Is AHPRA doing enough to curb unsafe prescribing?

ABC，听播客、广播、新闻、音乐等等。

ABC Listen, podcasts, radio, news, music, and more.

ABC Radio National百大澳大利亚图书评选投票现已开启。

Voting is open for ABC Radio National's top 100 Australian books countdown.

访问 abc.net.au/top100books，选出你最喜欢的最多10本书。

Go to abc.net.au/top 100 books and pick up to 10 of your favorites.

你可以从推荐书单中选择，也可以添加你自己的书目。

Choose from the inspiration list or add your own title.

十月份我们会统计所有人的投票，然后在ABC国家广播电台和ABC Listen上从100倒数到第一名。

In October, we'll tally everyone's votes and countdown from 100 to number one on ABC Radio National and ABC Listen.

时间不多了。

You don't have long.

现在就去 abc.net.au/top100books 投票吧。

Vote now at abc.net.au/top100books.

劳伦，你的孩子比我的小，我敢打赌你对孕期和产后睡眠障碍的记忆还历历在目。

Lauren, your children are younger than mine, and I bet you that sleep disturbance in pregnancy and the postpartum phase is just so fresh in your mind.

太新鲜了。

So fresh.

太新鲜了。

So fresh.

我大儿子四岁，他以前睡觉特别差。

My oldest boy is four, and he was a woeful sleeper.

我记得我们经历了好长一段时间，他每45分钟醒一次。

I remember we went through the longest stretch of time where he woke up every 45.

哦，不会吧。

Oh, no.

那你感觉怎么样？

And how did you feel?

那不是很可怕吗？

Isn't that horrific?

我感觉自己像个僵尸。

I felt like a zombie.

我感觉自己像是裹着一层厚厚的、黏糊糊的污泥在生活。

I felt like I was living life through a thick, sludgy, slime coating.

有时候我甚至没法好好集中注意力听人说话。

I couldn't quite focus on conversations sometimes.

我觉得这也是刚当妈妈时的正常反应，但真的特别难熬。

And I think that's early motherhood as well, but it really really made it hard.

其实研究表明，孕期和产后阶段的睡眠不足和睡眠紊乱，对妈妈和宝宝都有很大影响，这也是今天健康报道的重点内容。

Well, it turns out that sleep deprivation, the sleep disturbance during pregnancy and postpartum phase has significant impacts for both mother and baby, and that is something that's coming up on today's health report.

我是普里亚·亚历山大，我们在加迪加尔人的土地上。

I'm Priya Alexander on Gadigal Land.

我是劳伦·罗伯茨，我们在拉拉克吉尔人的土地上。

And I'm Lauren Roberts on Larrakir Country.

另外在节目中，我们要跟进几周前报道的一个故事，关于远程医疗诊所为进食障碍患者开具GLP-1类减肥药的处方问题，包括筛查不足、潜在危害等，今天我们继续与澳大利亚医疗注册管理局（AHPRA）跟进这个故事的后续进展。

Also on the show, we are following up on a story we did several weeks ago regarding the prescription of GLP-1s or weight loss medications from telehealth clinics for people who have eating disorders, inadequate screening, the potential harms, and we are following up on that story today with the medical regulator AHPRA.

我们之前聊过一

And we've talked a

关于美国药品新定价政策如何影响澳大利亚药物供应的卫生报告，我们做了很多报道。

lot on the health report about how the new pricing policy for medicines in The US may impact the availability of drugs here in Australia.

我采访了一位研究人员，他们进行了一项新的建模研究，结果显示我们可能会完全错过这些药物。

Well, I spoke to a researcher on a new modelling study, and we may miss out altogether.

这确实是个引人入胜的故事，但先来看新闻：本周大多数人都看到了头条新闻，阿尔巴尼斯政府和卫生部长马克·巴特勒已通过立法，帮助澳大利亚人从非全科医生专科服务中获得更高价值，基本上是为了让收费更加透明。

Certainly a fascinating story, but first in the news, most people will have seen in their headlines this week that the Albanese government and the minister for health, Mark Butler, have passed legislation to help Australians get better value from non GP specialists, to basically get more transparency around their fees.

