Quagmire to goldmine?
> 从沼泽到金矿
> May 15th 2008 | NEW YORK
> From The Economist print edition
>
> Illustration by David Simonds
>
> The rapid growth in developing countries prompts a rethink by drugs companies
> 发展中国家药品需求的快速增长促使制药企业重新思考自己的商业模式
> BRAZIL has long been a thorn in the side of the global drugs companies. The country´s vibrant generics industry has often trampled over their patents. As recently as last year, its government threatened to invoke compulsory licensing (a legal mechanism that, in effect, legitimises such trampling) to browbeat a foreign drugs firm into offering huge discounts. And Brazil´s state-funded researchers have devised some impressive drugs, including a new therapy for malaria (see article). Small wonder, then, that big drugs firms have remained leery of this market.
> 对许多跨国制药企业而言,巴西是一片荆棘从生的市场.这个国家生机勃勃的仿制药企业经常向跨国制药企业的专利权发起挑战.就在去年,巴西政府还威胁要引用强制许可条款.(一种法律制度,事实上就是合法的践踏专利权)以迫使外国制药公司大幅降低药品价格.巴西的国有研究机构已经发明了一些让人印象深刻的药品,包括一种治疗疟疾的新药.难怪大型制药企业对这个市场怀有戒心.
> Indeed, they have been cautious about developing countries in general, which they have regarded as the source of many headaches and few profits. A decade ago Britain´s GlaxoSmithKline (GSK) got a bloody nose in South Africa when it tried too vigorously to defend patents on an HIV drug. More recently Novartis, a Swiss firm, lost a bitter battle in India over patent protection for Gleevec, a profitable cancer drug. In Thailand the government has invoked compulsory licensing for some drugs. And next week the industry can expect another drubbing over patents harming “innovation for the poor” at the World Health Organisation´s annual assembly.
> 事实上这些制药企业对发展中国家的市场一般都持一种谨慎的态度,它们一般认为从这些市场获得的利润很少但是却往往引起很多麻烦.10年之前,英国的葛兰素史克公司在南非遭受严重挫折,因为它过于强势的捍卫自己治疗爱滋病药物的专利权.最近诺华公司的高利润抗癌药物Gleevec在印度市场痛失专利保护.泰国政府也已经对一些药物引用强制许可条款.下周,世界卫生组织的年会将要召开,其”为穷人创新”的主题又将对制药企业的专利保护造成新的冲击.
> But consider the story of Moksha8, a new drugs firm launched last month with money from Texas Pacific Group, a private-equity outfit. It aims to capitalise on Big Pharma´s neglect of many emerging economies by striking licensing deals for branded drugs which it, in turn, intends to market to affluent customers in those countries. It already has some two dozen drugs under licence for Brazil from Roche and Pfizer. Fernando Reinach of Votorantim, a Brazilian firm that also invested in Moksha8, expects its annual sales to top $1 billion within a year or two.
> 但是我们应当关注一下Moksha8公司,这家新制药公司上月由私募资产投资公司Texas Pacific Group投资建立.它的目标是与品牌药企业达成销售许可协议从而开发那些被大型制药公司所忽略的新兴市场,向那些新兴市场的比较富裕的消费者推销药品.它已经与罗氏和辉瑞达成20多个品种在巴西销售的许可协议.一家叫Fernando Reinach of Votorantim的巴西公司也投资于Moksha8,希望它在一到两年内销售收入能够达到10亿美金.
> All of which suggests that the situation is ripe for change. For much of its history, the industry has focused chiefly on the diseases that afflict people in rich countries, while largely neglecting research into diseases of the poor. But as growth slows in developed markets, and the twin threats of generic drugs and price controls advance even in pharma-friendly America, drugs companies are thinking again.
