????是的，我們采取了一種不同的方法。大約10年前開始，我們就啟動了一種所謂的“途徑”法。我們知道，通常對于一種罕見的疾病來說，如果有了一個癥狀非常相似的患者群，我們就能了解這種特定疾病的分子途徑。

????但是這個患者群可能很小。

????雖然很小，但是一個非常同質的患者群可以讓我們研究這種疾病以及導致該疾病的分子途徑。然后我們會研發能阻斷這種途徑的藥物，再有條理地擴展到受相同分子途徑影響的其它疾病領域。所以所謂“重磅藥品”的定義將會有所變化，一個藥品不再只對應一個疾病領域，而是可能能夠用于治療三種、四種甚至五種疾病。

????舉個例子？

????比如我們的癌癥藥物依維莫斯（Afinitor）。它是一種雷帕霉素靶蛋白（mTOR，人類細胞中的一種蛋白質）抑制劑，mTOR的分子途徑與多種疾病有關。我們一開始研發依維莫斯是為了治療腎細胞癌，然后我們開始在許多其它癌癥上測試依維莫斯的效果。我們最近剛剛證實，乳腺癌 也與mTOR的分子途徑有關，而這將對每年22萬名晚期乳腺癌患者提供幫助。這就是一個例子，最初用于治療腎細胞癌的藥物，最終也能治療乳腺癌。綜合效應使它成為了一個重磅藥物。

????研發是諾華的一項巨大投資，你們的競爭對手也是一樣。你們如何從投資的每一美元中獲得更好的研發效果？

????問得好。人人都想提高研發效果，我們發現了幾點：首先必須找到對的科學家。所以我們給科學家們建立了研究中心。我們沒有要求他們集中在一個特定的地點，我們在美國、西歐都建立了研究中心，而且我們正在上海建立另一個研究中心。人才在哪里，我們就去哪里。這是第一點。

????第二點是要保持在研發上的強大投入。在諾華公司，我們承諾把大約20%的銷售額投入到研發上。對于我們的藥品業務規模來說，就是每年投入90多億美元。所以我們有了對的人才，和對的投資數額，我們認為這是讓我們成功的第一部分。

????然后你還要有正確的研究方法，從不同的角度來思考，到底應該如何進行藥物開發，我認為那就是途徑法。

????對你來說，在美國和西歐以外，增長潛力最大的地區是哪里？

????我們在中國的業務規模非常龐大，而且增長很快。中國市場剛剛成為我們的全球十大市場之一。去年我們的中國市場增長了24%。而且中國政府前不久表示，將提高城鄉地區的醫療支出，所以我們認為中國將是一個持續增長的地區。另一個地區是俄羅斯。俄羅斯有一個問題，就是它的人口數量在下降。俄羅斯政府表示將提高醫療水平，扭轉人口規模下降趨勢。另外還有很多發展中國家，我們認為都是增長中的市場，也都進行了大量投資。

????你們在那些市場中的業務模式是否很不一樣？因為那兒的大多數民眾都得自己掏錢治病。

????Yes, we took a different approach. Starting about 10 years ago, we started what's called the pathways approach, where we understand the molecular pathway of a particular disease, usually in a rare disease where you have a very homogeneous patient population.

????But maybe a very small population.

????A small population, but a very homogeneous patient population that allows us to study the disease and the molecular pathway that leads to that disease. We then develop a drug that can interrupt that pathway, and then we look to mechanistically expand into other disease areas that are impacted by the same pathway. So essentially it doesn't mean that blockbusters will go away, but the definition of a blockbuster will change pretty dramatically away from having one disease area to a drug that maybe is active in three or four or even five diseases.

????What's an example?

????An example is our oncology drug called Afinitor, which is an mTOR [a type of protein in human cells] inhibitor. The mTOR pathway is implicated in many different types of diseases. So we initially developed Afinitor in renal cell cancer, and then we started testing Afinitor in many other cancers. Breast cancer is another indication that we just received approval for, and that's now going to help more than 220,000 patients every year who have advanced breast cancer. So here's an example of a drug that started in renal cell cancer, has expanded into breast cancer, and then there are a number of other indications. That together will make it a blockbuster.

????R&D is a huge investment for Novartis, as it is for your competitors. How do you get more than the other guys from a dollar of R&D?

????A good question -- everybody's trying to increase productivity in research and development. We've found a couple of things. First you have to find the right scientists. So we have built research centers where the scientists are. We have not asked them to come to a particular location. We've built research centers in the U.S., in Europe, and we're building one in Shanghai. So we're going where the talent is. That's No. 1.

????The second is keeping spending strong in research and development. At Novartis we've made the commitment to spend about 20% of sales on research and development. In our pharma business, that's over $9 billion a year that we invest. So if you have the right talent and the right amount of spending, we find that that's the first part of success.

????Then you have to have the right approach, and I think that's the pathways approach, taking a different look at how we're going to discover and develop drugs.

????Where are the geographic areas of growth for you outside the U.S. and Western Europe?

????We have a very large and growing business in China, which has just become one of our top 10 markets. Last year it grew 24%. The Chinese government has made a massive commitment to improving health care among rural and urban Chinese, and so we see that as a continued growth area. Another area is Russia. Russia has a problem. It has a declining population. And the government in Russia has made the commitment to improve access to health care in ways that will reverse that population decline. There are many developing countries in which we're investing quite heavily as growth areas.

????In markets like that, isn't it a very different business? Those people are paying for their own medical care for the most part.