<p><img src="https://imageproxy.pbkrs.com/https://s.yimg.com/ny/api/res/1.2/GddaOplpZknfBSfJyK0bHQ--/YXBwaWQ9aGlnaGxhbmRlcjt3PTEyNDI7aD02OTk-/https://media.zenfs.com/en/cnn_articles_875/f3dc4439a5400b8762d3fdbd33b766f9?x-oss-process=image/auto-orient,1/interlace,1/resize,w_1440,h_1440/quality,q_95/format,jpg" alt="" original-src="https://imageproxy.pbkrs.com/https://s.yimg.com/ny/api/res/1.2/GddaOplpZknfBSfJyK0bHQ--/YXBwaWQ9aGlnaGxhbmRlcjt3PTEyNDI7aD02OTk-/https://media.zenfs.com/en/cnn_articles_875/f3dc4439a5400b8762d3fdbd33b766f9"/></p>
<p>一名美国最高法院警察于 2026 年 3 月 24 日在法院大楼的广场上站立。 - Jonathan Ernst/路透社</p>
<p>美国最高法院周一驳回了几家全国最大制药公司对一项计划的多项上诉，该计划预计将通过要求公司与医疗保险就一些最受欢迎药物的价格进行谈判，为纳税人和联邦政府节省数十亿美元。</p>
<p>法院拒绝上诉的决定没有解释，维持了几项下级法院的裁决，这些裁决支持国会在 2022 年通过的该计划。关于该计划的其他诉讼仍在进行中。</p>
<p>争议的焦点是 2022 年《通货膨胀削减法》中的一项条款，该条款允许医疗保险在经过多年的辩论后首次就某些药物的价格进行谈判，讨论是否这样的谈判实际上是政府的价格管制。然而，处方药价格的上涨给医疗保险及其受益人带来了财务压力。</p>
<p>包括阿斯利康和扬森在内的制药公司表示，该计划导致了一种 “虚假的谈判”，侵犯了他们的正当程序权利。大多数公司还辩称，该计划违反了第一修正案，因为它迫使他们 “接受政府的叙述” 作为谈判协议。下级法院驳回了这些论点，指出公司可以自由选择退出政府健康计划。</p>
<p>仅在 2021 年，特朗普政府告诉最高法院，联邦政府在医疗保险覆盖的药物上花费超过 2500 亿美元。</p>
<p>第一轮谈判涉及 10 种药物，预计将为联邦政府节省 60 亿美元，并为老年人减少 15 亿美元的自付费用，拜登政府在 2024 年宣布。这些价格于 1 月生效。</p>
<p>这些药物包括阿斯利康生产的 Farxiga，用于治疗糖尿病、心脏病和肾病。第一轮中另一个药物是由百时美施贵宝生产的 Eliquis，这是一种用于治疗和预防血栓和中风的抗凝血药物。阿斯利康告诉最高法院，Farxiga 的谈判过程导致其标价的 68% 的折扣。</p>
<p>第二轮涉及 15 种药物，预计将为医疗保险节省约 120 亿美元，并在明年 1 月价格生效时减少参保者的自付费用 685 百万美元，特朗普政府在 11 月表示。第三轮的谈判正在进行中。</p>
<p>这些药物是从医疗保险支出最高的合格药物名单中选择的。</p>
<h3>‘抓住宪法的稻草’</h3>
<p>制药公司及其盟友在过去三年中一直在法庭上对抗医疗保险药品价格谈判计划。在美国不同地区提起了多起诉讼。迄今为止，所有的裁决都对行业不利，法官裁定参与医疗保险是自愿的，如果公司不喜欢政府提供的价格，可以自由退出。</p>
<p>制造商提出的法律挑战之一是，他们被迫在没有合理补偿的情况下将药物提供给医疗保险，乔治城大学 O’Neill 研究所健康政策与法律中心主任安德鲁·特维纳马茨科表示。这，制药公司称，构成了违反第五修正案的违宪 “征收”。</p>
<p>如果公司不同意谈判价格，他们要么必须退出医疗保险和医疗补助——对行业来说是巨大的市场——要么支付高额的消费税。</p>
<p>制药公司还辩称，他们被迫同意谈判价格，尽管他们表示实际上是在抗议下这样做。公司还声称，医疗保险和医疗补助服务中心超越了其权限，国会没有为初始谈判轮次提供公众评论期，剥夺了行业的正当程序。</p>
<p>制药公司在最高法院处于劣势。由于没有下级法院支持他们的立场，他们无法证明联邦上诉法院在他们提出的宪法问题上存在分歧。最高法院通常在批准案件之前会寻找下级法院之间的分歧。</p>
<p>“行业提出的挑战在法律上是薄弱的。他们是在抓住宪法的稻草，” 特维纳马茨科说。</p>
<p>特维纳马茨科和一位同事在 3 月的一篇《健康事务》文章中写道，联邦法院在制药公司案件中提出的宪法问题上 “明确表态”。</p>
<p>“政府可以在不违反征收、言论或正当程序权利的情况下，要求参与自愿的联邦项目的条件是接受其定价条款，只要存在正式的退出选项，” 他们说，描述了下级法院对案件的理论。</p>
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诺华制药

强生

百时美施贵宝

<p>美国最高法院驳回了主要制药公司对一项允许对某些药物进行价格谈判的医疗保险项目的上诉，该项目预计将为纳税人节省数十亿美元。该决定维持了下级法院的裁决，并遵循了 2022 年《通货膨胀削减法》。制药公司辩称该项目侵犯了他们的权利，但法院裁定参与医疗保险是自愿的。预计第一轮谈判将为政府节省 60 亿美元，并降低老年人的费用</p>