这是对《卫生立法法案》的一项修正案。

So this is the an amendment to the Health Legislation Act.

我觉得，Lauren，大多数人应该都知道那个医疗费用查询网站。

And I think, Lauren, most people know about the Medical Cost Finder website.

咱们得先交代一下背景，把前因后果说清楚。

We've got to give some context here and go back.

所以这个网站主要是用来查不同地区看专科医生或者做膝盖置换手术这类项目的常规费用的。

So this is obviously the website where you can use it to figure out the typical costs for a specialist appointment, something like a knee replacement based on where you live.

这是莫里森政府推出的。

And that was introduced by the Morrison government.

问题是，他们往里面投了2400万。

The issue with it is that they've injected 24,000,000 into it.

你可以想象，这是一个非全科医生专科医师自愿加入的服务。

And you can imagine it's an opt in service for non GP specialists.

到了2022年底，只有六位医生愿意报名上线。

At the end of twenty twenty two, only six doctors had volunteered to actually go on it.

在6300名符合条件的医生里，只有六位。

Six doctors out of 6,300 eligible people.

四年之后，这个数字才只涨到了106。

And four years later, the number's only risen to a 106.

所以说，医疗费用查询网站并没有真正达到它的预期效果，也没多少人愿意主动使用。

So it's fair to say that the medical cost finder website hasn't really done what it had intended, and not many people really opt in.

这里确实存在一个大问题，我作为全科医生深有体会。我经常给病人转诊，比如你来看病，说普里雅，我好像有腕管综合征的症状，各种办法都试过了，我就把你转给手外科医生；或者你需要做膝关节置换，我就把你转给骨科医生。

There's a real problem, and I say this as a GP, you know, I refer a lot of patients, and you might come and see me and say, Priya, I need you know, perhaps you have carpal tunnel symptoms, we've tried everything, and I refer you to a hand surgeon, or you you need a knee replacement, and I refer you to an orthopaedic surgeon.

其实我和患者根本没法提前知道那位特定医生的收费是多少，除非我去问他们，或者打电话去诊所打听。

There's actually no way for me or the patient to know what that particular surgeon's costs are unless I ask them or we call the rooms and find out.

所以你可以想象，你可能会去找某位医生咨询并得到报价，我的很多患者都遇到过这种情况，做关节置换手术自付费用高达两万美元。

So you can imagine you might go and see someone and get quoted, and this has happened to many of my patients, dollars 20,000 for a joint replacement surgery out of pocket.

而他们的第二诊疗意见就要一千美元。

And their second opinion is $1,000.

这其中的差距非常大，意味着患者无法获得财务上的透明度。

There's a huge discrepancy and it means that patients don't have financial transparency.

这意味着当他们看完外科医生的门诊后，某种程度上就已经被锁定在这位医生身上了。

It means that by the time they've seen a surgeon for their consult, they're kind of potentially locked in with this person.

他们报了一个天价，而且患者已经走到这一步了，很难再回头。

They quoted a huge number and they're somewhat far down the path and locked in.

所以这里是在尝试提高对患者透明的程度。

So there is an attempt here to improve transparency for patients.

这项立法变更预计会产生两个主要影响。

This legislative change is likely to have two main impacts.

第一点就是，是的。

The first is yes.

希望专科医生的费用能更加透明。

Hopefully, there's going to be more transparency with specialist fees.

现在，政府提议要公布专科医生的费用，而且不需要专科医生提供任何信息。

Now, what the government is proposing is that they're going to publish the fees of specialists and they don't need the specialist to put anything in.

他们会从医疗保险、医院和保险公司的账单中提取数据。

They're gonna draw the data from Medicare hospital and insurer billings.

他们会收集这些数据，然后放到网站上。

So they're gonna accumulate the data and they're gonna put it onto the website.

他们说这会增加转诊全科医生和患者的透明度。

And they're saying that it's going to add transparency for both referring GPs and also for patients.

不过，你知道，我对此有些疑虑。

Now, you know, I have some qualms about it.

