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These deals are eye-catching, but when patients turn up at pharmacies, they may find they cannot grab a bargain.
這些交易很吸引眼球，但當病人來到藥店時，他們可能會發(fā)現(xiàn)自己買不到便宜貨。
Shaina Kasper of T1International, an advocacy group for diabetes patients, is a type-1 diabetic.
糖尿病患者權益組織T1國際的莎爾娜·卡斯珀是一名1型糖尿病患者。
She says she tried to buy Eli Lilly’s non-branded Insulin Lispro, the specific drug available from May 1st for $25.
她說，她嘗試購買禮來公司的非品牌賴脯胰島素，這種特殊藥物從5月1日起以25美元的價格上市。
Her pharmacy in Vermont quoted her $90.
佛蒙特州的藥房給她開價90美元。
Perhaps Eli Lilly’s programme needs time to work out the kinks, or the pharmacy charged more on top.
也許禮來公司的項目需要時間來解決問題，或者藥店收取的費用更高。
But this is not the first time such a scheme has caused problems.
但這并不是此類計劃第一次引發(fā)問題了。
For years pharma firms have offered a patchwork of plans to help customers afford insulin and other drugs.
多年來，制藥公司提供了各種各樣的計劃來幫助客戶負擔胰島素和其他藥物。
Some are for almost anyone, others for the poor or uninsured.
有些計劃幾乎適用于所有人，有些則適用于窮人或沒有保險的人。
But they tend to be difficult for people to access, says Stacie Dusetzina, a drug-pricing expert at Vanderbilt University.
但范德比爾特大學的藥品定價專家史黛西·杜塞茨娜表示，人們往往很難獲得這些藥物。
First patients must be aware that the scheme exists and that they are eligible, which is often unclear.
首先，患者必須知道該計劃的存在，并且知道他們有資格，而他們通常不清楚。
Then they must jump through hoops.
然后他們必須克服重重困難。
Some need applications, doctor’s notes, proof of residence, tax documents and more.
有些需要各種申請、醫(yī)生說明、居住證明、稅務文件等等。
Pharmacies must also know about the programme and participate in it.
藥店也必須了解該計劃并參與其中。
It can be hard to know whom to blame—the drug companies for the faulty deals or the pharmacies for failing to implement them properly.
很難知道該怪誰——是制藥公司搞砸了交易，還是藥店沒能正確執(zhí)行交易。
These programmes can also end at any time.
這些項目也可以在任何時候結束。
“What the Lord giveth, the Lord can taketh away,” says David Mitchell of Patients For Affordable Drugs, an advocacy organisation for patients.
“上帝給的，上帝也能拿走”，病人權益組織“為了便宜藥”的大衛(wèi)·米切爾這樣說。
That is why Mr Mitchell and others are pushing for laws to lower drug prices rather than relying on a mishmash of special schemes.
這就是為什么米切爾先生和其他人正在推動降低藥品價格的法律，而不是依賴于特殊計劃大雜燴。
Some states have given up on waiting.
一些州已經(jīng)放棄了等待。
Colorado was the first to pass a cap on insulin, at $100 a month, in 2019.
科羅拉多州是第一個在2019年通過胰島素價格限額的州，每月收取100美元。
Since then nearly half of states have introduced caps, but these cover only state-regulated health plans.
從那以后，將近一半的州實行了上限，但這些只涵蓋了各州監(jiān)管的健康計劃。
In March Gavin Newsom, the governor of California, announced that he had signed a contract with a manufacturer to make and distribute insulin to Californians for $30.
今年3月，加州州長加文·紐森宣布，他已經(jīng)與一家制造商簽訂了一份合同，以30美元的價格向加州人分發(fā)生產(chǎn)出來的胰島素。
Maine, Michigan and Washington may follow.
緬因州、密歇根州和華盛頓州可能會緊隨其后。
There are also bills in Congress to tackle insulin prices and increase access to generics.
國會也有解決胰島素價格和增加非專利藥物獲取途徑的法案。
Perhaps insulin’s cost will eventually come down further and become more predictable.
也許胰島素的成本最終會進一步下降，變得可以預測。
