Express Scripts and Medco

　　美國快捷藥方公司與美可保健

　　Bigger means cheaper

　　越大越便宜

　　A new drugs manager may change the way Americans pop their pills

　　全新的藥物管理者可能改變美國人購買藥品的方式

　　IT TOOK eight months and more than 200 interviews.

　　花了八個多月的時間，會面達到200多次。

　　But on April 2nd America s Federal Trade Commission decided, in a three-to-one vote,to let Express Scripts acquire Medco.

　　但是4月2日，美國聯邦貿易委員會以三比一的投票決定同意美國快捷藥方公司收購美可保健。

　　The two firms are America s second-biggest and biggest pharmacy-benefit managers.

　　兩家公司合并后將成為美國第二大藥品公司以及最大的藥品福利管理者。

　　Eventually, they may change the way Americans take drugs.

　　這兩家公司的合并可能最終改變美國人購買藥物的方式。

　　Despite an intolerably dull title, pharmacy-benefit managers are important.

　　盡管標題無聊的令人無法忍受，但是藥品福利管理者十分重要。

　　America is the world s biggest drug market; in 2010 it spent more than $307 billion onprescription medicines.

　　美國是世界上最大的藥品市場;2010年美國在處方藥上的花費達到3070億美元。

　　PBMs are the middlemen that manage drug costs for employers and insurers. Together,Express Scripts and Medco will control more than 40% of the market.

　　藥品福利管理是是平衡雇主和保險公司之間醫藥費用的中間人，快捷藥方公司與美可保健一起將能控制40%以上的藥品市場份額。

　　Express Scripts announced the acquisition in July 2011. Medco was a good company thathad had a bad year, and so looked cheap.

　　快捷藥方公司曾宣布在2011年7月完成收購工作，美可保健去年情況不佳，看起來有點貶值，但美可保健是一個業績不錯的公司。

　　It had lost about 30% of its business in a few months as some of its largest clients ended theircontracts.

　　由于一些大客戶終止了合同，美可保健幾個月內就損失了30%的生意。

　　For both firms, bigger ought to mean better.

　　對兩家公司來說，擴大經營必須意味著良好的收益。

　　With scale would come the power to negotiate fatter discounts on drugs, lowering costs foremployers and insurers.

　　大規模將在藥品折扣問題的商討上占有更大的優勢，并降低雇傭者和保險公司的成本。

　　Pharmacists felt sick when they heard the news.

　　聽說了這個消息之后藥劑師感覺并不好。

　　PBMs encourage consumers to fill their prescriptions through the mail instead of going to acostly pharmacy.

　　藥品福利管理者鼓勵消費者通過郵件方式而不是通過花費過高的藥品公司購買藥物。

　　PBMs, pharmacists fret, will crush their fees for dispensing drugs.

　　藥品福利管理者讓藥劑師們很頭痛，藥品福利管理者會把削減開處方藥的費用。

　　Worse, PBMs will demand that drugmakers give them exclusive deals for new, complexmedicines.

　　更糟糕的是，藥品福利管理者要求藥品制造上對于新藥和合成藥給與特別的折扣。

　　Competitors and consumers will suffer, the pharmacists argue.

　　藥劑師認為競爭者和消費者都會遭受損失。

　　The FTC disagreed.

　　聯邦貿易委員會并不這么認為。

　　The merged firm is unlikely to squeeze pharmacies fees for dispensing drugs, it ruled.

　　合并后的公司不可能壓榨藥劑師配置藥物的費用，只是對此收費進行規范。

　　There remain plenty of lively, smaller PBMs.

　　市場中還有很多小規模活躍的藥品福利管理者。

　　John Kreger of William Blair, an investment bank, says there is enough turmoilthanks bothto the merger and to Express Scripts continuing fight with Walgreens, a big pharmacythatsmaller PBMs may snatch new business in the next year.

　　投資銀行William Blair的John Kreger說已經夠亂了多虧兩家公司的合并，還有快捷藥方公司與大型的醫藥公司Walgreens不斷的競爭小規模的藥品福利管理者明年會搶走新業務。

　　The small fry may also benefit if the pharmacy lobby s lawsuit against the merger movesforward.

　　如果反對合并進程的藥品游說訴訟能夠成功的話，小公司也能從中獲益。

　　The combined firm will have $91 billion in revenue in 2023, estimates Lawrence Marsh, ananalyst at Barclays Capital.

　　據巴萊克集團的分析師Lawrence Marsh預測，合并后的公司在2023年的收益能夠達到910億美元。

　　It is so big that it could shape a new era for America s drug market.

　　收益如此巨大以至于可以塑造美國藥品市場的新紀元。

　　As more drugs lose their patents, consumers will increasingly fill their prescriptions withgenerics.