劳伦，我不确定这是不是解决办法，因为，你知道，如果你现在公布医学界的所有费用，是不允许串通的。

I don't know if this is the solution, Lauren, because, you know, if you publish all the fees at the moment in medicine, there's you're not allowed to collude.

所以我不能去问其他全科医生，你收多少钱？

So I'm not allowed to go and ask another GP, what do you charge?

而且，一群外科医生不能都统一说：我做膝关节置换术就收这么多钱。

And you can't have a group of surgeons all saying, I charge this much for a knee replacement.

大家都定一样的价格。

Let's all charge the same.

所以，串通定价是不被允许的。

So collusion is not allowed.

我确实有点怀疑，公布这些价格，能不能达到政府预期的效果。

And I do wonder if publishing these prices, it's I don't know if it will have the impact that the government desires.

因为大家可能会凑在一起商量，根据其他专科医生的收费标准来定价。

Because people could just be putting putting their heads together and and setting their prices based on what other specialists are charging.

但如果这些信息都公开了，大家都看得到，我敢肯定有些人会想，我可不想做这条街上收费最低的。

Well, if it's exposed and everyone can see it, I'm sure some people are going to go, well, I don't wanna be the cheapest person on the block.

他们会提高费用，去匹配那条街五百米外那位干着同样活儿的人的收费。

I'm going to increase my fees to match this other person who's literally, you know, doing the same thing 500 meters down the road.

我觉得这个问题比单纯提供费用透明度要复杂得多，不过这确实是个好步骤。澳大利亚医学会（AMA）也欢迎这一举措，并表示会密切关注其实施情况，总的来说他们的反应是积极的。

I think the issue is much more complex than just giving fee transparency, though it is a good step and it's a step that's been welcomed by the Australian Medical Association, the AMA, who have said they'll closely watch the implementation of this, but, you know, they're mainly positive in their reaction.

这项法案可能带来的另一个变化是针对私人保险公司的。

The other change that may come about from this bill is with private insurers.

而且，针对一种叫做‘产品凤凰’的现象将会进行严厉打击。

And really, there's going to be a crackdown on something that's called product phoenixing.

简单来说，目前的私人健康保险公司可以这么说：劳伦，你现在的健康保险是金级套餐，但我们会告诉你，今天我们就取消这个套餐了。

And basically, private health insurers at the moment, they can say, you know, Lauren, you might have a gold policy on your health insurance and I'll say to you, well, Lauren, we're removing that today.

我们会推出一个同样叫‘金一级’的产品，而你需要为此多付200澳元。

We're gonna have the same product labeled Gold One, and you now need to pay $200 more for that.

基本上是一样的。

It's basically the same.

但是对于五年前就加入这项政策的人来说，他们仍然享受较低的收费标准，但同样的服务却要付更多的钱。

But for the people who joined the policy five years ago, they're still on the lower fee, but you're paying much more for the same service.

所以这实际上就像是推出同样的产品，只是稍微改动一下，换个名字，让新病人或新客户支付更高的费用？

So it's effectively like putting the same product out there, but maybe changing something slightly, giving it a a different name so that newer patients, newer clients are paying a bigger fee?

是的。

Yes.

其实就是换个包装，换个马甲重新上架。

It's rebranding it and kind of putting it in a different bow.

简单来说，这项修正案要求保险公司在调整现有产品的保费之前，必须先获得部长的批准。

Basically, the amendment is saying that insurers will need to seek ministerial approval before they change premiums for existing products.

所以，私人保险领域可能也会因此增加一些监管措施。

So this may actually bring a little bit more regulation in the private insurance space as well.

顺便提一下，最近关于这方面的新闻还挺多的。

It's worth just saying that there's been some big news items on all of this.

落实这项政策需要花点时间。

This is a, you know, implementing this is gonna take some time.

具体会有多大影响，我也不确定。

How much impact it will all have, I don't know.

不过既然已经发生了，也就这样吧。

But I guess it's, you know, this has happened.

