2023年经济学人 胰岛素的价格战（2）（在线收听）

    These deals are eye-catching, but when patients turn up at pharmacies, they may find they cannot grab a bargain.

    这些交易很吸引眼球，但当病人来到药店时，他们可能会发现自己买不到便宜货。

    Shaina Kasper of T1International, an advocacy group for diabetes patients, is a type-1 diabetic.

    糖尿病患者权益组织T1国际的莎尔娜·卡斯珀是一名1型糖尿病患者。

    She says she tried to buy Eli Lilly’s non-branded Insulin Lispro, the specific drug available from May 1st for $25.

    她说，她尝试购买礼来公司的非品牌赖脯胰岛素，这种特殊药物从5月1日起以25美元的价格上市。

    Her pharmacy in Vermont quoted her $90.

    佛蒙特州的药房给她开价90美元。

    Perhaps Eli Lilly’s programme needs time to work out the kinks, or the pharmacy charged more on top.

    也许礼来公司的项目需要时间来解决问题，或者药店收取的费用更高。

    But this is not the first time such a scheme has caused problems.

    但这并不是此类计划第一次引发问题了。

    For years pharma firms have offered a patchwork of plans to help customers afford insulin and other drugs.

    多年来，制药公司提供了各种各样的计划来帮助客户负担胰岛素和其他药物。

    Some are for almost anyone, others for the poor or uninsured.

    有些计划几乎适用于所有人，有些则适用于穷人或没有保险的人。

    But they tend to be difficult for people to access, says Stacie Dusetzina, a drug-pricing expert at Vanderbilt University.

    但范德比尔特大学的药品定价专家史黛西·杜塞茨娜表示，人们往往很难获得这些药物。

    First patients must be aware that the scheme exists and that they are eligible, which is often unclear.

    首先，患者必须知道该计划的存在，并且知道他们有资格，而他们通常不清楚。

    Then they must jump through hoops.

    然后他们必须克服重重困难。

    Some need applications, doctor’s notes, proof of residence, tax documents and more.

    有些需要各种申请、医生说明、居住证明、税务文件等等。

    Pharmacies must also know about the programme and participate in it.

    药店也必须了解该计划并参与其中。

    It can be hard to know whom to blame—the drug companies for the faulty deals or the pharmacies for failing to implement them properly.

    很难知道该怪谁——是制药公司搞砸了交易，还是药店没能正确执行交易。

    These programmes can also end at any time.

    这些项目也可以在任何时候结束。

    “What the Lord giveth, the Lord can taketh away,” says David Mitchell of Patients For Affordable Drugs, an advocacy organisation for patients.

    “上帝给的，上帝也能拿走”，病人权益组织“为了便宜药”的大卫·米切尔这样说。

    That is why Mr Mitchell and others are pushing for laws to lower drug prices rather than relying on a mishmash of special schemes.

    这就是为什么米切尔先生和其他人正在推动降低药品价格的法律，而不是依赖于特殊计划大杂烩。

    Some states have given up on waiting.

    一些州已经放弃了等待。

    Colorado was the first to pass a cap on insulin, at $100 a month, in 2019.

    科罗拉多州是第一个在2019年通过胰岛素价格限额的州，每月收取100美元。

    Since then nearly half of states have introduced caps, but these cover only state-regulated health plans.

    从那以后，将近一半的州实行了上限，但这些只涵盖了各州监管的健康计划。

    In March Gavin Newsom, the governor of California, announced that he had signed a contract with a manufacturer to make and distribute insulin to Californians for $30.

    今年3月，加州州长加文·纽森宣布，他已经与一家制造商签订了一份合同，以30美元的价格向加州人分发生产出来的胰岛素。

    Maine, Michigan and Washington may follow.

    缅因州、密歇根州和华盛顿州可能会紧随其后。

    There are also bills in Congress to tackle insulin prices and increase access to generics.

    国会也有解决胰岛素价格和增加非专利药物获取途径的法案。

    Perhaps insulin’s cost will eventually come down further and become more predictable.

    也许胰岛素的成本最终会进一步下降，变得可以预测。