<p><img src="https://imageproxy.pbkrs.com/https://s.yimg.com/ny/api/res/1.2/GddaOplpZknfBSfJyK0bHQ--/YXBwaWQ9aGlnaGxhbmRlcjt3PTEyNDI7aD02OTk-/https://media.zenfs.com/en/cnn_articles_875/f3dc4439a5400b8762d3fdbd33b766f9" alt="" original-src="https://s.yimg.com/ny/api/res/1.2/GddaOplpZknfBSfJyK0bHQ--/YXBwaWQ9aGlnaGxhbmRlcjt3PTEyNDI7aD02OTk-/https://media.zenfs.com/en/cnn_articles_875/f3dc4439a5400b8762d3fdbd33b766f9"/></p>
<p>A US Supreme Court police officer stands on the plaza of the court building on March 24, 2026. - Jonathan Ernst/Reuters</p>
<div class="lb-trans"><p>一名美国最高法院警察于 2026 年 3 月 24 日在法院大楼的广场上站立。 - Jonathan Ernst/路透社</p>
</div><p>The US Supreme Court on Monday rejected a series of appeals from several of the nation’s largest drugmakers challenging a program that is expected to save taxpayers and the federal government billions of dollars by requiring the companies to negotiate with Medicare on the prices for some of their most popular drugs.</p>
<div class="lb-trans"><p>美国最高法院周一驳回了几家全国最大制药公司对一项计划的多项上诉，该计划预计将通过要求公司与医疗保险就一些最受欢迎药物的价格进行谈判，为纳税人和联邦政府节省数十亿美元。</p>
</div><p>The court’s decision to deny the appeals, which it made without explanation, leaves in place several lower court rulings upholding the program that Congress enacted in 2022. Other lawsuits over the program are still pending.</p>
<div class="lb-trans"><p>法院拒绝上诉的决定没有解释，维持了几项下级法院的裁决，这些裁决支持国会在 2022 年通过的该计划。关于该计划的其他诉讼仍在进行中。</p>
</div><p>At issue is a provision in the 2022 Inflation Reduction Act that allows Medicare to negotiate the prices of certain drugs for the first time after years of debate about whether such negotiation would effectively be government price fixing. Yet the rising cost of prescription drugs has added financial pressure on Medicare and its beneficiaries.</p>
<div class="lb-trans"><p>争议的焦点是 2022 年《通货膨胀削减法》中的一项条款，该条款允许医疗保险在经过多年的辩论后首次就某些药物的价格进行谈判，讨论是否这样的谈判实际上是政府的价格管制。然而，处方药价格的上涨给医疗保险及其受益人带来了财务压力。</p>
</div><p>The drugmakers, including AstraZeneca and Janssen, said the program leads to a “sham negotiation” that violates their due process rights. Most also argued that the program violates the First Amendment because it compels them to “adopt the government’s narrative” of a negotiated agreement. Lower courts have rejected those arguments, noting that the companies are free to pull their products from government health programs.</p>
<div class="lb-trans"><p>包括阿斯利康和扬森在内的制药公司表示，该计划导致了一种 “虚假的谈判”，侵犯了他们的正当程序权利。大多数公司还辩称，该计划违反了第一修正案，因为它迫使他们 “接受政府的叙述” 作为谈判协议。下级法院驳回了这些论点，指出公司可以自由选择退出政府健康计划。</p>
</div><p>In 2021 alone, the Trump administration told the Supreme Court, the federal government spent more than $250 billion on drugs covered by Medicare.</p>