大家不妨持续关注，很快可能就能上网登录，查看你所在区域所有骨科医生的收费情况，从而在财务和选择医生方面做出明智的决定，我觉得这对整个过程来说很重要。

Watch this space and you may soon be able to go onto website, log on, and actually see all the orthopaedic surgeons in your area and what they charge, and make an informed decision when it comes to finances as well as the health professional you choose, which I think is an important part of the process.

接下来这则新闻跟劳伦有关，讲的是痴呆症以及我们最近刚在健康报道中介绍过的一种血液检测。

And Lauren, the next news story revolves around dementia and a blood test that we've covered previously on the health report quite recently, actually.

对。

Yes.

当然。

Of course.

这个测试的结果并不是非黑即白的。

It's not a yes or a no test.

它是在寻找该疾病的潜在生物标志物。

It's looking for potential biomarkers of the disease.

也就是那些可能预示未来会发展成阿尔茨海默病的早期指标。

So early markers that you may potentially go on to develop Alzheimer's disease.

其实就是把各种信息整合在一起。

It's just kind of putting everything together.

这项在澳大利亚试行的检测，目的是当患者开始出现症状时，可以去专科医生那里进行检查。它可以作为诊断工具包中的一环，如果适合这位特定患者的情况，就能帮助确诊阿尔茨海默病。

And and the goal of this test that's being trialed in Australia is so that someone can go to their specialist when symptoms start to develop, and it can be one of the tools in the toolkit to potentially lead to an Alzheimer's disease diagnosis if that's right for that particular patient.

明确一下，我们说的是磷酸化tau蛋白。

Just to be clear, we're talking about the phosphorylated tau protein.

就是最近健康节目报道过的那个指标，正如你所说，它是整体评估的一部分，包括病史和其他检查。

That's the one that we've been covered on the health report recently, and it's part of, as you say, that holistic, the history, other investigations.

它是诊断拼图中的一块。

It's a part of the diagnostic picture.

对，现在悉尼大学有新研究出来了。研究人员分析了188篇帖子，这些帖子在2014年3月到2025年5月期间被分享给了超过1.14亿粉丝。

And so there's new research now out of the University of Sydney, and what the researchers did is they looked at a 188 posts, which was shared to more than a 114,000,000 followers between, you know, March 2014 and and May 2025.

有36%的帖子在讨论或提及无症状筛查的应用，也就是这项检测可以用于那些尚未表现出阿尔茨海默病症状的人群。

36% of the posts were describing or talking about how we could use asymptomatic screening so that this test could be used for someone that wasn't showing symptoms in Alzheimer's disease.

在我们最初讨论这项检测时，大家有些担心，健康人可能会拿它来试探自己会不会出现这些生物标志物。

And at the time when we were first talking about this test, there was a bit of concern that potentially healthy people would be using this test as a bit of a will I potentially show up with these biomarkers?

这背后其实存在两个潜在问题。

So there's there's two problems with this potentially.

其一就是可能出现假阳性结果。

One is that it could be a a false positive.

所以，有些人其实根本不会发展成阿尔茨海默病，却可能因为这项生物标志物检测的结果，误以为自己会得病。

So someone that never goes on to develop Alzheimer's disease believes that perhaps they will because of a result from this biomarker test.

但另一方面，检测结果也可能显示你没有患病，或者根据这些生物标志物得出你不太可能患阿尔茨海默病的结论，而这种结论也可能是错误的。

But the other thing is it could potentially say no, you don't have it or or come up with an unlikely to have Alzheimer's disease diagnosis based on these biomarkers, which could also not be true.

所以我们看到的是，社交媒体上在传播关于这项检测用途的错误信息，而这并不是它的设计目的。

So what we are seeing is misinformation being peddled on social media about how this test should be used, and and that is not its purpose.

我觉得你刚才说得很重要，大家 understandably 对认知障碍和痴呆症感到紧张，这是完全可以理解的。

And I think it's important you've just said, you know, people get quite nervous, understandably, about cognitive impairment, dementia.

所以这其实针对的是一类非常脆弱的群体。

So this is really targeting a very vulnerable group of people.

