诺华制药CEO：中国蕴藏大商机

    是的，我们采取了一种不同的方法。大约10年前开始，我们就启动了一种所谓的“途径”法。我们知道，通常对于一种罕见的疾病来说，如果有了一个症状非常相似的患者群，我们就能了解这种特定疾病的分子途径。

    但是这个患者群可能很小。

    虽然很小，但是一个非常同质的患者群可以让我们研究这种疾病以及导致该疾病的分子途径。然后我们会研发能阻断这种途径的药物，再有条理地扩展到受相同分子途径影响的其它疾病领域。所以所谓“重磅药品”的定义将会有所变化，一个药品不再只对应一个疾病领域，而是可能能够用于治疗三种、四种甚至五种疾病。

    举个例子？

    比如我们的癌症药物依维莫斯（Afinitor）。它是一种雷帕霉素靶蛋白（mTOR，人类细胞中的一种蛋白质）抑制剂，mTOR的分子途径与多种疾病有关。我们一开始研发依维莫斯是为了治疗肾细胞癌，然后我们开始在许多其它癌症上测试依维莫斯的效果。我们最近刚刚证实，乳腺癌 也与mTOR的分子途径有关，而这将对每年22万名晚期乳腺癌患者提供帮助。这就是一个例子，最初用于治疗肾细胞癌的药物，最终也能治疗乳腺癌。综合效应使它成为了一个重磅药物。

    研发是诺华的一项巨大投资，你们的竞争对手也是一样。你们如何从投资的每一美元中获得更好的研发效果？

    问得好。人人都想提高研发效果，我们发现了几点：首先必须找到对的科学家。所以我们给科学家们建立了研究中心。我们没有要求他们集中在一个特定的地点，我们在美国、西欧都建立了研究中心，而且我们正在上海建立另一个研究中心。人才在哪里，我们就去哪里。这是第一点。

    第二点是要保持在研发上的强大投入。在诺华公司，我们承诺把大约20%的销售额投入到研发上。对于我们的药品业务规模来说，就是每年投入90多亿美元。所以我们有了对的人才，和对的投资数额，我们认为这是让我们成功的第一部分。

    然后你还要有正确的研究方法，从不同的角度来思考，到底应该如何进行药物开发，我认为那就是途径法。

    对你来说，在美国和西欧以外，增长潜力最大的地区是哪里？

    我们在中国的业务规模非常庞大，而且增长很快。中国市场刚刚成为我们的全球十大市场之一。去年我们的中国市场增长了24%。而且中国政府前不久表示，将提高城乡地区的医疗支出，所以我们认为中国将是一个持续增长的地区。另一个地区是俄罗斯。俄罗斯有一个问题，就是它的人口数量在下降。俄罗斯政府表示将提高医疗水平，扭转人口规模下降趋势。另外还有很多发展中国家，我们认为都是增长中的市场，也都进行了大量投资。

    你们在那些市场中的业务模式是否很不一样？因为那儿的大多数民众都得自己掏钱治病。

    Yes, we took a different approach. Starting about 10 years ago, we started what's called the pathways approach, where we understand the molecular pathway of a particular disease, usually in a rare disease where you have a very homogeneous patient population.

    But maybe a very small population.

    A small population, but a very homogeneous patient population that allows us to study the disease and the molecular pathway that leads to that disease. We then develop a drug that can interrupt that pathway, and then we look to mechanistically expand into other disease areas that are impacted by the same pathway. So essentially it doesn't mean that blockbusters will go away, but the definition of a blockbuster will change pretty dramatically away from having one disease area to a drug that maybe is active in three or four or even five diseases.

    What's an example?

    An example is our oncology drug called Afinitor, which is an mTOR [a type of protein in human cells] inhibitor. The mTOR pathway is implicated in many different types of diseases. So we initially developed Afinitor in renal cell cancer, and then we started testing Afinitor in many other cancers. Breast cancer is another indication that we just received approval for, and that's now going to help more than 220,000 patients every year who have advanced breast cancer. So here's an example of a drug that started in renal cell cancer, has expanded into breast cancer, and then there are a number of other indications. That together will make it a blockbuster.

    R&D is a huge investment for Novartis, as it is for your competitors. How do you get more than the other guys from a dollar of R&D?

    A good question -- everybody's trying to increase productivity in research and development. We've found a couple of things. First you have to find the right scientists. So we have built research centers where the scientists are. We have not asked them to come to a particular location. We've built research centers in the U.S., in Europe, and we're building one in Shanghai. So we're going where the talent is. That's No. 1.

    The second is keeping spending strong in research and development. At Novartis we've made the commitment to spend about 20% of sales on research and development. In our pharma business, that's over $9 billion a year that we invest. So if you have the right talent and the right amount of spending, we find that that's the first part of success.

    Then you have to have the right approach, and I think that's the pathways approach, taking a different look at how we're going to discover and develop drugs.

    Where are the geographic areas of growth for you outside the U.S. and Western Europe?

    We have a very large and growing business in China, which has just become one of our top 10 markets. Last year it grew 24%. The Chinese government has made a massive commitment to improving health care among rural and urban Chinese, and so we see that as a continued growth area. Another area is Russia. Russia has a problem. It has a declining population. And the government in Russia has made the commitment to improve access to health care in ways that will reverse that population decline. There are many developing countries in which we're investing quite heavily as growth areas.

    In markets like that, isn't it a very different business? Those people are paying for their own medical care for the most part.