一項(xiàng)研究顯示,司美格魯肽注射液諾和泰(Ozempic)月服用量的成本價(jià)為5美元,而制造商諾和諾德在美國(guó)的售價(jià)接近每月1000美元。這項(xiàng)研究再次引發(fā)了人們對(duì)糖尿病和肥胖癥暢銷藥物價(jià)格的質(zhì)疑。
耶魯大學(xué)(Yale University)、倫敦國(guó)王學(xué)院醫(yī)院(King’s College Hospital)和非營(yíng)利組織無(wú)國(guó)界醫(yī)生組織(Doctors Without Borders)的研究人員在《美國(guó)醫(yī)學(xué)會(huì)雜志網(wǎng)絡(luò)開(kāi)放》(JAMA Network Open)上報(bào)告稱,這種暢銷藥物月服用量的成本價(jià)為89美分至4.73美元,其中包括利潤(rùn)率。相比之下,每周注射一次的司美格魯肽注射液在美國(guó)的月服用量的標(biāo)價(jià)為968.52美元。
諾和諾德拒絕提供司美格魯肽注射液諾和泰和威哥維(Wegovy)的生產(chǎn)成本,后者也是諾和諾德生產(chǎn)的治療肥胖癥的相關(guān)藥物。該公司表示,其正在進(jìn)行重大投資,以確保公眾能夠獲得其廣受歡迎的藥物。在通過(guò)電子郵件回答問(wèn)題時(shí),該公司表示,其資本支出約為60億美元,并斥資110億美元從康泰倫特(Catalent Inc.)收購(gòu)生產(chǎn)設(shè)施。
參議員伯尼·桑德斯(Bernie Sanders)(曾就美國(guó)藥品價(jià)格居高不下的問(wèn)題舉行聽(tīng)證會(huì))在調(diào)查結(jié)果公布后發(fā)表聲明說(shuō):“這一高得離譜的價(jià)格有可能使醫(yī)療保險(xiǎn)、美國(guó)人民和我們整個(gè)醫(yī)療體系破產(chǎn)。”這位佛蒙特州的獨(dú)立參議員呼吁諾和諾德將諾和泰的月服用量標(biāo)價(jià)降至155美元或更低,與該公司在其他國(guó)家的標(biāo)價(jià)保持一致。
這項(xiàng)研究擴(kuò)大了研究范圍,表明美國(guó)對(duì)司美格魯肽注射液諾和泰和威哥維等GLP-1藥物的加價(jià)幅度非常大,并強(qiáng)調(diào)了長(zhǎng)期以來(lái)對(duì)糖尿病治療藥物(尤其是胰島素)價(jià)格的批評(píng)意見(jiàn)。研究發(fā)現(xiàn),司美格魯肽注射液諾和泰月服用量的成本價(jià)通常低于各種形式的胰島素,而胰島素是用于治療糖尿病的救命藥,已上市數(shù)十年。
該研究的通訊作者、耶魯大學(xué)公共衛(wèi)生經(jīng)濟(jì)學(xué)家梅麗莎·巴伯(Melissa Barber)說(shuō):“諾和泰等藥物的利潤(rùn)空間巨大,應(yīng)該從政策角度討論合理的價(jià)格水平。”
諾和諾德公司的司美格魯肽注射液諾和泰和威哥維在2023年的總銷售額超過(guò)180億美元。根據(jù)彭博法律(Bloomberg Law)的估計(jì),與這兩種藥物相關(guān)的專利可能將于2033年6月到期。諾和諾德的股價(jià)在哥本哈根下跌了0.8%,今年已經(jīng)上漲了26%。
透明度目標(biāo)
藥品生產(chǎn)成本往往不為人知,就算成本與價(jià)格有關(guān),也很難弄清楚其與價(jià)格之間的關(guān)系。巴伯和她的同事使用了最新的原料成本估算值,并重點(diǎn)研究了包括司美格魯肽注射液諾和泰 等GLP-1藥物在內(nèi)的糖尿病藥物以及其他糖尿病藥物和胰島素的生產(chǎn)成本。
巴伯說(shuō):“這項(xiàng)研究的目標(biāo)是要企業(yè)公布收入,并盡可能做到透明。”
去年,在拜登政府的壓力下,諾和諾德以及其他制藥商將某些形式的胰島素在美國(guó)的出售價(jià)格下調(diào)了75%。然而,據(jù)估計(jì),降價(jià)使這些產(chǎn)品的利潤(rùn)更高,因?yàn)樗鼈內(nèi)∠酥Ц督o藥房福利經(jīng)理的回扣,而藥房福利經(jīng)理是為納稅人和雇主談判價(jià)格的中間人。