我看有人讨论这篇论文时，一位专家说，就像社交媒体上很多内容那样，虽然这个说法比较笼统，但大家的兴奋劲儿往往跑在了证据前面。

And I saw in the discussion about this paper, someone, one of the experts said, like a lot of stuff on social media, and this is a very loose, kind of description of the quote, but the excitement can outpace the evidence.

劳伦，这种情况我们见得太多了。医学界刚推出某项新技术或新发现时，研究人员、医护人员乃至整个行业都会谨慎地强调：只有在特定条件下才能使用。可一到社交媒体上，大家就盲目跟风，这可能会带来潜在的危害。

And I we see this so often, Lauren, where there's something new that comes out in the medical field and, you know, the researchers, the health professionals, the the entire profession says, with caution, this is the only time it can be used, but you see people just run with it on social media and it can potentially cause harm.

所以我觉得这是一个非常重要的话题。

So I think it's a very important story.

没错。

Absolutely.

这里是ABC国家广播电台，您正在收听《健康报告》。

On ABC Radio National, you're with The Health Report.

劳伦，几周前我们做过一期节目，讲的是远程医疗诊所给有进食障碍病史的人开GLP-1类减重药的情况。

Lauren, several weeks ago, we did a story looking at GLP-one or weight loss medications being prescribed by telehealth clinics in people with a preexisting eating disorder.

那期节目里，我们请到了凯特，她非常慷慨地分享了自己的经历。

And it was really a story we had Kate, a case study, who very generously shared her experience.

她之前已经被确诊患有神经性厌食症。

She had a pre existing diagnosis of anorexia nervosa.

像她这样有这种病史的人还能用上GLP-1类药物，这可能会带来非常严重的问题。

She was able to attain a GLP-one with a history like that, which can be really, really problematic.

我们也确实关注过远程医疗行业的监管问题，当时还特意请了澳大利亚医疗执业管理局（AHPRA）的负责人来参与讨论。

And we did go into regulation of telehealth industries, and we did ask the regulator AHPRA to come on at the time.

但他们没来。

They didn't.

他们拒绝了，但给了我们一份声明。

They declined, but gave us a statement instead.

今天，我们将跟进这个故事，采访监管机构的CEO。

Well, today, we are going to follow this story up with the CEO of the regulator.

首先，回顾一下凯特的故事。

But first, here's a reminder of Kate's story.

我很难为自己感到担忧，但想到我那么轻易就能接触到这些药物，又想到那么多人在与进食障碍作斗争，这让我同时感到非常害怕。

I have trouble getting concerned for myself, but knowing how easy it was to access for me and knowing how many people struggle with an eating disorder, it actually made me scared at the same time.

对于那些还在与进食障碍作斗争、康复程度远不如我的人，如果他们接触到了这类药物，又无法像我这样因为长期参与康复而建立起合理的认知，那会非常危险。

If people who are struggling with an eating disorder and aren't as far along in their recovery as me do access it and aren't able to rationalize the thoughts that I've been able to do because I've been engaging in recovery for so long.

所以今天早些时候，我采访了澳大利亚医疗执业人员监管局（AHPRA）的首席执行官贾斯汀·安斯特泰纳。

So earlier today, I spoke with the chief executive officer of the Australian Health Practitioner Regulation Agency, AHPRA, Justin Untersteiner.

谢谢邀请。

Thanks for having me.

几周前我们报道过，通过远程医疗诊所获取GLP-1类药物非常容易，尤其是对进食障碍患者而言。

We did a story several weeks ago on the very easy access of GLP-one medications from these telehealth clinics, particularly for people with eating disorders.

我们的收件箱里塞满了大家的来信，很多人说他们尝试向诊所或从业者举报，但在实际操作中遇到了各种经历和困难。

And our inbox was flooded with people reaching out and saying that they'd tried to report either a clinic or a practitioner and their experiences or difficulties in actually doing that.

其中一位联系我们的人是瑞秋。

One of the people who reached out to us is Rachel.

