Unit 88
Governments around the world are struggling to cope with the rising cost of health care, and of drugs in particular. Many rich countries have resorted to price controls, and some on the American left advocate them noisily. But drug firms maintain that America, where they are free to price patented pills largely as they please, is the engine of global pharmaceutical innovation, while price-controlling Europeans are free riders. That, says PhRMA, the industry’s lobby based in Washington, D.C., is because price regulations seen in other rich countries “chill innovation, impede patients’ access to the newest cutting-edge medicines, and trigger innovators to relocate to countries with more progressive public policy.”
A new study, written by Donald Light, a visiting professor at Stanford University, claims that European drug firms are more innovative than American ones, in spite of price controls. That flies in the face of an influential paper published in the same journal in 2006, which examined the geographic origins of drugs registered between 1982 and 2003 and concluded that favourable public policies had helped propel America to the top of the list. PhRMA has rushed to denounce Mr Light’s study, insisting it gives a “distorted picture” and understates the impact of “home-grown innovation”.
The tiff exposes two fallacies that come from looking at a globalised industry through national spectacles. Both sides attribute new drugs to a specific country of origin(based on the location of the headquarters of the firm that first launches them). But Patricia Danzon of the Wharton Business School argues that this makes little sense when most big drug firms have laboratories in several countries and often acquire drugs under development from biotechnology firms located elsewhere. By the same token, firms develop drugs for the global market, observes Alan Garber of Stanford, not just for the local one. So the imposition of price caps in a given country will not necessarily quash innovation there, thanks to the lure of exports.
The exception to this rule, of course, is the United States, which alone accounts for over 40% of global sales. So what would happen if America’s Congress imposes price regulations? If the cuts are swinging, then the prize for inventors everywhere will be reduced. But short of such a radical scenario, pricing reform would not kill off innovation, according to Sanford Bernstein, a financial-research firm. It has analysed the likely impact of a cut of 20% in the prices Medicare, the government health scheme for the elderly, pays for its drugs. It concluded that the earnings per share of big pharmaceutical firms would drop by 3-8%.
There is even reason to think that pricing reforms may boost innovation. Britain and Germany are pioneering comparative reviews of drugs’ effectiveness and cost-benefit analyses aimed at reimbursing firms for new drugs based on how well they perform. Janssen-Cilag persuaded Britain’s health service to accept Velcade, its expensive cancer drug, by offering a money-back guarantee if it did not work as well as promised.
The American pharmaceutical lobby is violently opposed to making such an approach compulsory. Some suspect that its opposition stems from the fear that many expensive and profitable pills would be found to be of dubious value. But as Ms Danzon points out, “Comparative-effectiveness reviews are an indirect form of price control—but one that is consistent with encouraging innovation.”
注(1):本文選自Economist;
注(2):本文習(xí)題命題模仿的是2004年真題Text 1。
1. How does the new study mentioned in Paragraph 2 support government’s health-care reform?
A) It says the government should impose exact price controls of drugs.
B) It claims that American drug companies should imitate their European counterparts.
C) It indicates that price control does not reduce the innovativeness of drug making.
D) It suggests that price control can promote the innovativeness of drug making.
2. Which of the following is NOT true concerning price control of drugs?
A) The measure has contributed to many free riders.
B) The measure is agreed upon by many rich countries.
C) The measure has encountered resistance from drug firms.
D) The measure has aroused a controversy that is yet to be settled.
3. The expression “by the same token” (Line 5, Paragraph 3) most probably means ______.
A) in the same way
B) symbolically
C) by the same expression
D) in the same sense
4. Why does the author say that price control may promote innovation?
A) Because it works in Britain and Germany.
B) Because firms are encouraged by government to guarantee better performance.
C) Because firms will be reimbursed for new drugs based on how well they perform.
D) Because Britain’s health service would like to try new drugs.
5. Which of the following is TRUE according to the text?
A) Medicare may reduce pharmaceutical firms’ earning per share in future.
B) The price-control-for-innovation approach is not applicable to US.
C) The American pharmaceutical industry utilizes politics for its own benefit.
D) Comparative-effectiveness analysis is the best way to encourage innovation.
