原文標(biāo)題：
Drug pricing
Problem solved？
Insulin is cheaper, but some struggle to get it at a price they can afford
藥品定價(jià)
問(wèn)題解決了？
胰島素更便宜了，但有些人卻買(mǎi)不起

The push to bring insulin prices down in America
But not all patients are able to use the available schemes
美國(guó)推動(dòng)胰島素降價(jià)
但并非所有患者都能用到這個(gè)方案

[Paragraph 1]

“MOVE TO THE back if you’ve lost your life savings to the drug companies,” shouts a woman walking by your correspondent.

“如果你把畢生積蓄都給了藥廠，請(qǐng)到后面排隊(duì)，"一位從本報(bào)記者身邊走過(guò)的女士喊道。

A spirited group follows her to the end of a long queue for a Senate hearing on insulin prices on May 10th.

在5月10日參議院關(guān)于胰島素價(jià)格的聽(tīng)證會(huì)上，一群人興致勃勃地跟在她身后，排起了長(zhǎng)隊(duì)。

In the room David Ricks of Eli Lilly, a large American drug firm, testifies that insulin, used to regulate blood-sugar levels for diabetics, is cheap and even free in some instances.

在房間里，美國(guó)大型藥企“禮來(lái)公司”的大衛(wèi).里克斯證實(shí)說(shuō)，胰島素（用于調(diào)節(jié)糖尿病患者血糖水平）很便宜，在某些情況下甚至免費(fèi)。"

“If you contact Lilly today, we will ship you a month’s supply at no cost with one question: ‘What’s your address?’” he says.

他說(shuō)："如果你今天聯(lián)系我們禮來(lái)公司，我們將免費(fèi)寄你一個(gè)月的藥量，只需提供地址即可。

Those dressed in gear with slogans like “Insulin for All” shake their heads in disbelief.

那些穿著印有 "人人都買(mǎi)得起胰島素 "口號(hào)服裝的人不相信地?fù)u搖頭。

Drug companies may be offering cheap insulin, but it is not reaching all patients.
藥物公司可能會(huì)提供廉價(jià)的胰島素，但它并未惠及所有患者。

[Paragraph 2]

The high price of drugs is a long-running grievance for Americans—and insulin is a flashpoint, since more than 8m of them depend on it to survive.

美國(guó)人對(duì)藥品貴積怨已久--胰島素是一個(gè)導(dǎo)火索，因?yàn)橛?00多萬(wàn)人靠它生存。

A standard unit that costs on average $9 in other rich countries sets Americans back $99.

一個(gè)標(biāo)準(zhǔn)單位在其他富裕國(guó)家平均花費(fèi) 9 美元，而美國(guó)人要花費(fèi) 99 美元。

A study in 2021 in the Annals of Internal Medicine, a journal, found that 1.3m people skipped or reduced insulin doses due to cost.
2021年《內(nèi)科學(xué)年鑒》雜志的一項(xiàng)研究發(fā)現(xiàn)，有130萬(wàn)人因?yàn)橘M(fèi)用問(wèn)題而放棄或減少了胰島素劑量。

[Paragraph 3]

According to GoodRx, a company that helps customers find low drug prices, the average cash price of insulin rose by 54% between 2014 and 2019.

根據(jù)幫助客戶(hù)尋找低價(jià)藥品的GoodRx公司的數(shù)據(jù)，2014年至2019年間，胰島素的平均現(xiàn)貨價(jià)格上漲了54%。

The price then dropped by 11% between January 2020 and May 2023. Despite the recent dip, insulin prices remain high.

隨后在2020年1月至2023年5月間，價(jià)格下跌了11%。盡管最近有所下探，但胰島素價(jià)格仍居高不下。

[Paragraph 4]
For older patients, the cost is now coming down.
對(duì)于老年患者來(lái)說(shuō)，費(fèi)用正在下降。

The Inflation Reduction Act, one of President Biden’s landmark laws, allows Medicare to negotiate with manufacturers for lower drug prices.
《減少通貨膨脹法案》是拜登總統(tǒng)具有里程碑意義的法律之一，它允許醫(yī)療保險(xiǎn)與藥企談判以降低藥品價(jià)格。