我觉得在向AHPRA举报的过程中，最让人沮丧的一点是，因为我从来没有预约过这家诊所雇佣的护士或全科医生的咨询，所以我无法提供直接举报这位医生的具体细节。

The thing that I think I found the most frustrating about the process of reporting to AHPRA was that because I had never followed through with booking a consult with the nurse or the GP that this clinic employs, I couldn't provide details to report the doctor directly.

所以最后，我唯一能举报这家公司的，也就是他们的一些广告行为了。

And so in the end, the only thing that I could really, you know, report this company for were some of their advertising practices.

我就是担心，这种让公众去举报公司的做法，反而会让那些容易受到伤害的人先遭殃，甚至把自己置于危险之中。而在那之前，这些公司明明没有尽到应有的审慎义务，却什么事都没发生。

And I just am worried that this method of reporting these companies relies on people who are vulnerable to get harmed themselves or put themselves in harm's way before anything can be done about these companies which are very clearly not exercising their due diligence.

我补充一下背景情况：瑞秋在2025年6月收到了收件确认函，贾斯汀，但从那以后就再没收到任何消息，之后也没有和AHPRA有过任何正式接触。

I should add for context that Rachel received an acknowledgment of receipt, Justin, in June 2025, but has heard nothing since then, had no formal interaction with AHPRA since then.

瑞秋的经历是特例吗？还是说AHPRA在处理这类投诉时经常遇到类似的情况？

Is Rachel's experience a unique one, or is this something that AHPRA is seeing a lot of in terms of complaints in this area?

嗯，这么说吧。

So, look.

首先，如果Rachel还没有收到回复，我感到很失望，作为AHPRA的CEO，我一定会跟进这件事。

First of all, you know, I am disappointed if if Rachel hasn't had a response, and that's something I will certainly follow-up, as CEO of AHPRA.

我的意思是，我们确实需要和那些向我们反映情况的人保持良好的沟通，因为这是保障我们体系安全的重要机制。

I mean, it's really important that we are, you know, communicating well with those that are coming to us because it's a really important mechanism for the safety of our system.

说实话，和你一样，我们对目前某些肽类药物的处方量过高感到担忧，我们也担心这可能会造成伤害，尤其是当处方不当的时候。

I mean, we are concerned, really concerned as you are, about high levels of prescribing of particular peptides at the moment, and we're concerned about the harm that that might be causing, particularly with inappropriate prescribing as well.

我们现在监管着近一百万名医疗从业人员。

We now regulate, almost 1,000,000 health practitioners.

今年晚些时候，这个数字就要突破了。

We're about to tip over that number, later this year.

随着从业人员数量的增加，投诉量也随之上升。

And and with that growing workforce, we've seen an increase in complaints.

但我们要说清楚的是，针对肽类药物处方的投诉并没有相应增加。

But what we're not necessarily seeing is an increase in complaints as it relates to peptide prescribing, for instance.

这里有个难点：很多时候，只要患者拿到了他们想要的药，即便处方本身可能不当，他们也不会向我们投诉。

And one of the challenges we have there is that we know that in many cases, aren't complaining to us when they receive the medicine that they were seeking, even if, of course, prescribing may have been inappropriate.

不过话说回来，我们也在做投诉之外的工作。

In saying that, though, there's work that we're doing outside of complaints.

我们想在伤害发生之前就预防它。

We wanna be preventing harm before it occurs.

但是，贾斯汀，有很多人联系了我们，说——雷切尔的故事只是其中之一。

But, Justin, there are a lot of people who reached out to us and said and and Rachel's story is just one of them.

但很多人说，我举报过这个。

But many people saying, I've reported this.

但什么都没发生。

Nothing has happened.

什么都没改变。

Nothing has changed.

我还在被这些远程医疗诊所的广告轰炸。

I'm still being bombarded by advertisements from these telehealth clinics.

获取药物还是很容易。

It's still very easy access.

你知道，人们会想，举报有什么用呢，反正也没结果。

You know, people kinda go, what's the point in reporting because nothing happens?

他们觉得监管机构其实什么都没做。

They feel like the regulator doesn't actually do anything.

好吧，听你这么说，我确实感到失望。

Well, look, again, I'm disappointed to hear that.

