體系——已成爲2020年總統競選的關鍵議題。唐納德·特朗普總統一再發誓要“降低藥價”，而幾位民主黨總統候選人已公佈了針對處方藥成本飆升的提案。民意調查顯示：大多數選民——在整個政治領域——支持一系列旨在控制處方藥成本的聯邦政策。
Americans are also frustrated that they spend more on prescription drugs — average costs are about $1,200 per person per year — than anyone in the developed world, despite the fact that generics represent roughly 84% of the U.S. market, the greatest proportion among high-income countries.
美國人對此也感到沮喪：他們比其它發達國家的人民在處方藥上花費更多——平均每人每年支出約1200美元，儘管仿製藥佔美國市場的84%左右（在高收入國家中佔比最高）。
Natasha Sriraman, a practicing pediatrician and professor of pediatrics at Eastern Virginia Medical School, said that the price of medications in the U.S. have made treatments increasingly out of reach for millions of Americans. She said a growing number of Americans are not filling a prescription, skipping a scheduled dose or taking an expired medication due to high costs.
東弗吉尼亞醫學院的兒科醫生和兒科學教授娜塔莎·斯瑞拉曼（Natasha Sriraman）說道，美國的藥價使得數百萬美國人得不到治療。她表示，越來越多的美國人由於藥價高昂而無法照配方抓藥、無法按規定劑量服藥、甚至服用過期藥物。
"I don't think people are realizing how that is affecting my 7-year-old patient who could die if he doesn't get the EpiPen or the 4-year-old who has a walnut allergy," Sriraman told Salon, referring to the high cost of the epinephrine auto-injectable medication that stops allergic reactions. (EpiPen's manufacturer, Mylan Pharmaceuticals, has come under intense scrutiny for steadily hiking the price for anaphylaxis drug from less than $100 to $600.)
“我覺得人們尚未意識到這一現象對患者的影響，一名7歲的患者和一名對核桃過敏的4歲兒童若無法注射EpiPen，都可能會死，”斯瑞拉曼對Salon期刊說道，意味着售價高的腎上腺素自動注射藥物可救治過敏反應。（EpiPen的製造商邁蘭製藥公司將其過敏藥物的價格從低於100美元提升至600美元，現已受到嚴格審查。）
Drug manufacturers often cite their research costs in an attempt to justify high drug prices, arguing that steps to cut costs would stifle innovation in the future. And while it's true that research and development is expensive, experts have questioned Big Pharma's assertion that research spending ultimately determines prices.
藥品製造商經常提及他們的研究成本以說明藥價高的合理性，認爲降低成本的政策將壓制未來的創新。雖然研發成本高昂，但專家也對大型製藥公司的說法（研發成本決定最終藥價）提出了質疑。