It also requires companies to pay back Medicare if prices rise faster than inflation, and it capped insulin prices at $35 a month for Medicare.
如果價(jià)格上漲快于通貨膨脹，法案還要求公司將這部分費(fèi)用退還給醫(yī)療保險(xiǎn)，而且胰島素醫(yī)保價(jià)格上限為每月35美元。

[Paragraph 5]
The new law seems to have nudged drug companies into offering lower prices for everyone.
新的法律似乎已經(jīng)推動(dòng)藥企為所有患者提供更低的價(jià)格。

On March 1st Eli Lilly announced an automatic $35-a-month cap on all insulins for those with private insurance at select pharmacies, and a similar programme for the uninsured.
3月1日，禮來(lái)公司宣布，對(duì)于那些有商業(yè)保險(xiǎn)的人來(lái)說(shuō)，在特定藥店購(gòu)買(mǎi)的所有胰島素每月自動(dòng)封頂35美元，未投保的人也可參與類(lèi)似的計(jì)劃。

The firm also promised to sell one of its non-branded insulins for $25 a vial, from May 1st.
該公司還承諾從5月1日起以每瓶25美元的價(jià)格出售一款非品牌胰島素。

Sanofi, a French drug company, followed suit with a similar deal for one of its insulins, starting next year. Novo Nordisk, a Danish firm, likewise announced lower prices for 2024.
法國(guó)藥企“賽諾菲”緊隨其后，從明年開(kāi)始對(duì)一款胰島素進(jìn)行類(lèi)似的定價(jià)。丹麥的“諾和諾德公司”也同樣宣布從2024年開(kāi)始降價(jià)。

[Paragraph 6]
These deals are eye-catching, but when patients turn up at pharmacies, they may find they cannot grab a bargain.
這些定價(jià)很吸引眼球，但是當(dāng)患者去藥店買(mǎi)藥時(shí)，他們可能會(huì)發(fā)現(xiàn)根本無(wú)法買(mǎi)到便宜藥。

Shaina Kasper of T1International, an advocacy group for diabetes patients, is a type-1 diabetic.
糖尿病患者權(quán)益組織“T1國(guó)際”的沙伊娜·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. Her pharmacy in Vermont quoted her $90.
她說(shuō)她想購(gòu)買(mǎi)禮來(lái)公司的非品牌Insulin Lispro，這種特定的藥物從5月1日開(kāi)始以25美元的價(jià)格出售。但是佛蒙特州的藥店向她報(bào)價(jià)90美元。

[Paragraph 7]
Perhaps Eli Lilly’s programme needs time to work out the kinks, or the pharmacy charged more on top. But this is not the first time such a scheme has caused problems.
也許禮來(lái)公司的計(jì)劃需要時(shí)間來(lái)解決這些問(wèn)題，或許是藥店收費(fèi)更高。但這并不是此類(lèi)方案第一次引發(fā)問(wèn)題。

For years pharma firms have offered a patchwork of plans to help customers afford insulin and other drugs. Some are for almost anyone, others for the poor or uninsured.
多年來(lái)，藥企提供了一系列的計(jì)劃，來(lái)使客戶(hù)能夠買(mǎi)得起胰島素和其他藥物。有些計(jì)劃幾乎面向所有人，其他計(jì)劃則適用于窮人或沒(méi)有保險(xiǎn)的人。

But they tend to be difficult for people to access, says Stacie Dusetzina, a drug-pricing expert at Vanderbilt University.
范德比爾特大學(xué)的藥物定價(jià)專(zhuān)家斯泰西·杜塞齊娜說(shuō)，但人們往往難以真正受益。

[Paragraph 8]
First patients must be aware that the scheme exists and that they are eligible, which is often unclear. Then they must jump through hoops.
首先，患者必須知道該計(jì)劃的存在，且知曉參與資格（這一點(diǎn)往往并不明確）。然后他們必須跨過(guò)重重障礙。

Some need applications, doctor’s notes, proof of residence, tax documents and more.
有些人需要申請(qǐng)單、醫(yī)生證明、居住證明、稅務(wù)文件等等。

Pharmacies must also know about the programme and participate in it.
藥店也必須了解該計(jì)劃并參與其中。

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.
很難判定是誰(shuí)的錯(cuò)--是藥企的錯(cuò)誤定價(jià)，還是藥店未能正確執(zhí)行。