　　由于越來越多的藥品不再擁有專利權，越來越多的消費者都會使用非專利藥物開具處方。

　　If Express Scripts has its way, they will also fill their prescriptions by post.

　　如果快捷藥品公司也采用此方法，那么他們也會采取郵寄方式開藥方。

　　Medco recently acquired a firm that compares the efficacy of different drugs.

　　美可保健最近收購了一家比較藥品不同功效的公司。

　　This may prove useful when America begins to see cheap copies of complex drugs, calledbiosimilars, which will be tested against the originals.

　　美國開始看到合成藥劑的復制品，即生物仿制藥，價格低廉，能用來與源藥品做對比試驗。此時上述收購還是極為有益的。

　　The new Express Scripts may also play a role on Barack Obama s new insurance exchanges,working with insurers to court individuals shopping for health care.

　　新的快捷藥方公司同樣在奧巴馬提出的新型保險交易中扮演了重要角色，他和保險代理人一起勸說個人購買健康保險。

　　Most intriguingly, the new Express Scripts could push Americans to buy the right medicinesand take them at the right time.

　　最有趣的是新的快捷藥方公司可以推動美國人在正確的時間購買正確的藥物。

　　For years PBMs have tested ways to urge consumers to buy cheaper, effective drugs.

　　幾年來，藥品福利管理者嘗試新的方法以促使消費者購買便宜而有效的藥物，

　　For example, if a patient wants a branded pill rather than a generic, he must pay for more ofit himself.

　　例如如果病人想購買品牌藥物而非一般藥物，他要為多出的費用自己掏腰包。

　　Experiments will probably scale up and become more sophisticated.

　　這樣的試驗將逐步擴大規模，也會越來越復雜。

　　Eventually, they might even spread to Medicaid, the public programme for the poor.

　　最終將波及醫療補助計劃，該計劃是救助窮人的公共計劃。

　　Health reform will add 16m new members toMedicaid by 2023, a 27% jump.

　　到2023年，健康改革將增加160萬名新的受益者，約增長了27%。

　　PBMs such as Medco and Express Scripts have so far spent little time chasing the Medicaidmarket.

　　像美可保健和快捷藥方公司這樣的藥品福利管理者迄今為止在醫療補助計劃投入的時間還不多。

　　That may change.

　　這種情況可能會有所改變。

　　Express Scripts and Medco

　　美國快捷藥方公司與美可保健

　　Bigger means cheaper

　　越大越便宜

　　A new drugs manager may change the way Americans pop their pills

　　全新的藥物管理者可能改變美國人購買藥品的方式

　　IT TOOK eight months and more than 200 interviews.

　　花了八個多月的時間，會面達到200多次。

　　But on April 2nd America s Federal Trade Commission decided, in a three-to-one vote,to let Express Scripts acquire Medco.

　　但是4月2日，美國聯邦貿易委員會以三比一的投票決定同意美國快捷藥方公司收購美可保健。

　　The two firms are America s second-biggest and biggest pharmacy-benefit managers.

　　兩家公司合并后將成為美國第二大藥品公司以及最大的藥品福利管理者。

　　Eventually, they may change the way Americans take drugs.

　　這兩家公司的合并可能最終改變美國人購買藥物的方式。

　　Despite an intolerably dull title, pharmacy-benefit managers are important.

　　盡管標題無聊的令人無法忍受，但是藥品福利管理者十分重要。

　　America is the world s biggest drug market; in 2010 it spent more than $307 billion onprescription medicines.

　　美國是世界上最大的藥品市場;2010年美國在處方藥上的花費達到3070億美元。

　　PBMs are the middlemen that manage drug costs for employers and insurers. Together,Express Scripts and Medco will control more than 40% of the market.

　　藥品福利管理是是平衡雇主和保險公司之間醫藥費用的中間人，快捷藥方公司與美可保健一起將能控制40%以上的藥品市場份額。

　　Express Scripts announced the acquisition in July 2011. Medco was a good company thathad had a bad year, and so looked cheap.

　　快捷藥方公司曾宣布在2011年7月完成收購工作，美可保健去年情況不佳，看起來有點貶值，但美可保健是一個業績不錯的公司。

　　It had lost about 30% of its business in a few months as some of its largest clients ended theircontracts.

　　由于一些大客戶終止了合同，美可保健幾個月內就損失了30%的生意。

　　For both firms, bigger ought to mean better.

　　對兩家公司來說，擴大經營必須意味著良好的收益。

　　With scale would come the power to negotiate fatter discounts on drugs, lowering costs foremployers and insurers.

　　大規模將在藥品折扣問題的商討上占有更大的優勢，并降低雇傭者和保險公司的成本。

　　Pharmacists felt sick when they heard the news.