篇章剖析
本文主要討論了藥品價(jià)格管制對(duì)于藥品行業(yè),尤其是新藥開(kāi)發(fā)的影響。第一、二段分別提出了兩個(gè)相反的觀點(diǎn),其中美國(guó)的藥品公司認(rèn)為價(jià)格管制會(huì)抑制藥品創(chuàng)新,而萊特教授則持相反意見(jiàn);第三段說(shuō)明這場(chǎng)爭(zhēng)論存在的問(wèn)題,即人們過(guò)于注重藥品源產(chǎn)地而忽視了當(dāng)今的全球化趨勢(shì);第四段則分析了美國(guó)制藥業(yè)的特殊情況;第五、六段說(shuō)明了歐洲國(guó)家正在采取新的措施,而美國(guó)制藥業(yè)反對(duì)這種強(qiáng)制措施。
詞匯注釋
patent /?pe?t?nt/ v. 給予…專(zhuān)利權(quán);取得…的專(zhuān)利權(quán)
pharmaceutical /?fɑ?m??sju?t?kl/ adj. 制藥的;藥品的
trigger /?tr?g?/ v. 引發(fā),引起
denounce /d??na?ns/ v. 指責(zé),譴責(zé)
tiff /t?f/ n. 口角,爭(zhēng)執(zhí);生氣
fallacy /?f?l?si/ n. 錯(cuò)覺(jué);誤解;謬見(jiàn)
spectacle /?spekt?kl/ n. 景象;奇觀,壯觀
token /?t??k?n/ n. 標(biāo)記;標(biāo)志,象征
scenario /s??nɑ?r???/ n. 方案;設(shè)想
reimburse /?ri??m?b??s/ v. 賠償;償還
lobby /?l?bi/ n. 游說(shuō)議員的團(tuán)體
難句突破
That, says PhRMA, the industry’s lobby based in Washington, D.C., is because price regulations seen in other rich countries “chill innovation, impede patients’ access to the newest cutting-edge medicines, and trigger innovators to relocate to countries with more progressive public policy.”
主體句式:That, says PhRMA, ...is because...
結(jié)構(gòu)分析:本句有較多難點(diǎn)。首先主體句式是一個(gè)倒裝結(jié)構(gòu),主語(yǔ)是PhRMA,其他內(nèi)容都是says的賓語(yǔ)。第二個(gè)難點(diǎn)是間接引語(yǔ)和直接引語(yǔ)的交雜。PhRMA說(shuō)的內(nèi)容都是says的賓語(yǔ),但這個(gè)賓語(yǔ)從句的主體結(jié)構(gòu)是間接引語(yǔ)that is because...,而在price regulations seen in other countries后面則加入了直接引語(yǔ),注意引號(hào)里面是三個(gè)動(dòng)詞并列的結(jié)構(gòu),即chill... impede... and trigger...。
句子譯文:設(shè)在華盛頓的制藥行業(yè)游說(shuō)團(tuán)體美國(guó)藥品研究與制造商協(xié)會(huì)(PhRMA)認(rèn)為,因?yàn)槠渌粐?guó)采取的價(jià)格管制措施“阻礙創(chuàng)新,使病人無(wú)法使用最新藥物,致使創(chuàng)新者不得不選擇到公共政策更為寬松的國(guó)家去進(jìn)行創(chuàng)新”。
題目分析
1. C 細(xì)節(jié)題。第二段提到“斯坦福大學(xué)客座教授唐納德·萊特所做的最新研究指出,即使面臨價(jià)格管制,歐洲醫(yī)藥企業(yè)的創(chuàng)新性也高于美國(guó)企業(yè)”,這說(shuō)明價(jià)格管制并沒(méi)有影響制藥行業(yè)的創(chuàng)新性,因此C是正確選項(xiàng)。A和B文中并沒(méi)有提到,故排除。原文并沒(méi)有指出價(jià)格管制能夠促進(jìn)創(chuàng)新性的發(fā)展,故排除D。