[Paragraph 9]
These programmes can also end at any time.
這些計(jì)劃也可以隨時(shí)結(jié)束。

“What the Lord giveth, the Lord can taketh away,” says David Mitchell of Patients For Affordable Drugs, an advocacy organisation for patients.
患者權(quán)益組織Patients For Affordable Drugs的大衛(wèi).米切爾說(shuō)："上帝賜予的東西，上帝也可以收回"。

That is why Mr Mitchell and others are pushing for laws to lower drug prices rather than relying on a mishmash of special schemes.
這就是為什么米切爾和其他人采取行動(dòng)的原因，他們正在推動(dòng)立法來(lái)降低藥品價(jià)格，而不是依賴(lài)一系列的特殊計(jì)劃。

[Paragraph 10]
Some states have given up on waiting. Colorado was the first to pass a cap on insulin, at $100 a month, in 2019.
一些州已經(jīng)放棄了等待?？屏_拉多州于2019年率先規(guī)定了胰島素為每月 100 美元的上限價(jià)格。

Since then nearly half of states have introduced caps, but these cover only state-regulated health plans.
從那時(shí)起，近一半的州規(guī)定了價(jià)格上限，但這些僅涵蓋州監(jiān)管的健康計(jì)劃。

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. Maine, Michigan and Washington may follow.
3月，加州州長(zhǎng)加文.紐森宣布，他已經(jīng)與一家藥企簽署了合同，以30美元的胰島素價(jià)格生產(chǎn)并分售給加州人。緬因州、密歇根州和華盛頓州可能會(huì)緊隨其后。

There are also bills in Congress to tackle insulin prices and increase access to generics.
國(guó)會(huì)也有解決胰島素價(jià)格和增加仿制藥供應(yīng)的法案。

Perhaps insulin’s cost will eventually come down further and become more predictable.
最終，胰島素的成本也許會(huì)一降再降，且變得更加可預(yù)測(cè)。

（恭喜讀完，本篇英語(yǔ)詞匯量814左右）
原文出自：2023年5月27日《The Economist》United States版塊

精讀筆記來(lái)源于：自由英語(yǔ)之路

本文翻譯整理: Irene本文編輯校對(duì): Irene
僅供個(gè)人英語(yǔ)學(xué)習(xí)交流使用。

【補(bǔ)充資料】（來(lái)自于網(wǎng)絡(luò)）
禮來(lái)公司是一家全球性制藥公司，成立于1876年，總部位于美國(guó)印第安納州的印第安納波利斯市。公司致力于研發(fā)和銷(xiāo)售創(chuàng)新藥物，主要領(lǐng)域包括糖尿病、癌癥、神經(jīng)學(xué)、心血管和免疫學(xué)。伊利莎公司在全球擁有數(shù)百個(gè)研究和制造設(shè)施，產(chǎn)品在全球超過(guò)125個(gè)國(guó)家銷(xiāo)售。公司在全球約有38,000名員工，是全球制藥行業(yè)的領(lǐng)先企業(yè)之一。

美國(guó)醫(yī)療保險(xiǎn)計(jì)劃Medicare是面向65歲及以上的老年人和符合一定條件的殘障人士。制藥公司向Medicare提供的藥物需要符合規(guī)定，并且價(jià)格需要合理，如果藥品價(jià)格過(guò)高，Medicare可能會(huì)要求制藥公司退還部分費(fèi)用。這是為了保護(hù) Medicare 的財(cái)務(wù)穩(wěn)定性和合理使用納稅人的資金。

【重點(diǎn)句子】（3個(gè)）
Drug companies may be offering cheap insulin, but it is not reaching all patients.
藥物公司可能會(huì)提供廉價(jià)的胰島素，但它并未惠及所有患者。

These deals are eye-catching, but when patients turn up at pharmacies, they may find they cannot grab a bargain.
這些定價(jià)很吸引眼球，但是當(dāng)患者去藥店買(mǎi)藥時(shí)，他們可能會(huì)發(fā)現(xiàn)根本無(wú)法買(mǎi)到便宜藥。

First patients must be aware that the scheme exists and that they are eligible, which is often unclear. Then they must jump through hoops.
首先，患者必須知道該計(jì)劃的存在，且知曉參與資格（這一點(diǎn)往往并不明確）。然后他們必須跨過(guò)重重障礙。