Pharma spends more on marketing than development製藥公司花費更多的營銷比發展
Why are pharmaceuticals so expensive?為什麼藥品那麼貴？ This question has been asked for many years.這個問題已問過了很多年。 In fact this was the question asked by Senator Estes Kefauver (D) in the late 1950s.其實這是質詢參議員estes kefauver （ d ）在上世紀50年代末。 Senator Kefauver was the first to put together an indictment against the business practices of the pharmaceutical industry.參議員kefauver是第一家放在一起刑事起訴書對商業慣例的製藥業。 In fact he lobbed three charges at the pharmaceutical industry at the time.其實，他lobbed三項控罪，在製藥工業上的時間。
They were the following:它們分別是：
1) Patents sustained predatory prices and excessive margins 1 ）專利持續掠奪性的價格和過高的利潤率
2) Costs and prices were extravagantly increased by large expenditures in marketing 2 ）成本及價格均大手大腳，增加大筆支出，在市場營銷
3) Most of the industry’s new products were no more effective than established drugs on the market(1). 3 ）大部分行業的新產品，沒有更有效的既定藥物對市場（ 1 ） 。
If you look at these charges they are much the same accusations that many people blame the如果你看看這些收費是多少，同時指責說，很多人責怪 pharmaceutical industry製藥業 of practicing right now, fifty years later.練，現在， 50年後。 Has anything changed in the past fifty years?有什麼改變，在過去的五十年？
The core of this debate, especially in the US where direct-to-consumer marketing is legal, is the amount核心這次辯論中，特別是在美國哪裡直接面向消費者的營銷是合法的，是數額 pharmaceutical companies製藥公司 spend on marketing vs. the amount spent on research and development (R&D).花在行銷主場迎戰數額用於研究和開發（ R ＆ D ） 。 Aren’t we all lead to believe that the high cost of research and development is the reason that是不是我們都帶頭認為，成本高的研究和發展是原因 pharmaceuticals藥品 are so incredibly expensive?如此令人難以置信的昂貴？ The Pharmaceutical Research and Manufacturers of America (PhRMA) uses data from IMS, a firm specializing in pharmaceutical market intelligence, to conclude that pharmaceutical companies spend US $29.6 billion on R&D and US $27.7 billion for all promotional activities (data from 2004).藥品研究與製造商協會（ phrma ）使用數據，從IMS的，堅定的專門從事藥品市場情報，得出結論認為，製藥公司花費美國296億美元的研發與美國27700000000美元所有宣傳活動（數據從2004年） 。 Even if these numbers can be trusted, and the pharmaceutical industry is altruistic, why are these expenses so close?即使這些數字可以信任和製藥業是利他，為什麼這些費用如此接近？ An investigative article in the Public Library of Science (PLoS), who used proprietary databases to construct a new, and quite possibly more accurate estimate, states the money goes to marketing twice as often than R&D.負責調查工作的文章中的Public Library of Science （ plos ） ，他們使用自有的數據庫，以建造一個新的，而且很可能更準確的估計，國家的錢去推銷的兩倍，往往比研發。
Show me the money. 顯示出我的錢。
It is important to note that the PLoS is an open source publication.但必須注意的是，該plos是一個開源出版。 In fact the publication states that you may use its articles and “download, copy, distribute, and use (with attribution) any way you wish.” This means that the PLoS is not taking money from anyone and so are free to publish articles that go against the mainstream.其實出版的國家，你可以用它的文章和"下載，複製，分發，並使用（歸屬） ，以任何方式，你想" ，這意味著該plos不是以金錢的人，所以可以自由發表文章，認為違背主流。 Most importantly, they are not taking money from pharmaceutical companies and can publish content like this without fear of reprisal.最重要的是，他們不是以錢來自製藥公司和可以公佈的內容，像這樣沒有懼怕報復。 What was published in “The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States” does go against the mainstream – by clearly stating that the pharmaceutical industry is spending more on marketing, much more than most people would expect.什麼是發表在"成本推動丸：一種新的估計，藥品推廣支出，在美國"是否違背主流-明確表示，製藥業是多花些營銷，遠遠超過了大多數人所期望的。
As the US represents 43% of global sales and global promotion expenditures, knowing the amount of money put into marketing is essential.作為美國代表43 ％的全球銷售和全球推廣支出，明知這筆錢投入市場營銷是必不可少的。 It is also important to note that according to CAM, which is a global company that audits the promotional activities of the pharmaceutical industry, about 30% of promotional spending is not accounted for in their figures.它也必須注意到，根據凸輪，這是一個全球性的公司，即審計促銷活動的製藥工業中，約有30 ％的促銷費用是沒有計算在他們的數據。 The breakdown is not accurately known of unmonitored promotion, but CAM believes that approximately 10% is due to incomplete disclosure by surveyed有關數字不準確已知的受檢推廣，但凸輪認為，大約有百分之十是由於不完全統計披露被調查 physicians醫師 and 20% comes from promotion geared towards physicians not surveyed or unmonitored journals.和20 ％來自於促進面向醫師不接受調查或受檢期刊。 Combining the information gathered from CAM, as well as IMS, the total amount of money spent on marketing by pharmaceuticals was US $57.5 billion for 2004.結合收集到的資料，由凸輪，以及IMS的，其總數額的金錢花在營銷藥品，是美國57500000000美元為2004 。 The total spent on domestic industrial pharmaceutical R&D was US $31.5 billion.總花費對國內製藥工業的研發，是美國31500000000美元。
There is quite a bit of difference between the money spent on R&D and marketing.有相當多的差異，將金錢用於研發和行銷。 If we exclude direct-to-consumer marketing, of the US $57.5 billion, CAM estimates that 80% of this money is spent on physicians.如果我們排除直接向消費者銷售，對美國57500000000美元，凸輪估計，有八成的錢是花在醫師。 This means that, with 700,000 practicing physicians in the US, the pharmaceutical industry spent nearly US $61,000 in promotion per physician!這意味著，隨著700000醫師，在美國，製藥業花了將近美國61000美元在推廣每醫師！ It is interesting to note that according to the US census the real median household income (2003) was $43,318.值得一提的是，根據美國人口普查真正的家庭入息中位數（ 2003 ） 43318美元。
Is Kefauver right? 是kefauver權利？
While knowing that the pharmaceutical industry spends nearly US $57.5 billion on marketing and US $31.5 billion on R&D, those that believe the industry is promotion based, and not entirely altruistic as the industry claims, have some proof to this claim.雖然明知製藥業花了將近美國57500000000美元對市場營銷和美國31500000000美元研發系統，因為那些相信是業界推廣為基礎，而且不完全利他作為業界聲稱，有一些證據證明這種說法。 How can we continue to pump money into, and grant legislation to, an industry that would rather hide the truth than be honest?我們如何能繼續泵資金投入，並給予立法，是一個行業會，而不是隱瞞真相比誠實嗎？ How far are we from formally proving Kefauver’s other claims to be true?還有多遠，我們從正式證明kefauver的其他索賠要求，是真實的嗎？ Whether or not we can all agree on the pharmaceutical industry’s place in our society – no industry should go fifty years without ethical restrictions, while claiming they are the champions of society.與否，我們大家都可以同意對製藥業的地方，在我們的社會-沒有業應該去五十年，沒有道德的限制，而聲稱他們是冠軍的社會。
References:參考文獻：
1) The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States 1 ）的成本推丸：一種新的估計，藥品推廣支出在美國
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