2. A 細(xì)節(jié)題。本題可以采用排除法。B選項(xiàng)對(duì)應(yīng)于文章第一段提到的信息“很多富國(guó)已經(jīng)采取措施來(lái)控制價(jià)格”,因此是正確的表述。文章第一段和最后一段都提到美國(guó)的制藥行業(yè)游說(shuō)團(tuán)體反對(duì)價(jià)格控制措施,對(duì)其進(jìn)行抵制,所以C選項(xiàng)的表述也是正確的。文章對(duì)實(shí)施價(jià)格控制措施進(jìn)行了討論,但是沒(méi)有給出定論,所以D的表述也是正確的。盡管文章第一段提到“采取價(jià)格控制措施的歐洲則坐享其成”,但第三段的研究結(jié)果則表明那些歐洲的制藥公司并不是所謂的“free riders”,所以A選項(xiàng)的表述不夠準(zhǔn)確。
3. D 語(yǔ)義題。從文章第三段我們可以發(fā)現(xiàn),沃頓商學(xué)院的帕特里夏·當(dāng)宗認(rèn)為這一觀點(diǎn)沒(méi)什么說(shuō)服力,因?yàn)榇蟛糠轴t(yī)藥巨頭都在多個(gè)國(guó)家設(shè)有實(shí)驗(yàn)室,而且經(jīng)常從其他國(guó)家的生物公司獲取開(kāi)發(fā)中的藥品,而斯坦福大學(xué)的艾倫·加伯發(fā)現(xiàn),企業(yè)不僅為本地市場(chǎng)開(kāi)發(fā)藥品,更要面對(duì)全球市場(chǎng),兩位專(zhuān)家所持觀點(diǎn)的基本立場(chǎng)是相同的,也就是現(xiàn)在的醫(yī)藥開(kāi)發(fā)都是全球化運(yùn)作,因此可以推出連接二者觀點(diǎn)的“by the same token”意為“同樣意義上”,因此D是正確答案。
4. B 細(xì)節(jié)題。本題對(duì)應(yīng)于文章的倒數(shù)第二段,該段第一句話就提出“我們甚至還有理由認(rèn)為價(jià)格改革可能會(huì)促進(jìn)創(chuàng)新”,后面舉例來(lái)說(shuō)明這一點(diǎn)。A、D兩項(xiàng)顯然是錯(cuò)誤的,關(guān)鍵是B、C兩項(xiàng),其內(nèi)容表述都是正確的。但是C選項(xiàng)的表述只是這些政府推出的做法,并不是原因,而B(niǎo)選項(xiàng)則是更好地說(shuō)明了原因,即政府通過(guò)價(jià)格管制能夠鼓勵(lì)企業(yè)更好地保證新產(chǎn)品質(zhì)量,從而也就是鼓勵(lì)了創(chuàng)新。
5. C 細(xì)節(jié)題。本題主要對(duì)應(yīng)于文章最后三段。倒數(shù)第三段中提到了Medicare,但是這里只是用于舉例說(shuō)明的一個(gè)假設(shè),與A選項(xiàng)的描述并不相符,因此A不正確。倒數(shù)第三段開(kāi)頭提出“當(dāng)然美國(guó)是個(gè)例外”,但是后面又指出“根據(jù)斯坦福伯恩斯坦金融研究公司的結(jié)論,在改革方案和措施不是很激進(jìn)的情況下,價(jià)格改革不會(huì)抹殺創(chuàng)新”,這說(shuō)明價(jià)格管制促進(jìn)創(chuàng)新這個(gè)觀點(diǎn)在美國(guó)是否適用還沒(méi)有定論,因此B也不正確。文章最后一句話指出“對(duì)比較療效的評(píng)價(jià)是一種間接的價(jià)格控制——但同樣可以鼓勵(lì)創(chuàng)新”,但這里并不是說(shuō)療效比較分析就是鼓勵(lì)創(chuàng)新的最好方法,所以D也不正確。文章第一段就提到了設(shè)在華盛頓的行業(yè)游說(shuō)團(tuán)體PhRMA,最后一段又提到美國(guó)醫(yī)藥企業(yè)游說(shuō)團(tuán)體,說(shuō)明美國(guó)醫(yī)藥行業(yè)充分通過(guò)政治手段來(lái)維護(hù)自己的利益,所以C是正確的說(shuō)法。
參考譯文