諾和諾德在一封電子郵件中表示,其總收入的75%用于支付回扣和折扣,以確保患者能夠獲得司美格魯肽等產(chǎn)品(司美格魯肽是威哥維和諾和泰的活性成分)。制藥商通常會(huì)將持續(xù)數(shù)年的高額研究費(fèi)用作為定價(jià)的原因。諾和諾德表示,去年在藥物研發(fā)方面的支出接近50億美元,今年還將增加。
盡管如此,關(guān)于諾和泰和威哥維等藥物成本的爭(zhēng)論仍在升溫。州醫(yī)療計(jì)劃和醫(yī)療補(bǔ)助辦公室發(fā)現(xiàn)諾和泰及其姊妹藥威哥維的賬單越來(lái)越多,這引發(fā)了人們對(duì)成本增長(zhǎng)是否可持續(xù)的質(zhì)疑。今年1月,北卡羅來(lái)納州取消了政府雇員的抗肥胖藥物醫(yī)保覆蓋,理由是成本飆升,而且制藥商未就定價(jià)達(dá)成一致。
令人驚訝的是,該研究發(fā)現(xiàn),生產(chǎn)諾和泰的最大成本不是被稱為司美格魯肽的活性藥物,而是用于注射的一次性注射筆。根據(jù)對(duì)注射器制造商前雇員和顧問(wèn)的采訪,作者得出結(jié)論,月服用量相關(guān)的一次性注射筆的成本價(jià)不超過(guò)2.83美元。每周使用一支諾和泰注射筆,可持續(xù)使用一個(gè)月。
其他成本
研究發(fā)現(xiàn),相比之下,諾和泰中的活性藥物月服用量的成本價(jià)約為29美分,一周普通劑量的成本價(jià)為7.2美分。它的生產(chǎn)成本并不低,每公斤司美格魯肽的成本超過(guò)7萬(wàn)美元。但每周一劑的用藥量中司美格魯肽成分極少。
其他成本包括每支筆的灌裝成本(估計(jì)每月為20美分)和其他化學(xué)成分成本(研究估計(jì)每月為15美分)。
這項(xiàng)分析并不包括威哥維的生產(chǎn)成本估算。利物浦大學(xué)和其他機(jī)構(gòu)去年進(jìn)行的另一項(xiàng)研究發(fā)現(xiàn),威哥維月服用量的成本價(jià)為40美元。(財(cái)富中文網(wǎng))
譯者:中慧言-王芳
一項(xiàng)研究顯示,司美格魯肽注射液諾和泰(Ozempic)月服用量的成本價(jià)為5美元,而制造商諾和諾德在美國(guó)的售價(jià)接近每月1000美元。這項(xiàng)研究再次引發(fā)了人們對(duì)糖尿病和肥胖癥暢銷藥物價(jià)格的質(zhì)疑。
耶魯大學(xué)(Yale University)、倫敦國(guó)王學(xué)院醫(yī)院(King’s College Hospital)和非營(yíng)利組織無(wú)國(guó)界醫(yī)生組織(Doctors Without Borders)的研究人員在《美國(guó)醫(yī)學(xué)會(huì)雜志網(wǎng)絡(luò)開(kāi)放》(JAMA Network Open)上報(bào)告稱,這種暢銷藥物月服用量的成本價(jià)為89美分至4.73美元,其中包括利潤(rùn)率。相比之下,每周注射一次的司美格魯肽注射液在美國(guó)的月服用量的標(biāo)價(jià)為968.52美元。
諾和諾德拒絕提供司美格魯肽注射液諾和泰和威哥維(Wegovy)的生產(chǎn)成本,后者也是諾和諾德生產(chǎn)的治療肥胖癥的相關(guān)藥物。該公司表示,其正在進(jìn)行重大投資,以確保公眾能夠獲得其廣受歡迎的藥物。在通過(guò)電子郵件回答問(wèn)題時(shí),該公司表示,其資本支出約為60億美元,并斥資110億美元從康泰倫特(Catalent Inc.)收購(gòu)生產(chǎn)設(shè)施。
參議員伯尼·桑德斯(Bernie Sanders)(曾就美國(guó)藥品價(jià)格居高不下的問(wèn)題舉行聽(tīng)證會(huì))在調(diào)查結(jié)果公布后發(fā)表聲明說(shuō):“這一高得離譜的價(jià)格有可能使醫(yī)療保險(xiǎn)、美國(guó)人民和我們整個(gè)醫(yī)療體系破產(chǎn)。”這位佛蒙特州的獨(dú)立參議員呼吁諾和諾德將諾和泰的月服用量標(biāo)價(jià)降至155美元或更低,與該公司在其他國(guó)家的標(biāo)價(jià)保持一致。
這項(xiàng)研究擴(kuò)大了研究范圍,表明美國(guó)對(duì)司美格魯肽注射液諾和泰和威哥維等GLP-1藥物的加價(jià)幅度非常大,并強(qiáng)調(diào)了長(zhǎng)期以來(lái)對(duì)糖尿病治療藥物(尤其是胰島素)價(jià)格的批評(píng)意見(jiàn)。研究發(fā)現(xiàn),司美格魯肽注射液諾和泰月服用量的成本價(jià)通常低于各種形式的胰島素,而胰島素是用于治療糖尿病的救命藥,已上市數(shù)十年。