我的意思是，我能告诉你的是，我们并没有看到大量投诉进入系统。

I mean, what I can tell you is we're not seeing a large number of complaints come into the system.

需要说明的是，我们确实在采取行动。

Just to clarify, we are out there taking action.

就在这周，我们发布了针对从业者的新指南，明确列出了我们对超适应症处方获批产品的期望。

Just this week, we've released new guidance for practitioners which expressly outlines our expectations when prescribing off label one approved products as well.

我们也在与联邦政府、各州和领地积极沟通，以获取更多的处方数据。

We've been in active conversations with the Commonwealth government, with states and territories to get access to increased prescribing data, as well.

但对我来说，Kia，我们在谈的是受监管的。

But to me, Kia, we're talking about we're talking about regulated.

我知道你们这周发了一个关于未监管肽类药物的媒体声明。

I know you've done a media release this week on unregulated peptides.

我知道你说投诉数量很少，但当然，那些为了诱发或维持进食障碍而寻求这些药物的人，正如你提到的，可能不会去举报。

And I know you're saying a small number of complaints, but of course, potentially seeking these medications to fuel or maintain an eating disorder, as you allude to, may not be the people to report it.

但AHPRA两年前就成立了一个快速反应小组，用AHPRA的话说，是为了打击不道德的商业行为和处方行为，包括涉及医用大麻和减肥药的情况。

But AHPRA has established a rapid response unit two years ago, to quote AHPRA, to tackle unethical business practices and prescribing, including for medicinal cannabis and weight loss medications.

那是两年前的事情了。

That was two years ago.

而且作为一名一线临床医生，贾斯汀，作为全科医生，从我们收到的邮件和反馈来看，情况似乎没有任何改变。

And as a clinician on the ground, Justin, as a GP, and from the inbox that we're getting and and the emails, nothing appears to have changed.

看起来监管机构在监管方面确实落后了，尤其是在这些存在利益冲突的远程医疗诊所中，如果一边开药一边配药，却没有对患者进行充分评估、提供全面护理以及筛查进食障碍，它们反而能蓬勃发展。

That it appears as if the regulators really behind the eight ball in terms of regulation and these telehealth clinics where there is a conflict of interest, if you're prescribing and dispensing and not adequately reviewing people and providing wraparound care and screening for eating disorders are able to thrive.

我明白。

I know.

你看。

Look.

我同意，这确实是一个变化迅速且令人担忧的领域。

I agree that this is a really changing and concerning area.

疫情之后，远程医疗迎来了爆发式增长。我们知道远程医疗能带来很多好处，但在某些情况下使用它也存在风险。

We've seen this boom of telehealth post the pandemic, and we know telehealth can do wonderful things, but there are also risks attached to the use of telehealth in certain situations.

我们看到各种技术成为医生与患者互动的一部分，但这有时反而减少了他们与患者的直接接触。

We're seeing different technologies form part of the way that practitioners may engage with patients, and sometimes that's reducing contact that they're having with patients.

正如你刚才描述的，那些闭环或垂直整合的商业模式正在兴起。这意味着有些公司既做产品广告，又开处方，还负责配药。

We're seeing, as you've just described there, those closed loop or vertically integrated business models are growing and popping up, meaning that you've got businesses that are advertising products, prescribing them, and dispensing them.

我们确实觉得，有时候他们更看重利润，而不是患者的安全。

And we really believe at times focusing on profit rather than patient safety.

然后呢，这里还有另一个问题，就是社交媒体。

And then we've got, of course, the other issue here too, which is social media.

你知道的，越来越多人转向社交媒体和网红寻求建议，包括健康方面的建议，但这些提供建议的人可能并没有相应的资质。

You know, more and more people are turning social media and influencers for advice, including health advice, from people who may not be qualified to provide it.

这些情况无疑给市场甚至监管机构（比如AHPRA）都带来了挑战。

And those things are certainly creating challenges for the market and even for regulators, including AHPRA.

这毫无疑问。

There's there's no doubt about it.

这段时间确实很艰难。

This has been a challenging period.

我们刚才在广告，因为你提到了社交媒体。

We are on advertising for a second there because you've mentioned mentioned social media.