全球的政府都在想盡辦法來(lái)對(duì)付不斷上漲的醫(yī)療費(fèi)用,尤其是藥品價(jià)格。很多富國(guó)已經(jīng)采取措施來(lái)控制價(jià)格,一些美國(guó)左翼人士也對(duì)此表現(xiàn)出積極支持的態(tài)度。但是美國(guó)的制藥公司卻認(rèn)為,正是因?yàn)槊绹?guó)的制藥公司擁有為其專(zhuān)利藥品定價(jià)的自由,因此美國(guó)才能成為世界新藥研發(fā)的生力軍。而相比之下,采取價(jià)格控制措施的歐洲則坐享其成。設(shè)在華盛頓的制藥行業(yè)游說(shuō)團(tuán)體美國(guó)藥品研究與制造商協(xié)會(huì)(PhRMA)認(rèn)為,因?yàn)槠渌粐?guó)采取的價(jià)格管制措施“阻礙創(chuàng)新,使病人無(wú)法使用最新藥物,致使創(chuàng)新者不得不選擇到公共政策更為寬松的國(guó)家去進(jìn)行創(chuàng)新”。
斯坦福大學(xué)客座教授唐納德·萊特所做的最新研究指出,即使面臨價(jià)格管制,歐洲醫(yī)藥企業(yè)的創(chuàng)新性也高于美國(guó)企業(yè)。這種觀點(diǎn)與2006年同一本期刊的另一篇較有影響力的文章正好相反,該文章檢驗(yàn)了1982年至2003年注冊(cè)藥品的地理來(lái)源,結(jié)論是,有利的公共政策確實(shí)幫助美國(guó)成為了第一大醫(yī)藥國(guó)家。PhRMA迅速反駁了萊特先生的研究,堅(jiān)持認(rèn)為萊特的研究曲解和低估了美國(guó)國(guó)內(nèi)創(chuàng)新的影響。
這場(chǎng)爭(zhēng)論暴露了從國(guó)家的角度來(lái)看全球化藥業(yè)時(shí)容易產(chǎn)生的兩個(gè)誤解。雙方都把新藥的產(chǎn)生歸結(jié)于特定的源頭國(guó)家(即那些最先開(kāi)發(fā)出新藥的公司的總部所在地)。但是沃頓商學(xué)院的帕特里夏·當(dāng)宗認(rèn)為這一觀點(diǎn)沒(méi)什么說(shuō)服力,因?yàn)榇蟛糠轴t(yī)藥巨頭都在多個(gè)國(guó)家同時(shí)擁有實(shí)驗(yàn)室,而且經(jīng)常從其他國(guó)家的生物科技公司獲取正在開(kāi)發(fā)的藥品。同樣,斯坦福大學(xué)的艾倫·加伯發(fā)現(xiàn),企業(yè)不僅為本地市場(chǎng)開(kāi)發(fā)藥品,更是著眼全球市場(chǎng)。所以由于出口的誘惑,特定國(guó)家的價(jià)格管制不會(huì)阻礙當(dāng)?shù)氐膭?chuàng)新。
當(dāng)然美國(guó)是個(gè)例外,其藥品銷(xiāo)量占到全球的40%以上。如果美國(guó)國(guó)會(huì)實(shí)行價(jià)格管制,那么會(huì)產(chǎn)生怎樣的影響?如果下降幅度較大,世界其他地方新藥研發(fā)者的獲利也將減少。但是根據(jù)斯坦福伯恩斯坦金融研究公司的結(jié)論,在改革方案和措施不是很激進(jìn)的情況下,價(jià)格改革不會(huì)抹殺創(chuàng)新。報(bào)告分析了如果政府針對(duì)老年人的醫(yī)保計(jì)劃Medicare中藥品的價(jià)格降低20%可能會(huì)產(chǎn)生的影響,其結(jié)論是大型醫(yī)藥企業(yè)每股收益將因此下降3%~8%。
我們甚至還有理由認(rèn)為價(jià)格改革可能會(huì)促進(jìn)創(chuàng)新。英國(guó)和德國(guó)正在率先開(kāi)展對(duì)藥品療效的比較和成本—收益分析,目的是以企業(yè)表現(xiàn)來(lái)決定對(duì)新藥的資助力度。楊森藥廠說(shuō)服英國(guó)健康服務(wù)部門(mén)接受其昂貴的抗癌藥物萬(wàn)珂,同時(shí)承諾若藥品達(dá)不到預(yù)期療效,將予以退款。
美國(guó)醫(yī)藥企業(yè)游說(shuō)團(tuán)體強(qiáng)烈反對(duì)強(qiáng)制推行類(lèi)似的方法。一些人猜測(cè),美國(guó)醫(yī)藥界反對(duì)的原因是害怕很多價(jià)格昂貴且獲利豐厚的新藥被發(fā)現(xiàn)物非所值。但是就像當(dāng)宗女士所指出的那樣:“對(duì)比較療效的評(píng)價(jià)是一種間接的價(jià)格控制——但同樣可以鼓勵(lì)創(chuàng)新?!?
瘋狂英語(yǔ) 英語(yǔ)語(yǔ)法 新概念英語(yǔ) 走遍美國(guó) 四級(jí)聽(tīng)力 英語(yǔ)音標(biāo) 英語(yǔ)入門(mén) 發(fā)音 美語(yǔ) 四級(jí) 新東方 七年級(jí) 賴世雄 zero是什么意思包頭市林南四化小區(qū)英語(yǔ)學(xué)習(xí)交流群