> 所有这些都预示着变革的时机已经成熟,长久以来,制药行业一直关注于那些对富有国家人民影响较大的疾病,而对困扰贫穷国家的主要疾病的关注程度则远远不够.但是现在随着发达国家市场对药品需求的增长放缓以及仿制药公司和政府价格管制的双重冲击(即使是对制药行业最友好的美国也传出了价格管制的呼声),跨国制药企业开始重新定位.
> That is not simply because governments in developing countries are wielding the big stick of busting patents: their expanding middle classes also provide a tantalising carrot. McKinsey, a consultancy, estimates that the value of the Indian drugs market will grow from $6.3 billion in 2005 to $20 billion in 2015. China´s market is expected to soar even more spectacularly. Given such prospects for growth, says Mark Feinburg of Merck, an American drugs giant, “you´ve got to be in these markets—it´s a great opportunity.”
> 但是事情并不是那么简单的，因为一方面发展中国家的政府正在挥舞着破坏专利保护的大棒；另一方面它们迅速扩张的中产阶层却提供了跨国制药企业急需的胡萝卜。麦肯锡公司（一家世界知名咨询公司）预测印度制药市场的价值将从2005年的63亿美金增长到2015年的200亿美金。而中国市场被寄予的希望甚至更大一些。面对这样一种增长前景，美国制药巨人默克公司的Mark Feinburg说：“你已经进入了这些市场，它是个巨大的机会。”
> G.V. Prasad, vice-chairman of Dr Reddy´s, a successful Indian drugs firm that is evolving from copycat to innovator, is convinced that the thinking at Western firms is changing, and cites a recent reorganisation at GSK as evidence. Andrew Witty, who takes over as the firm´s chief executive on May 22nd, wants to combine all its little divisions that deal with developing countries into one emerging-markets group, to be run by Abbas Hussain, whom he has just poached from Eli Lilly, a rival American firm.
> Dr Reddy´s公司(一家正在成功的从仿制药向原创药迈进的印度制药公司)的副董事长G.V. Prasad相信西方制药企业的思路也在改变,并引用了最近葛兰素史克公司公司的重组作为证据.5月22日Andrew Witty接任该公司的CEO,他准备将那些与发展中国家做生意的小部门统一合并为一个新兴市场部,由刚从礼来公司挖来的Abbas Hussain负责.
> Serving these markets will mean building up local expertise and research efforts. Where drugs firms have set up shop in developing markets, it has generally been to cut costs, rather than to cater to the needs of locals. But that is changing. Novartis has opened a research centre in Shanghai and has another outpost in Singapore focused on tropical diseases. Merck has struck several deals with firms in emerging markets to do early-stage research. The drugs giants argue that this new approach allows them to tap a global network of innovation, and also provides insights into local markets.
> 要想服务于当地的市场就必须增加适合当地市场需求的研究开发与专业技术投入.在过去这些跨国制药企业在发展中国家销售产品一般只想到如何削减费用而不是去迎合当地市场的需要.但是现在情况有所改变.诺华已经在上海建立了一个研发中心并在新加坡建立了一个专门研究热带疾病的基地.默克公司也与几家新兴市场的公司签定的早期研发协议.制药巨人们认为这样做不但可以扩展它们在全世界的研发网络也会让它们对当地的市场更加了解.
>
> Paul Herrling of Novartis points out that virally induced cancers are rare in Europe but common in China. Terry Hisey of Deloitte, a consultancy, notes that Asians and Europeans can respond differently to anaesthesia. “We see China and India as research-and-development partners, and partnerships can help us learn how to do business there,” says Robert Court of GSK.
> 诺华公司的Paul Herrling指出病毒诱发性的癌症在欧洲很罕见但是在中国却很常见. 德勤公司(一家世界知名顾问公司)的Terry Hisey注意到亚洲人和欧洲人对麻醉的反应不太相同. 葛兰素史克公司的Robert先生说:“我们把中国和印度当作研发方面的伙伴，这些伙伴可以教会我们如何在当地做生意。”
> New thinking is also needed when deciding how to sell drugs in developing countries. In the past Western firms either ignored such countries or saw them as charity cases. But now, says Tachi Yamada of the Gates Foundation, who was at GSK when the firm faced the South African backlash over HIV drugs, “pharma companies can´t possibly survive without recognising their responsibilities to the poor.”