<div class="lb-trans"><p>仅在 2021 年，特朗普政府告诉最高法院，联邦政府在医疗保险覆盖的药物上花费超过 2500 亿美元。</p>
</div><p>The first round of negotiations involved 10 drugs and is expected to lead to $6 billion in savings for the federal government and a $1.5 billion reduction in out-of-pocket costs for seniors, the Biden administration announced in 2024. The prices took effect in January.</p>
<div class="lb-trans"><p>第一轮谈判涉及 10 种药物，预计将为联邦政府节省 60 亿美元，并为老年人减少 15 亿美元的自付费用，拜登政府在 2024 年宣布。这些价格于 1 月生效。</p>
</div><p>Those drugs included Farxiga, made by AstraZeneca, which is used to treat diabetes, heart disease and kidney disease. Another drug included in that first round was Eliquis, a blood thinner made by Bristol Myers Squibb that is used to treat and prevent blood clots and strokes. For Farxiga, AstraZeneca told the Supreme Court that the negotiated process at the center of the case resulted in a 68% discount off its list price.</p>
<div class="lb-trans"><p>这些药物包括阿斯利康生产的 Farxiga，用于治疗糖尿病、心脏病和肾病。第一轮中另一个药物是由百时美施贵宝生产的 Eliquis，这是一种用于治疗和预防血栓和中风的抗凝血药物。阿斯利康告诉最高法院，Farxiga 的谈判过程导致其标价的 68% 的折扣。</p>
</div><p>The second round, which covered 15 drugs, is projected to save Medicare about $12 billion and reduce enrollees’ out-of-pocket costs by $685 million when prices take effect next January, the Trump administration said in November. Negotiations for the third round are underway.</p>
<div class="lb-trans"><p>第二轮涉及 15 种药物，预计将为医疗保险节省约 120 亿美元，并在明年 1 月价格生效时减少参保者的自付费用 685 百万美元，特朗普政府在 11 月表示。第三轮的谈判正在进行中。</p>
</div><p>The medications are chosen from a list of eligible drugs with the highest total Medicare spending.</p>
<div class="lb-trans"><p>这些药物是从医疗保险支出最高的合格药物名单中选择的。</p>
</div><h3>‘Grasping at constitutional straws’</h3>
<div class="lb-trans"><h3>‘抓住宪法的稻草’</h3>
</div><p>Drugmakers and their allies have been fighting the Medicare drug price negotiations program in court for the past three years. Multiple lawsuits were filed in different districts across the US. All the decisions to date have gone against the industry, with judges ruling that participation in Medicare is voluntary and the companies are free to withdraw if they don’t like the price the government is offering.</p>
<div class="lb-trans"><p>制药公司及其盟友在过去三年中一直在法庭上对抗医疗保险药品价格谈判计划。在美国不同地区提起了多起诉讼。迄今为止，所有的裁决都对行业不利，法官裁定参与医疗保险是自愿的，如果公司不喜欢政府提供的价格，可以自由退出。</p>
</div><p>Among the legal challenges the manufacturers are making are that they are being forced to give their drugs to Medicare without just compensation, said Andrew Twinamatsiko, director of the Center for Health Policy and the Law at Georgetown University’s O’Neill Institute. That, the drug companies say, amounts to an unconstitutional “taking” in violation of the 5th Amendment.</p>
