大家论坛

 找回密码
 注册
查看: 1050|回复: 0

[经济学人] [2011.09.03]Coming up short 美国药品短缺

[复制链接]

269

主题

299

帖子

2683

金币

大家网大学二年级

Rank: 15Rank: 15Rank: 15

积分
1949
发表于 2011-9-21 15:39 | 显示全部楼层 |阅读模式
Pharmaceutical shortages
药品短缺


Coming up short
快没啦

America continues to have a dearth of medicines
美国持续药品供应不足



FOSCARNET, potassium phosphate, kanamycin sulphate—for healthy people, these names are a meaningless garble. For the sick, the list is a nightmare. In 2004 America had a shortage of 58 drugs. Last year it had 211 and this year 198 so far. As the problem has spread, so too has a sense of panic, with patients lacking essential medicines, doctors fretting over alternatives and hospitals navigating a “grey market” for drugs. On September 26th the Food and Drug Administration (FDA) will hold a hearing with the hope of answering urgent questions: why the world’s biggest pharmaceutical market is failing its customers, and what might be done about it.
磷甲酸,磷酸钾,硫酸卡那霉素——对于健康人来说,这些词没有任何意义,但是对于病人来说,这些词是一串噩梦。2004年美国有58种药物供应不足,去年达到211种,今年到现在为止有198种。随着问题扩散,恐慌也不断蔓延。病人无法获得至关重要的药物,医生焦急万分地寻找替代品,医院潜入“黑市”寻找药物。9月26日,美国食品和药品管理局将举行听证会,力求为以下紧急问题找到答案:为什么世界上最大的药品市场无法满足客户需求?应该怎么做解决这个问题?

The shortage affects a variety of treatments, but most are generic, injected drugs. Some can be replaced by other medicines, often inferior in quality and more expensive. Others have few substitutes. Hospitals are desperate, for example, to have electrolytes that keep premature babies alive, explains Erin Fox, who tracks drug shortages at the University of Utah. Oncologists are anxious for cytarabine, a leukaemia drug. “That’s the type of cancer that doesn’t have time to wait,” says Michael Link, president of the American Society of Clinical Oncology.
药物短缺影响到多种疾病治疗,而大部分短缺的药物都是注射型仿制药。有些药物可以被其它的替代,但是替代品通常质量更差价格更贵。还一些短缺药物则很难有替代品。犹他州立大学的阿林•福克斯一直在追踪药品短缺情况,他举例说医院极度匮乏让早产儿保住生命的电解质。肿瘤医生则急于获得治疗白血病的阿糖胞苷。美国临床肿瘤学会主席麦克•林克说:“这种癌症的患者可等不起。”

The causes of the shortage remain tangled, but a few factors are probably to blame. First, manufacturing problems are increasingly common, as firms trim costs and import cheap ingredients of variable quality. Some companies say the FDA has become stricter, too. Second, generic drugmakers have merged, so a given drug is often made by just one or two companies. When one firm shuts a factory, the other cannot fill the void quickly. Third, these drugs may have a basic problem of pricing. After a drug loses its patent protection, its price plunges as generic drugmakers fight for market share. Even if demand rises, a drug’s price remains low thanks to the distorting rules of Medicare Part B, which pays for many injected drugs. Squeezed by slim margins, a firm may simply discontinue a drug. Dysfunction ensues. Grey-market vendors, health-care’s scalpers, hoard drugs and then sell them for many times their usual cost.
短缺的原因很复杂,不过很有可能是以下几个因素造成的。第一,生产上的问题越来越普遍,很多公司都削减成本,采购质量不一的便宜原料。有些公司认为是食品和药品管理局变得越来越严格了。第二,仿制药生产商不断合并,每种药物的生产商通常只有一两个公司。一旦一个公司关闭工厂,供应缺口很难迅速得到填补。第三,短缺药品的定价都有问题。一旦某种药物失去专利保护,仿制药生产商就会一拥而上争夺市场份额,导致价格暴跌。此外联邦医疗保险计划的第二部分造成了市场扭曲,即便需求上扬,很多注射型药物的价格还是很低。厂商在利润过低的压力下可能干脆停止生产这种药物,从而导致市场失灵。黑市卖家和医疗黄牛党会囤积药物,以原价的多倍卖出。

It remains unclear what might be done. Legislation in Congress would require firms to tell the FDA at least six months before they stopped making a drug. But this might just inspire wholesalers to stockpile medicine, says Dr Link. Politicians could liberalise pricing under Part B, but this is unlikely—if anything they may extend controls to other types of drugs. Congress could also give more cash and authority to the FDA, which now has just four staff working feverishly to ease the shortages. But Republicans would resist.
关于应该采取何种措施尚无有效建议。国会有意立法规定公司在停止生产一种药品前必须提前六个月以上通知食品和药品管理局。但是林克认为这条规定可能会导致批发商大量收购囤积药物。政治家可以选择放宽联邦医疗保险计划第二部分的限价规定,但是看起来他们并不会这么做,而是有可能将限制扩大到其他品种的药物。国会也可以选择给食品和药品管理局更多的资金和决定权,因为该局现在只有四名工作人员为缓解紧缺忙得团团转,但是共和党肯定会反对。

For now, the FDA and firms are scrounging for solutions. Eight times in the past two years the agency has allowed the import of drugs unapproved in America but used safely elsewhere. Some drugs with minor quality problems, meanwhile, are being shipped to pharmacies with warning letters. In such cases, the patient will at least receive the drug he needs. Others should be so lucky.
现在食品和药品管理局以及药物厂商都在努力寻找解决方案。过去两年中,管理局曾经八次允许美国尚未批准但在其他国家已安全使用多年的药物进口。公司也将有轻微质量问题的药品送往药店,同时附上警告信。这样病人至少可以得到所需药物。其他人也能这么走运就好了。
回复

使用道具 举报

您需要登录后才可以回帖 登录 | 注册

本版积分规则



诚聘英才|移动端|Archiver|版权声明|大家论坛 ( 京ICP备06071611号,京公网安备11010802018363号 )

GMT+8, 2019-12-9 11:11 , Processed in 0.072005 second(s), 8 queries , Redis On.

Powered by Discuz!

© Comsenz Inc.

快速回复 返回顶部 返回列表