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Why are Medicines so Cheap in India? The Economics of Drug Pricing
为什么药品在印度如此便宜？药物定价中的经济学
India has been called the pharmacy of the world. Many generic drugs are made there and much of its drug production is exported internationally.
印度被称为“世界药房”。许多仿制药都是在那里生产的，而且它的大部分药品都出口到国际上。
Developing New Medicines is Risky and Expensive
（1）开发新药是有风险的而且成本高昂
Potential Dilemma of Drug-Pricing
（2） 药品定价的潜在困境
The cost of developing a new drug is very expensive however the cost of manufacturing a drug that has already been invented is relatively cheap. For example, Lipitor one of the top-selling drug that lowers cholesterol costs $5.80 per 100 tablets to manufacture however the cost of inventing Lipitor was still in billions.
开发一种新药的成本非常昂贵，但是药物研发成功后，生产药品的成本相对较低。例如，立普妥（Lipitor）是最畅销的药物之一，它能降低胆固醇，生产成本为每100片售价为5.80美元，然而普妥的研发成本仍然高达数十亿美元。
The existence of high R&D costs and low manufacturing costs creates a huge problem for the overall drug development process. Due to low manufacturing costs, a pharmaceutical company that invests billions to develop a new drug faces immediate competition. Potential competitors without investing anything in R&D could manufacture the drug, enter the market, and sell a generic copy of the drug at a very low price. Because of this, the company that invested billions to develop the new drug can never recoup its R&D costs. Thus, this situation provides no incentive for anyone to invest in an already risky drug invention process.
高研发成本和低制造成本的并存，给药品的整个研发过程带来了巨大的问题。由于制造成本较低，一家投资数十亿美元开发新药的制药公司面临着直接竞争。没有在研发上投入任何资金的潜在竞争对手可以生产这种药物，进入市场，并以极低的价格出售仿制药。正因为如此，投资了数十亿美元开发新药的公司，永远无法收回研发成本。因此，这种情况导致不会有人投资于风险巨大的药物研发过程。
To incentivize drug invention pharmaceutical companies that innovate new drugs are provided patents i.e. market exclusivity. The market exclusivity provides an opportunity for the company to recover its R&D costs and make profits thus incentivizing innovation. The company however is given exclusivity only for a limited time (usually 10-12 years) after which the patents expire and generic companies can copy the medicine and enter the market. This process will eventually bring the prices down and provide treatments for life threatening diseases at extremely cheap costs.
为鼓励制药公司研发新药，政府授予药企专利，即垄断地位（译者注：原文意思是“市场排他性”）。垄断地位为公司提供了一个机会，使其能够收回研发成本并获得利润，从而激励创新。然而，公司的垄断性地位时间是有限的（通常是10-12年），专利到期后，药品仿制公司可以仿制药品并进入市场。这最终将降低药品价格，并以极低的价格为一些致命的疾病提供治疗。
The patent procedure allows the innovator pharmaceutical company to charge a high price for their drug to recoup their original R&D costs and report profits. For example, when Lipitor was still covered by a patent, the consumer cost was $272.37 for a 100 tablets, which provided Pfizer (the innovator company) a % markup of 4,696. Thus, it is not surprising that Lipitor generated more than $100 billion in revenue for Pfizer since it was approved in 1997.
专利权允许创新的制药公司对他们的药品收取高昂的费用，以收回他们最初的研发成本并获得利润。例如，当立普妥的专利权仍在有效期时，价格是100片272.37美元，这为辉瑞（药品研发公司）带来了4696%的溢价。因此，自1997年获得批准以来，立普妥为辉瑞公司创造了1000多亿美元的收入，这并不奇怪。
What makes medicines in India cheap?
（3）什么使得印度的药品如此便宜？
The patent system works well in countries where most people are covered by health insurance. This is the case in the west. Consumers pay a monthly or annual premium to insurance companies in exchange for coverage. By doing so the consumers do not incur the exorbitant cost of medication that the pharmaceutical company seeks to recoup its R&D costs.
绝大多数国民都被医疗保险覆盖的国家中，专利制度运行良好。这是西方的情况。消费者每月或每年向保险公司支付保险费，以换取保险。通过这样做，消费者不用承担制药公司为收回研发成本而收取的高昂的药物价格。
Things are very different in developing and underdeveloped countries. Most people in such countries are not covered by health insurance. Imagine a patient in India, a country with 276 million people living below $1.25 per day on purchasing power parity paying $272.37 for a 100 tablets of Lipitor. Hence it is not surprising that Lipitor was sold at a much lower cost in India than some of the western countries.
发展中国家和欠发达国家的情况则大不相同。在这些国家，大多数人没有医疗保险。想象一下，印度—— 一个有2.76亿人每天生活费低于1.25美元的国家——的一个病人（如何支付的起）每100片272.37美元的立普妥（按购买力平价计算）。因此，在印度，立普妥的售价比一些西方国家低得多，这也就不足为奇了。
Innovation of new drugs is bare minimum in India and without patent protection it is not surprising that is the case. If India desires to grow into its role as a scientific and technological powerhouse then it must come up with a way to provide some sort of patent protection to drugs thus incentivizing drug development and innovation.
除了药物的延迟供应，新药物的研发领域也出现了另一个不利因素。在印度，几乎没有药物方面的创新并且对于新药没有专利方面的保护。如果印度想要发展成为一个科学和技术强国的角色，那么它必须想出一种方法，为药物提供某种专利保护，从而激励药物研发和创新。
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