<div class="lb-trans"><p>制造商提出的法律挑战之一是，他们被迫在没有合理补偿的情况下将药物提供给医疗保险，乔治城大学 O’Neill 研究所健康政策与法律中心主任安德鲁·特维纳马茨科表示。这，制药公司称，构成了违反第五修正案的违宪 “征收”。</p>
</div><p>If the companies don’t agree to the negotiated price, they would either have to withdraw from Medicare and Medicaid – huge markets for the industry – or pay hefty excise taxes.</p>
<div class="lb-trans"><p>如果公司不同意谈判价格，他们要么必须退出医疗保险和医疗补助——对行业来说是巨大的市场——要么支付高额的消费税。</p>
</div><p>The drugmakers also argue they are being compelled to agree to the negotiated prices, though they say they are actually doing so under protest. The companies also claim that the Centers for Medicare and Medicaid Services is exceeding its authority, and that Congress did not provide a public comment period for the initial rounds of negotiations, depriving the industry of due process.</p>
<div class="lb-trans"><p>制药公司还辩称，他们被迫同意谈判价格，尽管他们表示实际上是在抗议下这样做。公司还声称，医疗保险和医疗补助服务中心超越了其权限，国会没有为初始谈判轮次提供公众评论期，剥夺了行业的正当程序。</p>
</div><p>The drugmakers arrived at the Supreme Court at a disadvantage. Because no lower courts had backed their position, they were unable to demonstrate that the federal appeals court had split over the constitutional questions they raised. The Supreme Court often looks for a split among lower courts before granting a case.</p>
<div class="lb-trans"><p>制药公司在最高法院处于劣势。由于没有下级法院支持他们的立场，他们无法证明联邦上诉法院在他们提出的宪法问题上存在分歧。最高法院通常在批准案件之前会寻找下级法院之间的分歧。</p>
</div><p>“The challenges that the industry presented were weak in law. They were grasping at constitutional straws,” Twinamatsiko said.</p>
<div class="lb-trans"><p>“行业提出的挑战在法律上是薄弱的。他们是在抓住宪法的稻草，” 特维纳马茨科说。</p>
</div><p>Twinamatsiko and a colleague wrote in a Health Affairs article in March that federal courts have “spoken unequivocally” on the constitutional questions presented by the pharma companies’ cases.</p>
<div class="lb-trans"><p>特维纳马茨科和一位同事在 3 月的一篇《健康事务》文章中写道，联邦法院在制药公司案件中提出的宪法问题上 “明确表态”。</p>
</div><p>“The government may condition participation in voluntary federal programs on acceptance of its pricing terms without violating takings, speech, or due process rights when formal exit options exist,” they said, describing the lower courts’ theory of the cases.</p>
<div class="lb-trans"><p>“政府可以在不违反征收、言论或正当程序权利的情况下，要求参与自愿的联邦项目的条件是接受其定价条款，只要存在正式的退出选项，” 他们说，描述了下级法院对案件的理论。</p>
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最高法院驳回了大型制药公司挑战医保药品价格谈判的上诉