17、Big Pharma
The benefits of hypertension
Dec 4th 2003 From The Economist print edition
Growing pressure on pharmaceutical firms is a force for good
FIRMS today fall from grace with the alarming ease of wayward bishops，few industries, however, have tumbled as far, as fast and on as many fronts as drugmakers. Only five years ago, big firms were celebrated as the purveyors of exciting new medicines, such as Viagra, and even more stimulating earnings growth.
Today, firms are seen by many as more profiteering than profit-making. Companies are castigated for spending billions on research and development, only to deliver too many “me too” drugs and too few genuinely new ones. Comparable sums spent on sales and marketing—particularly on direct-to-consumer advertising in America—are lambasted for corrupting doctors and creating demand on the back of fancy publicity rather than legitimate medical need or product superiority. Efforts to fend off lower-cost competition from manufacturers of generic drugs through patent lawsuits leave companies accused of driving up the drugs bill in rich countries and depriving millions of life-saving medicines in poor ones The shares of most big drug firms now trade at a discount to the market, as promises of bright times ahead are marred by risk.
To be sure, pharma companies come in for criticism not just because they are more profitable than those in other sectors but because they are profitable in a field, medicine, where money makes people uneasy. And not only are drug companies profitable, but also visible: in America, rising hospital and physician costs are as much to blame for soaring insurance premiums as pharmaceuticals, but it is drugs which are the most obvious recurring expense and the one that consumers are asked, at least in part, to shoulder directly. Firms are caught between shareholders, who fear drug prices will fall, and consumers, who complain about their rise.
Some of the pain which big firms now feel is undoubtedly self-inflicted. Firms were slow to recognise the gathering storm around the lack of access to life-saving drugs in the developing world. Their public relations on most other issues remains pretty clumsy too, and their promises to investors have been overblown.
And yet it is also true that producing new drugs today has become a more complicated, costly and risky business than before and many firms now face a couple of years during which they will have relatively few new products coming to market. For example, using the human genome to identify promising new treatments is proving a much more difficult scientific task than many had predicted, and it will be many years before the promised flood of new drugs occurs.
Current pressures on pharmaceutical firms are forcing a long-overdue examination of how they organise research and development and these changes could cut the cost, in time and money, of R&D and eventually boost output GlaxoSmithKline, the world’s second-largest company, this week showed early signs that such root-and-branch re-engineering is starting to bear fruit. The final step drug firms will need to take is to prove that the drugs they produce really do justify the prices charged, in conferring appreciable benefits compared with existing therapies.
17、如今，各行各业都纷纷在失去了幸运的眷顾;然而，像制药行业那样衰退得如此久远、迅速、而且广泛的行业还是很少见。仅仅在五年之前，大公司还以生产出伟哥那样让人兴奋的新药和更令人难以置信的收入增长而声名远扬。
现在，在许多人看来，制药公司是在牟取暴利而非赚取利润。他们花费数十亿用于研发，仅仅提供了太多雷同而非真正的新药，为此，公司常遭到惩罚。人们指责那些花在营销上，尤其是花在美国电视直销广告上的大笔钱是在贿赂医生、通过花哨的宣传来增加需求，而不是凭借正当的医疗需要或是产品优势。有些公司为避开来自普通药品生产商通过专利诉讼形成的低成本竞争而不断努力，这却使他们被指控为增加了富国的药物支出，也剥夺了贫穷国家数以百万计的救命药品。风险摧毁了对美好未来的承诺，大多数药品大公司的股票如今在市场上折价交易。
可以肯定的是，制药公司遭到批评不仅因为他们比其它部门更能获利，而是由于他们居然在医药这一领域都要盈利，这笔钱让人心存不安。而且，不仅制药公司盈利了，显而易见：在美国，日益上升的医疗成本很大程度上都归因于暴涨的药物保险等保险费，而药品却成了最明显的递增支出，而这部分支出至少在某种程度上要由消费者直接承担。公司受困于股东和消费者之间，前者害怕药价下跌，后者则抱怨药价上涨。
大公司现在承受的痛苦毫无疑问是他们自己造成的。他们很难意识到发展中国家由于难以得到救命的药物而危机四伏。其余很多问题的公关也同样相当笨拙，同时，他们给投资者的承诺也早已经忘到了九霄云外。
然而，现在生产新药比以往更复杂、更昂贵、更具风险，许多公司现在要面临一两年罕有新药面世的局面，这的确也是事实。比如，利用人类基因组发现有希望的新疗法这项科学工作已被证明比许多人预计要难得多，而先前承诺的新药大批面世可能是多年以后的事了。
当前制药公司面对的压力催生了一项早该进行的调查，调查他们是如何组织研发，如何削减研发的时间和资金成本、并最终增加产量。世界第二大制药公司GlaxoSmithKline，本周已经显示出这种彻底的改造开始奏效的先兆。药品公司所要做的最后一步是通过和已有疗法相比的可观好处来证明其所生产的药物是值得涨价的。
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