受够了药企开出的天价 加州要自行制造胰岛素

When it comes to out-of-control prescription drug prices, insulin is the poster child.

当谈到失控的处方药价格时，胰岛素是一个典型的例子。

Leading manufacturers have increased prices by more than 600% over the last 20 years.

在过去20年中，主要制造商的价格上涨了600%以上。

Insulin has become so expensive, many diabetes patients ration the drug.

胰岛素已经变得如此昂贵，许多糖尿病患者只能限量用药。

Although some states are now trying to address the problem.

尽管一些州正在努力解决这个问题。

And NPR's Allison Aubrey is covering that. Allison, good morning.

NPR新闻的艾莉森·奥布里将带来报道。早上好, 埃里森。

Good morning, Steve.

早上好, 史蒂夫。

I guess we need to start, actually, at the federal level because Congress passed this measure they called the Inflation Reduction Act, which is supposed to include prescription drug reforms.

实际上，我想我们需要从联邦层面开始谈起，因为国会通过了一项他们称之为《通胀削减法案》的措施，该法案应该包括处方药改革。

Does that help people with insulin?

这对使用胰岛素的人有帮助吗？

Well, it will help Medicare patients.

嗯，这对有医疗保险的病人有帮助。

There will be a new cap on out-of-pocket costs for them.

他们的自付费用将有一个新的上限。

But as for the other 80% of Americans, there are many families still struggling to afford insulin.

但对于其他80%的美国人来说，仍有许多家庭难以负担胰岛素费用。

I spoke to Clayton McCook. He lives in Edmond, Okla.

我和克莱顿·麦克库克谈过了。他住在俄克拉荷马州的埃德蒙德。

His 14-year-old daughter Lily has Type 1 diabetes.

他14岁的女儿莉莉患有1型糖尿病。

And due to their very high-deductible health plan, they pay thousands of dollars out of pocket each year.

由于他们健康计划的免赔额非常高，所以他们每年要自费支付数千美元。

He says he's angry that pharmaceutical companies price insulin at $300 a vial when it only costs about $6 to make.

他说，他对制药公司将胰岛素定价为300美元一小瓶感到愤怒，而该药物的生产成本只有6美元左右。

I could go to Canada right now and get my daughter's insulin - the same exact drug - for $35 to $40 a vial because the Canadian government says, this is it.

我现在就可以去加拿大买到我女儿的胰岛素——一模一样的药物——只要35到40美元一瓶，因为加拿大政府称，就是这个药物。

This is the most you can charge. And they're still making a profit at that price.

这是能收的最高价格。他们仍然在以这个价格获利。

They're still making a handsome profit.

他们仍然在赚取不菲的利润。

This is a very visceral thing for me. Without insulin, my daughter will die.

这对我来说是一件非常本能的事情。没有胰岛素，我女儿会死的。

And McCook says if there's not more action in Washington, D.C., to fix what he says is a broken system, he points to momentum at the state level.

麦库克称，如果华盛顿特区不采取更多行动来修复他所说的支离破碎的系统，他指出了州一级改变的势头。

What's happening at the state level?

州一级发生了什么?

Well, about 20 states have passed laws or programs to limit the amount patients pay for insulin.

嗯，大约有20个州通过了法律或计划来限制患者支付胰岛素的金额。

I'd say the boldest initiative is in California.

我想说，最大胆的举措是在加州。

Instead of buying insulin from big pharmaceutical companies such as Eli Lilly, Novo Nordisk, they want to make their own insulin.

他们不想从礼来、诺和诺德等大型制药公司购买胰岛素，而是想自己制造胰岛素。

Governor Gavin Newsom has said nothing epitomizes market failures as much as the cost of insulin.

州长加文·纽森表示，没有什么比胰岛素的价格更能体现市场失灵了。

I spoke to Dr. Mark Ghaly.

我和马克·加里博士谈过了。

He's secretary of health and human services for the state of California.

他是加州卫生与公共服务部部长。

The cost of actually creating the insulin is not nearly as much as what people are paying for it.

实际制造胰岛素的成本远没有人们支付的那么多。

California is looking at, what approach can we take to make sure what people pay for it is as close to the actual cost of creating it as possible?

加州正在考虑，可以采取什么方法来确保人们支付该药物的费用尽可能接近制造的实际成本?

Earlier this summer, state lawmakers approved $100 million for this project.

今年夏天早些时候，州议员批准了1亿美元用于该项目。

The idea is to kind of produce biosimilar - as they're called - insulin products akin to generic versions of the existing drugs.

他们的想法是生产一种所谓的生物仿制药--胰岛素产品，类似于现有药物的仿制品。

Is this doing something that is proven and practical that anyone can do?

这是一件任何人都能实施的、被证明可行的事情吗?

Well, it hasn't been done yet.

嗯，这个事情还没有做完。

But Californians are not the first to be thinking about this.

但加州有关人员并不是第一个考虑这个问题的人。

Civica Rx is a noNPRofit generic drug company.

Civica Rx是一家非营利性的仿制药公司。

It started back in 2018.

该公司始于2018年。

They're already in the process of developing three insulin products that will cost no more than $30 a vial.

他们已经在开发三种胰岛素产品，每瓶价格不超过30美元。

I spoke to Civica Rx's Allan Coukell.

我采访了Civica Rx公司的艾伦·库克尔。

Our timeline is to bring the first of those three insulins to market in 2024.

我们的期限是在2024年将这三种胰岛素中的第一种推向市场。

And we're working with the FDA now as we move through the development process.

随着开发过程的推进，我们正在与食品及药物管理局合作。

The FDA would need to authorize these insulin products, and he's optimistic this will happen, which could usher in much cheaper insulin for millions of Americans.

食品及药物管理局将需要批准这些胰岛素产品，他乐观地认为这将会发生，这将为数百万美国人带来更便宜的胰岛素。