該研究的通訊作者、耶魯大學(xué)公共衛(wèi)生經(jīng)濟(jì)學(xué)家梅麗莎·巴伯(Melissa Barber)說(shuō):“諾和泰等藥物的利潤(rùn)空間巨大,應(yīng)該從政策角度討論合理的價(jià)格水平。”
諾和諾德公司的司美格魯肽注射液諾和泰和威哥維在2023年的總銷售額超過(guò)180億美元。根據(jù)彭博法律(Bloomberg Law)的估計(jì),與這兩種藥物相關(guān)的專利可能將于2033年6月到期。諾和諾德的股價(jià)在哥本哈根下跌了0.8%,今年已經(jīng)上漲了26%。
透明度目標(biāo)
藥品生產(chǎn)成本往往不為人知,就算成本與價(jià)格有關(guān),也很難弄清楚其與價(jià)格之間的關(guān)系。巴伯和她的同事使用了最新的原料成本估算值,并重點(diǎn)研究了包括司美格魯肽注射液諾和泰 等GLP-1藥物在內(nèi)的糖尿病藥物以及其他糖尿病藥物和胰島素的生產(chǎn)成本。
巴伯說(shuō):“這項(xiàng)研究的目標(biāo)是要企業(yè)公布收入,并盡可能做到透明。”
去年,在拜登政府的壓力下,諾和諾德以及其他制藥商將某些形式的胰島素在美國(guó)的出售價(jià)格下調(diào)了75%。然而,據(jù)估計(jì),降價(jià)使這些產(chǎn)品的利潤(rùn)更高,因?yàn)樗鼈內(nèi)∠酥Ц督o藥房福利經(jīng)理的回扣,而藥房福利經(jīng)理是為納稅人和雇主談判價(jià)格的中間人。
諾和諾德在一封電子郵件中表示,其總收入的75%用于支付回扣和折扣,以確保患者能夠獲得司美格魯肽等產(chǎn)品(司美格魯肽是威哥維和諾和泰的活性成分)。制藥商通常會(huì)將持續(xù)數(shù)年的高額研究費(fèi)用作為定價(jià)的原因。諾和諾德表示,去年在藥物研發(fā)方面的支出接近50億美元,今年還將增加。
盡管如此,關(guān)于諾和泰和威哥維等藥物成本的爭(zhēng)論仍在升溫。州醫(yī)療計(jì)劃和醫(yī)療補(bǔ)助辦公室發(fā)現(xiàn)諾和泰及其姊妹藥威哥維的賬單越來(lái)越多,這引發(fā)了人們對(duì)成本增長(zhǎng)是否可持續(xù)的質(zhì)疑。今年1月,北卡羅來(lái)納州取消了政府雇員的抗肥胖藥物醫(yī)保覆蓋,理由是成本飆升,而且制藥商未就定價(jià)達(dá)成一致。
令人驚訝的是,該研究發(fā)現(xiàn),生產(chǎn)諾和泰的最大成本不是被稱為司美格魯肽的活性藥物,而是用于注射的一次性注射筆。根據(jù)對(duì)注射器制造商前雇員和顧問(wèn)的采訪,作者得出結(jié)論,月服用量相關(guān)的一次性注射筆的成本價(jià)不超過(guò)2.83美元。每周使用一支諾和泰注射筆,可持續(xù)使用一個(gè)月。
其他成本
研究發(fā)現(xiàn),相比之下,諾和泰中的活性藥物月服用量的成本價(jià)約為29美分,一周普通劑量的成本價(jià)為7.2美分。它的生產(chǎn)成本并不低,每公斤司美格魯肽的成本超過(guò)7萬(wàn)美元。但每周一劑的用藥量中司美格魯肽成分極少。
其他成本包括每支筆的灌裝成本(估計(jì)每月為20美分)和其他化學(xué)成分成本(研究估計(jì)每月為15美分)。
這項(xiàng)分析并不包括威哥維的生產(chǎn)成本估算。利物浦大學(xué)和其他機(jī)構(gòu)去年進(jìn)行的另一項(xiàng)研究發(fā)現(xiàn),威哥維月服用量的成本價(jià)為40美元。(財(cái)富中文網(wǎng))
譯者:中慧言-王芳
Ozempic could be profitably produced for less than $5 a month even as maker Novo Nordisk A/S charges almost $1,000 in the US, according to a study that revives questions about prices for top-selling treatments for diabetes and obesity.
