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PBS高端访谈:美国居高不下的药物价格

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JUDY WOODRUFF: During the 2016 election campaign, President Trump repeatedly pledged to bring down prescription drug prices. And his administration has taken some steps in recent months, including trying to increase the number of generic, or non-brand name products, available to substitute for high-cost drugs. They have also lowered the price Medicare pays initially for some medications. Feeling political pressure, some drugmakers have announced temporary price freezes. But a new analysis by the Associated Press finds there have been far more price hikes than cuts. While price increases did slow somewhat, the analysis found there have been 96 price hikes for every price cut in the first seven months of this year. Journalist Elisabeth Rosenthal watches health care costs. She's the author of a book on the subject called An American Sickness, and she's the editor in chief of Kaiser Health News. Elisabeth Rosenthal, welcome to the NewsHour.

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ELISABETH ROSENTHAL, Editor in Chief, Kaiser Health News: Thank you.

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JUDY WOODRUFF: So, in sum, what is this AP analysis telling us?

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ELISABETH ROSENTHAL: Well, it's showing us how hard it is to bring down drug prices, and that the president, despite his narrative of saying these companies are getting away with murder, isn't making a whole lot of headway. I mean, that's pretty extraordinary, 96 up to one down.

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JUDY WOODRUFF: But there, they do show there is some slowing in the rate of increase. Is that right?

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ELISABETH ROSENTHAL: Well, they do. But when you're saying slowing in the rate of increase, that means they're still going up. And these prices are already for many drugs, for an extraordinary number of Americans, unaffordable. So they shouldn't just be going up at a slower pace. I think we really need them to come down.

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JUDY WOODRUFF: Now, we know what, Elisabeth Rosenthal, we know what the drug companies say. They say, we need this additional money because we're doing experiments. We're trying to come up with new drugs to solve other problems, to cure other illnesses. And that costs money.

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ELISABETH ROSENTHAL: Yes, they say that. And that is true. But I think what we see, which is extraordinary to me, is that, over time, the same exact drug, a vaccine for pneumococcal pneumonia, a cancer drug, will go up, will double, will triple over time. Now, that isn't how any real market works, right? When things get older, the prices go down, because, hey, you have recouped your investment with this high price at the beginning. So why should it keep going up? That defies economic logic. It defies health care logic, and, frankly, it defies the drug companies' own logic.

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JUDY WOODRUFF: So, when the president of the United States says, as President Trump said in May, he said he would be announcing massive voluntary drug price cuts within two weeks, what actually happened after that?

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ELISABETH ROSENTHAL: Well, a bunch of companies started off just doing business as usual and announced price hikes. Then President Trump came back and said, shamed them. And shaming works a little bit. So there's a whole bunch of companies, probably half-a-dozen, that said, OK, we're not going to do price hikes this year. But, hey, we're going to pause. But what happens next year? No promises there. And, as I said, we're talking about price hikes of old drugs now. We're not talking about a new fabulous cancer treatment. We're talking about an annual 10 percent price hike on an old drug. And I don't think we have a good explanation for why that has occurred.

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JUDY WOODRUFF: Is, as somebody who has studied this for a long time, what do you think it takes? I mean, is it, it's going to take? Are we talking political pressure from a president or somebody else? What does it take?

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ELISABETH ROSENTHAL: Well, I don't think shaming enough is going to make it happen, right? So I think that the president proposed some ideas, like allowing greater generic competition, allowing biosimilars, which are complex molecules, to be done on a generic, basically, a generic basis. But that only affects a small number of drugs, maybe 10 to 15 right now. And the generics we have seen in this country don't lower prices. Look, the EpiPen, there was a brouhaha. It was $700. A generic meant it was $350. P.S., an EpiPen in 2007 was $100. So we're starting with this crazy high price point. So what will it take? I can tell you what other countries have found, is that it takes some sort of price-setting, some kind of national price negotiation.

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JUDY WOODRUFF: Government action.

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ELISABETH ROSENTHAL: Yes, basically, large-scale government action. I mean, maybe when Amazon and J.P. Morgan Chase and Berkshire Hathaway get together, they will have that kind of clout. But whether the market and these market manipulations can do it, I think Secretary Azar today said you need to give it time. I mean, my feeling is, yes, maybe some of them would work over time. But we're running out of time here. People are hurting right now. And these prices are extreme ordinarily high right now.

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JUDY WOODRUFF: The other thing we see about drug pricing is, frankly, a lack of transparency. We don't see what it is inside these companies that is leading to these price increases, do we?

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ELISABETH ROSENTHAL: No. And I think a number of politicians have called for that. A number of states are calling for that, which is interesting.
There's a lot of action at the state level right now, where a state is saying, if you want to raise prices, OK, explain why you need to do this.
We want a justification. So far, at a federal level, it's been kind of willy-nilly. Why do we raise prices? Well, I mean, economists would say because they can.

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JUDY WOODRUFF: But it sounds like you're saying, in the near term, we're not going to see much change?

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ELISABETH ROSENTHAL: Well, slow change. But we find in Kaiser Family Foundation surveys 80 percent of people want the government to do something; 40 percent say they're worried that they can't afford their medicines. We see young people dying because they can't afford insulin now. I think this is an acute problem, so a long-term solution is not going to really be enough right now. And I hope voters realize that and start putting on the political pressure, because I think we do need a solution.

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JUDY WOODRUFF: Well, we're paying attention now. And let's hope a lot more people pay attention.

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ELISABETH ROSENTHAL: I hope so. Thanks.

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JUDY WOODRUFF: Elisabeth Rosenthal, thank you very much, Kaiser Health News.

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ELISABETH ROSENTHAL: Thanks.

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重点单词   查看全部解释    
pressure ['preʃə]

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n. 压力,压强,压迫
v. 施压

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military ['militəri]

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adj. 军事的
n. 军队

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generic [dʒi'nerik]

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adj. 一般的,普通的,共有的,没有商标的

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election [i'lekʃən]

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n. 选举

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complex ['kɔmpleks]

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adj. 复杂的,复合的,合成的
n. 复合体

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solution [sə'lu:ʃən]

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n. 解答,解决办法,溶解,溶液

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solve [sɔlv]

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v. 解决,解答

 
prescription [pris'kripʃən]

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n. 药方,对策,开处方

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analysis [ə'næləsis]

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n. 分析,解析

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transparency [træns'pærənsi]

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n. 透明度,幻灯片

 

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