> 要在发展中国家销售药品就必须有新的思路。在过去西方制药企业对这些国家或者重视不够或者把它们当作施舍的对象。但是现在，正如曾经在葛兰素史克公司的抗爱滋病药物在南非市场遭受专利危机时供职于该公司后来到盖茨基金会工作的Tachi Yamada所说：“制药企业必须认识到它们对穷人所应承担的责任才有可能存活下来。”
> Some firms have adopted “differential pricing” schemes that use formulas, based on average income per head, to set lower prices in poor countries. Merck, for example, recently launched Januvia, a blockbuster diabetes drug, in India for a fraction of the price it charges in America. But in future, says Prashant Yadav of the Massachusetts Institute of Technology, firms must “price differentially not between OECD and developing-country markets, but within each developing-country market.” In other words, middle-class Indian patients will pay more than the rural poor.
> 一些公司已经在采用依据人均收入区别定价的方法向贫穷国家提供价格较低的药品。例如默克公司在印度销售的治疗糖尿病药物的重磅炸弹药物Januvia的价格只有在美国销售价格的零头而已。麻省理工学院的Prashant Yadav说：将来药品价格的差异不仅应当体现在OECD国家与发展中国家之间而且应当体现在发展中国家内部。换句话说，印度的中产阶级病人应当比乡村里的穷人花更多的钱。
> Both Novartis and GSK say they are thinking along these lines. But is there not a danger that cheap drugs intended for the poorest will be pilfered and sold at a profit to the urban middle classes, or shipped overseas to rich countries? This has been the standard argument against differential pricing from the drugs companies.
> 诺华和史克公司都表示它们也在考虑差别定价的问题。但是那样做是否会造成一种危险即：准备卖给某些穷人的廉价药品被转卖给城市里的中产阶级甚至转卖到富裕的国家以谋取更高的利润。这也成为一些公司反对差别定价的理由。
> Once again attitudes are shifting. Some diversion will happen, but firms that have tried tiered pricing have found ways to reduce it. Just changing the colour of a pill can help. So too can after-market checks on distributors and pharmacists by drugs companies: those selling looted products may be cut off from future distribution. Nan Wang of Sinovac Biotech, a Chinese vaccine firm, says her company has long sold the same vaccine at lower prices in poor parts of China than in rich cities; the two versions have different packaging.
> 但是这种观点实际上似是而非的。一些转移可能会发生，是是已经有一些采取差别定价的公司找到了减少这种现象的有效办法。例如改变药片的颜色就可以了。也可以加强对市场上分销商和药店的检查，将那些敢于窜货的销售商从销售体系中踢出去。一位在中国一家疫苗公司工作的女士说她的公司销往中国贫困地区的疫苗一直比富裕地区的价格低，因为两个地区采用了不同的包装形式。
> But not everyone is convinced. “In the absence of competition, differential pricing is a hoax,” scoffs Yusuf Hamied, chairman of Cipla, an Indian generics firm. In his view, only generics-makers like his firm provide genuine competition to Big Pharma, which he insists should have no patent rights in poor countries. Even if the drugs giants really have changed their approach to the developing world, the arguments over their rights and responsibilities will continue to rage.
> 但是并不是所有人都相信这种办法。Cipla公司（一家印度仿制药公司）的董事长Yusuf Hamied说：“在缺乏竞争的情况下，差别定价只是一场骗局。”在他看来像他们公司这样的仿制药公司与大公司之间的竞争才是降低价格的最好办法，他也坚持贫困国家没必要保护药品的专利权。看来即使这些大型制药公司真的改变了他们在发展中国家的策略，关于他们的权利与义务的争论依然会继续下去