The blockbuster drug could be manufactured for 89 cents to $4.73 for a month’s supply, figures that include a profit margin, researchers at Yale University, King’s College Hospital in London and the nonprofit Doctors Without Borders reported in the journal JAMA Network Open. That compares to the monthly US list price of $968.52 for Ozempic, a weekly injection.
Novo declined to provide production costs for Ozempic and Wegovy, its related drug for obesity. The company said it’s making significant investments to ensure that the public has access to its widely popular drugs. It’s making about $6 billion in capital expenditures and spending $11 billion to acquire production facilities from Catalent Inc. as part of those efforts, according to an emailed response to questions.
“This outrageously high price has the potential to bankrupt Medicare, the American people and our entire health care system,” Senator Bernie Sanders, who has held hearings about high US drug prices, said in a statement after the findings came out. The Vermont independent called on Novo Nordisk to lower the list price of Ozempic to $155 a month or less, in line with what it charges in other countries.
The study extends research showing how steep US markups are for GLP-1 drugs like Ozempic and Wegovy and underlines longstanding criticism of prices for diabetes therapies, especially insulin. On a per-month basis, Ozempic generally can be produced for less than various forms of insulin, a lifesaving diabetes drug that’s been available for decades, the study found.
“The profit margin is immense,” on drugs like Ozempic, said Melissa Barber, a public health economist at Yale and the study’s corresponding author. “There should be a conversation in policy about what is a fair price.”
Novo’s combined 2023 sales of Ozempic and Wegovy topped $18 billion. Patents linked to the drugs are likely to expire in June 2033, according to estimates from Bloomberg Law. Novo shares fell 0.8% in Copenhagen, and have gained 26% this year.
Transparency Goal
Drug production costs are often shrouded in secrecy with little clarity on how they relate to prices, if at all. Barber and her colleagues used updated estimates for raw ingredient costs and focused on the costs of producing diabetes drugs, including GLP-1 drugs like Ozempic, along with other diabetes pills and insulins.
“The goal of this research is to have receipts, to be as transparent as possible,” Barber said.
Novo and other drugmakers slashed US prices for some forms of insulin by as much as 75% last year under pressure from the Biden administration. By some estimates, however, the reductions made those products more profitable because they eliminated rebates paid to pharmacy benefit managers, the middlemen who negotiate prices for payers and employers.
Novo said in an email that 75% of its gross earnings goes to rebates and discounts to ensure patients have access to products like semaglutide, the active ingredient in Wegovy and Ozempic. Drugmakers often cite the high costs of research that may last years as a reason for their prices. Spending on drug research and development was almost $5 billion last year and will rise this year, Novo said.
Still, debate over the cost of drugs like Ozempic and Wegovy is ramping up. State health plans and Medicaid offices are seeing growing bills for Ozempic and its sister drug Wegovy, raising questions about whether the increases in cost are sustainable. In January, North Carolina cut off coverage of anti-obesity medicines for state employees, citing soaring costs and lack of agreement on pricing from drugmakers.
Surprisingly, the study found that the biggest cost in producing Ozempic is not the active medicine, called semaglutide, but the disposable pens used to inject it. They can be made for no more than $2.83 per month’s supply, the authors concluded, based on interviews with former employees and consultants to injection device manufacturers. One Ozempic pen is used weekly and lasts a month.
Other Costs
By contrast, the active drug in Ozempic can be produced for about 29 cents for a month’s supply, or 7.2 cents for a typical weekly dose, the research found. It’s not cheap to make — semaglutide costs over $70,000 per kilogram. But only a tiny quantity of the drug is used in each weekly dose.
Other costs include those of filling each pen, estimated at 20 cents per monthly dose, and other chemical ingredients, which the study estimates at 15 cents per monthly dose.
The analysis doesn’t include estimates for the cost of making Wegovy. Separate research from the University of Liverpool and elsewhere found last year that Wegovy could be produced for a mere $40 a month.