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  • This is an EpiPen.

    這是一支 EpiPen (艾筆腎上腺素注射筆)。

  • It's a device that injects you with adrenaline if you're having a possibly deadly allergic reaction.

    當你發生可能致命的過敏反應時,這個裝置可以讓你注射腎上腺素。

  • If you have severe allergies, you basically need it.

    如果你有非常嚴重的過敏,基本上就需要它。

  • And if you live in the UK, an EpiPen will cost you the equivalent of 38 US dollars.

    如果你住在英國,一支 EpiPen 大約會花你 38 美金。

  • But if you live in the US, it'll cost you $300.

    但如果你住在美國,它會花你 300 美金。

  • And it's not just the EpiPen.

    不只是 EpiPen。

  • Let's look at five of the top selling prescription drugs in the world.

    我們來看看全球銷量前五名的處方藥。

  • Advair, a brand-name asthma inhaler: more expensive in the US.

    Advair,一種氣喘吸入劑的品牌:在美國比較貴。

  • Lantus, a type of Insulin: more expensive in the US.

    Lantus,一種胰島素:在美國比較貴。

  • Sovaldi for hepatitis C?

    C 型肝炎用的 Sovaldi?

  • Yup. Costs more in the US.

    沒錯。在美國比較貴。

  • Humira for arthritis?

    關節炎用的 Humira?

  • Crestor for cholesterol: more expensive in the US.

    控制膽固醇的 Crestor:在美國比較貴。

  • So here's an unsurprising chart.

    這是一張不令人意外的圖表。

  • Americans spend more on prescription drugs than anyone else in the world.

    美國人在處方藥上花的錢比世界上其他國家都多。

  • Why?

    為什麼?

  • The first thing you have to understand is that in the US, drugs get to patients differently than almost everywhere else.

    首先你要了解,在美國,藥物抵達病人手中的方式幾乎與所有地方都不同。

  • Let's look at that popular hepatitis C drug, Sovaldi.

    我們來看一下 C 型肝炎常用的藥物,Sovaldi。

  • In 2014 Sovaldi became the first drug to completely cure hepatitis C.

    2014 年,Sovaldi 成為世界上第一種能夠徹底治療 C 型肝炎的藥物。

  • Here's how it got to market in, for example, the UK.

    以下是它如何進入市場,以英國為例。

  • First a government agency had to decide that Sovaldi was safe and that it actually worked.

    首先一個政府專門機構必須確認 Sovaldi 是安全且有效的。

  • Then it was evaluated by a regulatory agency to see if was worthwhile.

    接著經由一個監管機構評估它是否值得進口。

  • Are there too many side effects?

    是否有太多副作用?

  • Is there already a similar drug?

    是否已經有類似的藥物?

  • Is there a cheaper option?

    是否有更便宜的選項?

  • Sovaldi was deemed worthwhile.

    Sovaldi 被認為是有價值的。

  • Next, they negotiated the price.

    然後,他們針對價格進行談判。

  • In the UK, the government buys the stock of medicine for the country.

    在英國,政府會替國家購入藥物的庫存。

  • That means they're usually able to get a lower rate, kind of like a bulk discount.

    這表示他們通常可以拿到比較低的價格,有點像是量販折扣。

  • Which keeps prescription drugs cheaper for UK citizens.

    因此讓英國公民可以取得較便宜的處方藥。

  • In almost every developed country besides the US, this is what the system looks like.

    幾乎所有除了美國的已開發國家都是這樣的制度。

  • Safety evaluation, assessment of whether the country needs it, price negotiations, sold to patients.

    安全評估、國家需求評估、價格談判、賣給病患。

  • Now let's look at the system in the United States.

    現在我們來看一下美國的制度。

  • First, the drug is evaluated for safety, but that's it.

    首先,藥品會先經過安全評估,就沒了。

  • If it's safe, they can sell it, end of story.

    如果它夠安全,就可以販售,就這樣。

  • Drugs are sold by the drug companies to patients, usually through insurance.

    藥品通常是透過保險,由藥品公司賣給病患。

  • And since the US system lets them sell it for any price, Gilead, the company that makes Sovaldi, charged Americans more for it.

    既然美國制度讓他們能夠以任何價格販售,製造 Sovaldi 的公司,吉利德,跟美國人收取較高的費用。

  • When it first came to market, the entire treatment cost $84,000 in the US.

    當它剛進入市場時,整個療程在美國要價 8.4 萬美金。

  • In the UK?

    在英國呢?

  • Just about $58,000 US dollars.

