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Express Scripts and Medco
美国快捷药方公司与美可保健
Bigger means cheaper
越大越便宜
A new drugs manager may change the way Americans pop their pills
全新的药物管理者可能改变美国人购买药品的方式
IT TOOK eight months and more than 200 interviews.
花了八个多月的时间，会面达到200多次。
But on April 2nd America's Federal Trade Commission (FTC) decided, in a three-to-one vote, to let Express Scripts acquire Medco.
但是4月2日，美国联邦贸易委员会以三比一的投票决定同意美国快捷药方公司收购美可保健。
The two firms are America's second-biggest and biggest pharmacy-benefit managers.
两家公司合并后将成为美国第二大药品公司以及最大的药品福利管理者。
Eventually, they may change the way Americans take drugs.
这两家公司的合并可能最终改变美国人购买药物的方式。
Despite an intolerably dull title, pharmacy-benefit managers (PBMs) are important.
尽管标题无聊的令人无法忍受，但是药品福利管理者（PBMs）十分重要。
America is the world's biggest drug market; in 2010 it spent more than $307 billion on prescription medicines.
美国是世界上最大的药品市场；2010年美国在处方药上的花费达到3070亿美元。
PBMs are the middlemen that manage drug costs for employers and insurers. Together, Express Scripts and Medco will control more than 40% of the market.
药品福利管理是是平衡雇主和保险公司之间医药费用的中间人，快捷药方公司与美可保健一起将能控制40%以上的药品市场份额。
Express Scripts announced the acquisition in July 2011. Medco was a good company that had had a bad year, and so looked cheap.
快捷药方公司曾宣布在2011年7月完成收购工作，美可保健去年情况不佳，看起来有点贬值，但美可保健是一个业绩不错的公司。
It had lost about 30% of its business in a few months as some of its largest clients ended their contracts.
由于一些大客户终止了合同，美可保健几个月内就损失了30%的生意。
For both firms, bigger ought to mean better.
对两家公司来说，扩大经营必须意味着良好的收益。
With scale would come the power to negotiate fatter discounts on drugs, lowering costs for employers and insurers.
大规模将在药品折扣问题的商讨上占有更大的优势，并降低雇佣者和保险公司的成本。
Pharmacists felt sick when they heard the news.
听说了这个消息之后药剂师感觉并不好。
PBMs encourage consumers to fill their prescriptions through the mail instead of going to a costly pharmacy.
药品福利管理者鼓励消费者通过邮件方式而不是通过花费过高的药品公司购买药物。
PBMs, pharmacists fret, will crush their fees for dispensing drugs.
药品福利管理者让药剂师们很头痛，药品福利管理者会把削减开处方药的费用。
Worse, PBMs will demand that drugmakers give them exclusive deals for new, complex medicines.
更糟糕的是，药品福利管理者要求药品制造上对于新药和合成药给与特别的折扣。
Competitors and consumers will suffer, the pharmacists argue.
药剂师认为竞争者和消费者都会遭受损失。
The FTC disagreed.
联邦贸易委员会并不这么认为。
The merged firm is unlikely to squeeze pharmacies' fees for dispensing drugs, it ruled.
合并后的公司不可能压榨药剂师配置药物的费用，只是对此收费进行规范。
There remain plenty of lively, smaller PBMs.
市场中还有很多小规模活跃的药品福利管理者。
John Kreger of William Blair, an investment bank, says there is enough turmoil—thanks both to the merger and to Express Scripts' continuing fight with Walgreens, a big pharmacy—that smaller PBMs may snatch new business in the next year.
投资银行William Blair的John Kreger说已经够乱了——多亏两家公司的合并，还有快捷药方公司与大型的医药公司Walgreens不断的竞争——小规模的药品福利管理者明年会抢走新业务。
The small fry may also benefit if the pharmacy lobby's lawsuit against the merger moves forward.
如果反对合并进程的药品游说诉讼能够成功的话，小公司也能从中获益。
The combined firm will have $91 billion in revenue in 2012, estimates Lawrence Marsh, an analyst at Barclays Capital.
据巴莱克集团的分析师Lawrence Marsh预测，合并后的公司在2012年的收益能够达到910亿美元。
It is so big that it could shape a new era for America's drug market.
收益如此巨大以至于可以塑造美国药品市场的新纪元。
As more drugs lose their patents, consumers will increasingly fill their prescriptions with generics.
由于越来越多的药品不再拥有专利权，越来越多的消费者都会使用非专利药物开具处方。
If Express Scripts has its way, they will also fill their prescriptions by post.
如果快捷药品公司也采用此方法，那么他们也会采取邮寄方式开药方。
Medco recently acquired a firm that compares the efficacy of different drugs.
美可保健最近收购了一家比较药品不同功效的公司。
This may prove useful when America begins to see cheap copies of complex drugs, called biosimilars, which will be tested against the originals.
美国开始看到合成药剂的复制品，即生物仿制药，价格低廉，能用来与源药品做对比试验。此时上述收购还是极为有益的。
The new Express Scripts may also play a role on Barack Obama's new insurance exchanges, working with insurers to court individuals shopping for health care.
新的快捷药方公司同样在奥巴马提出的新型保险交易中扮演了重要角色，他和保险代理人一起劝说个人购买健康保险。
Most intriguingly, the new Express Scripts could push Americans to buy the right medicines and take them at the right time.
最有趣的是新的快捷药方公司可以推动美国人在正确的时间购买正确的药物。
For years PBMs have tested ways to urge consumers to buy cheaper, effective drugs.
几年来，药品福利管理者尝试新的方法以促使消费者购买便宜而有效的药物，
For example, if a patient wants a branded pill rather than a generic, he must pay for more of it himself.
例如如果病人想购买品牌药物而非一般药物，他要为多出的费用自己掏腰包。
Experiments will probably scale up and become more sophisticated.
这样的试验将逐步扩大规模，也会越来越复杂。
Eventually, they might even spread to Medicaid, the public programme for the poor.
最终将波及医疗补助计划，该计划是救助穷人的公共计划。
Health reform (unless the Supreme Court strikes it down) will add 16m new members to Medicaid by 2019, a 27% jump.
到2019年，健康改革（除非最高法院将其驳回）将增加160万名新的受益者，约增长了27%。
PBMs such as Medco and Express Scripts have so far spent little time chasing the Medicaid market.
像美可保健和快捷药方公司这样的药品福利管理者迄今为止在医疗补助计划投入的时间还不多。
That may change.
这种情况可能会有所改变。
