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同样的药,在美国的售价为何是欧洲的5-10倍?
虎嗅APP·2025-07-24 09:42

Core Viewpoint - The article discusses the significant disparity in drug prices between the United States and Europe, highlighting that the same medication can cost 5-10 times more in the U.S. than in European countries. It explores the complexities behind drug pricing, including historical, institutional, and market dynamics, as well as the influence of Pharmacy Benefit Managers (PBMs) in the pricing structure [3][5][6]. Group 1: Reasons Behind Drug Price Reform Challenges - Trump's executive order aimed to reduce drug prices by 30%-80%, but it lacked a clear implementation plan, leading to confusion and a rise in pharmaceutical stock prices instead of a decline [6][7]. - The U.S. government is legally restricted from negotiating drug prices directly with pharmaceutical companies, a situation rooted in the country's foundational philosophy of protecting commercial independence [8][9]. - Pharmaceutical companies have significant political influence, often contributing to campaigns, which complicates efforts to enforce price reductions [10][11]. Group 2: Mechanisms of Drug Pricing - Drug pricing in the U.S. involves multiple channels, including government insurance (Medicare) and commercial insurance, each with different pricing strategies and negotiation dynamics [12][13]. - The initial pricing of a drug is influenced by historical prices of similar drugs, expected efficacy, and market competition, leading to a complex pricing strategy that often results in high initial prices [16][17]. - The actual price paid by patients is often significantly lower than the listed price due to discounts and negotiations, creating a lack of transparency in the pricing structure [21][22]. Group 3: Global Drug Price Comparisons - In Europe, drug prices are generally lower than in the U.S., with some medications costing 50-100 euros compared to 1000 dollars in the U.S., reflecting different healthcare philosophies and pricing strategies [35][36]. - China's drug pricing system has evolved to include significant negotiations, leading to lower prices for many medications compared to the U.S., particularly for generic drugs [41][42]. - The introduction of price negotiation mechanisms in the U.S. under the Biden administration marks a shift towards a more European-style approach to drug pricing, aiming to balance pharmaceutical innovation with affordability [43][44].