    只要大約 5.8 萬美金。

  • That's still a lot of money, but it's a full 30% less.

    這還是一筆不小的數目,但是整整少了百分之 30。

  • So it seems like the UK has the better system right?

    所以這樣看來英國的制度比較好,對吧?

  • Well, it's complicated.

    其實這很複雜。

  • These photos are from protests in the US against the high price of EpiPens.

    這些照片來自於美國針對高價 EpiPen 的抗議活動。

  • And these are photos from protests in the UK, over the lack of access to a cystic fibrosis drug called Orkambi.

    而這些照片則來自於英國的抗議活動,原因是缺乏取得治療囊腫性纖維化的藥物 Orkambi的管道。

  • That's because when there's a committee that determines whether a new drug is worthwhile, sometimes they say no.

    這是因為當有一個委員會來決定一種藥品是否有價值的時候,有時答案會是否定的。

  • And when they negotiate the price, sometimes they don't come to an agreement and hit a standoff.

    另外在協商價格的時候,有時他們無法達成協議,形成了僵局。

  • That's what's happening with Orkambi.

    這就是 Orkambi 面臨的狀況。

  • Both systems require trade-offs.

    這兩種制度都需要權衡。

  • Regulated drug markets tend to make drugs more affordable, but some drugs are completely unavailable.

    受規範的藥品市場使得藥品較容易負擔,但是有些藥品則完全無法取得。

  • And while the US has more drugs technically available, they're often too expensive to actually afford.

    而雖然嚴格上來說,在美國有更多種類的藥品可以取得,但是它們往往太貴,無法負擔。

  • Americans without insurance are the most likely to skip medication because of the cost.

    沒有保險的美國人是最有可能因為價格而省略藥物治療的族群。

  • Even Americans with insurance, are second.

    即便是有保險的美國人,依舊排名第二。

  • But the commonality between these two systems is the drug companies.

    但是這兩種制度間的共通點是藥品公司。

  • Developing new drug products isn't cheap and they're for-profit businesses.

    開發新藥品並不便宜,而且他們是盈利企業。

  • If Gilead didn't think that researching and developing a hepatitis C cure, would make them money in the end, they might not have.

    如果 Gilead 覺得研究、開發 C 型肝炎的治療藥物最終無法使他們獲益的話,他們可能就不會開發。

  • And with these regulated markets keeping costs down, the only place drug companies can really make their money is, you guessed it, the US.

    而由於這些受規範市場維持著一個低價,這些製藥公司唯一可以賺錢的地方就剩—你猜對了,美國。

  • Americans are essentially subsidizing the cost of drugs for the rest of the world.

    美國人基本上在替全世界補貼藥品的價錢。

  • In other words, a big part of why prescription drugs are more expensive in the US is because they're cheaper everywhere else.

    換句話說,處方藥在美國比較貴的一大主因,正是因為這些藥在其他地方都比較便宜。

  • If you'd like to continue exploring the importance of easier access to medicine and vaccines, then I highly recommend a documentary called "Viruses: Destruction and Creation".

    如果你想繼續深入探討更加容易取得藥物及疫苗的重要性,那麼我非常推薦一部叫做《Viruses: Destruction and Creation》的紀錄片。

  • Available now on CuriosityStream.

    現在可以在 CuriosityStream 收看。

  • CuriosityStream is a subscription service that offers more than 2,400 documentaries and non-fiction titles, from some of the world's best filmmakers.

    CuriosityStream 是一個訂閱系統,提供超過 2400 部由一些全球最厲害的製片人所拍攝的紀錄片和紀實影片。

  • You can get unlimited access starting at $2.99 a month and because you're a Vox fan, the first 31 days are free if you sign up at curiositystream.com/vox and use the promo code "VOX".

    你可以用每個月 2.99 美金的價錢獲得無上限的權限,而且,由於你是 Vox 的紛絲,如果你用促銷代碼 "VOX" 到 curiositystream.com/vox 註冊,你就可以獲得前 31 天免費的體驗。

  • CuriosityStream doesn't directly impact our editorial, but their support makes videos like this one possible.

    CuriosityStream 並沒有直接地影響我們的頻道內容,但是他們的支持,讓類似這樣的影片得以拍攝。

  • So go check them out!

    所以去瞧瞧吧!

This is an EpiPen.

這是一支 EpiPen (艾筆腎上腺素注射筆)。

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B1 中級 中文 美國腔 Vox 藥品 藥物 美國 比較 制度

為什麼美國的藥價這麼高? (Why drugs cost more in America)

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    Nina 發佈於 2021 年 09 月 02 日
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