　　聽說了這個消息之后藥劑師感覺并不好。

　　PBMs encourage consumers to fill their prescriptions through the mail instead of going to acostly pharmacy.

　　藥品福利管理者鼓勵消費者通過郵件方式而不是通過花費過高的藥品公司購買藥物。

　　PBMs, pharmacists fret, will crush their fees for dispensing drugs.

　　藥品福利管理者讓藥劑師們很頭痛，藥品福利管理者會把削減開處方藥的費用。

　　Worse, PBMs will demand that drugmakers give them exclusive deals for new, complexmedicines.

　　更糟糕的是，藥品福利管理者要求藥品制造上對于新藥和合成藥給與特別的折扣。

　　Competitors and consumers will suffer, the pharmacists argue.

　　藥劑師認為競爭者和消費者都會遭受損失。

　　The FTC disagreed.

　　聯邦貿易委員會并不這么認為。

　　The merged firm is unlikely to squeeze pharmacies fees for dispensing drugs, it ruled.

　　合并后的公司不可能壓榨藥劑師配置藥物的費用，只是對此收費進行規范。

　　There remain plenty of lively, smaller PBMs.

　　市場中還有很多小規模活躍的藥品福利管理者。

　　John Kreger of William Blair, an investment bank, says there is enough turmoilthanks bothto the merger and to Express Scripts continuing fight with Walgreens, a big pharmacythatsmaller PBMs may snatch new business in the next year.

　　投資銀行William Blair的John Kreger說已經夠亂了多虧兩家公司的合并，還有快捷藥方公司與大型的醫藥公司Walgreens不斷的競爭小規模的藥品福利管理者明年會搶走新業務。

　　The small fry may also benefit if the pharmacy lobby s lawsuit against the merger movesforward.

　　如果反對合并進程的藥品游說訴訟能夠成功的話，小公司也能從中獲益。

　　The combined firm will have $91 billion in revenue in 2023, estimates Lawrence Marsh, ananalyst at Barclays Capital.

　　據巴萊克集團的分析師Lawrence Marsh預測，合并后的公司在2023年的收益能夠達到910億美元。

　　It is so big that it could shape a new era for America s drug market.

　　收益如此巨大以至于可以塑造美國藥品市場的新紀元。

　　As more drugs lose their patents, consumers will increasingly fill their prescriptions withgenerics.

　　由于越來越多的藥品不再擁有專利權，越來越多的消費者都會使用非專利藥物開具處方。

　　If Express Scripts has its way, they will also fill their prescriptions by post.

　　如果快捷藥品公司也采用此方法，那么他們也會采取郵寄方式開藥方。

　　Medco recently acquired a firm that compares the efficacy of different drugs.

　　美可保健最近收購了一家比較藥品不同功效的公司。

　　This may prove useful when America begins to see cheap copies of complex drugs, calledbiosimilars, which will be tested against the originals.

　　美國開始看到合成藥劑的復制品，即生物仿制藥，價格低廉，能用來與源藥品做對比試驗。此時上述收購還是極為有益的。

　　The new Express Scripts may also play a role on Barack Obama s new insurance exchanges,working with insurers to court individuals shopping for health care.

　　新的快捷藥方公司同樣在奧巴馬提出的新型保險交易中扮演了重要角色，他和保險代理人一起勸說個人購買健康保險。

　　Most intriguingly, the new Express Scripts could push Americans to buy the right medicinesand take them at the right time.

　　最有趣的是新的快捷藥方公司可以推動美國人在正確的時間購買正確的藥物。

　　For years PBMs have tested ways to urge consumers to buy cheaper, effective drugs.

　　幾年來，藥品福利管理者嘗試新的方法以促使消費者購買便宜而有效的藥物，

　　For example, if a patient wants a branded pill rather than a generic, he must pay for more ofit himself.

　　例如如果病人想購買品牌藥物而非一般藥物，他要為多出的費用自己掏腰包。

　　Experiments will probably scale up and become more sophisticated.

　　這樣的試驗將逐步擴大規模，也會越來越復雜。

　　Eventually, they might even spread to Medicaid, the public programme for the poor.

　　最終將波及醫療補助計劃，該計劃是救助窮人的公共計劃。

　　Health reform will add 16m new members toMedicaid by 2023, a 27% jump.

　　到2023年，健康改革將增加160萬名新的受益者，約增長了27%。

　　PBMs such as Medco and Express Scripts have so far spent little time chasing the Medicaidmarket.

　　像美可保健和快捷藥方公司這樣的藥品福利管理者迄今為止在醫療補助計劃投入的時間還不多。

　　That may change.

　　這種情況可能會有所改變。