这似乎是监管方面的一个空白地带。

This is where there appears to be a bit of a gap in terms of regulation.

TGA负责部分广告监管。

The TGA does some of the advertising.

AHPRA说我们监管从业者，是的。

AHPRA says we we regulate practitioners and Yep.

健康专业人士。

Health professionals.

然而，贾斯汀，我不知道你有没有看到，凯特，还有我们之前节目里的瑞秋，这些人都成了目标。

And yet, I don't know if you've seen it, Justin, but, you know, our stories, Kate, our previous person who spoke on the show, Rachel, these people have been targeted.

他们在社交媒体或播客上有过饮食失调的病史。

They've got a preexisting history of an eating disorder on social media or on a podcast.

监管机构的全部意图是保护公众。

And the whole intention of the regulator is to protect the public.

它失败了吗？

Is it failing?

比如，为什么在广告领域没有采取更多措施？

Like, why isn't more being done in the advertising realm?

这些远程医疗公司轰炸人们，并且只是在边缘试探，看看什么才算合规。

These telehealth companies bombard people and just skirt the boundary in terms of what is just okay.

听着。

Look.

我可以告诉你，我们正在积极调查和处理，不仅涉及广告，还有处方。

I can tell you we are actively out there investigating and tackling not just advertising, but prescribing as well.

我们现在讨论的是减肥药，但你也知道，我们也看到了同样的商业模式，在医用大麻处方和广告方面也出现了繁荣，其他多肽类药物也是如此。

We're talking about weight loss drugs right now, but, you know, we've also seen using the same kind of business models we saw a boom in medicinal cannabis prescribing, and advertising as well, and we're seeing it with other peptides.

我们现在有大量调查正在进行中，正在对诊所进行审计。

We have a large number of investigations that are currently underway where we are auditing practices.

我们在审计广告。

We're auditing advertising.

我们在审计从业者的广告和处方习惯。

We're auditing practitioners about both advertising and and prescribing habits.

我们看到药用大麻的处方量大幅增加。

We saw a a huge increase in prescribing rates of medicinal cannabis.

我们采取了一系列措施来应对这个问题。

We took a range of steps to lean into that.

我们发布了新的指导方针，明确我们对从业者的期望。

We released new guidance to be very clear about what we expect from practitioners.

我们收集了新数据，以便找出高处方率的地方。

We collected new data so we could go and identify where there was high prescribing happening.

我们审查了广告，并对违规者采取了行动。

We looked at advertising, and we took action against those doing the wrong thing.

就在最近，报告显示在我们采取这些措施后，药用大麻的销售量已经下降了。

Just recently, reports found that medicinal cannabis sales have fallen since we have undertaken this action.

事实上，这与自2016年以来该行业持续增长的态势形成了鲜明对比。报告明确指出，药用大麻销售额的下滑正是由于我们加强了监管和执法力度。我们现在也正以同样的方式大力加强对减肥药的管控。

And in fact, this contrast with the continuous growth in the industry that had been occurring since 2016, and the report very much attributed the decline in medicinal cannabis sales to our increased regulatory work and enforcement, we are absolutely leaning into weight loss drugs in the same way.

目前，我们有超过50个调查正在同时进行。

Right now, we have over 50 investigations that are happening right at this minute.

我正在看

I'm looking

是在健康诊所层面，还是针对个体执业者？

at health clinics or of individual practitioners?

如果是关于处方的问题，那自然是指执业者本人。

So when it relates to prescribing, obviously, it's the practitioner themselves.

而如果是涉及广告的话，可能就会指向诊所本身。

And when it relates to advertising, it can relate to the clinic.

贾斯汀，目前大家对AHPRA（澳大利亚卫生专业注册局）的信任度有所下降，我相信你也清楚这一点。我认为无论是医疗行业内部还是公众群体中，都有一种看法，认为监管机构的存在是为了保护大众。

Justin, there's a kind of loss of faith in AHPRA, and I'm sure that you're aware of this, and I think it's both within the health profession and in the community that the regulator is there to protect the public.

而且我觉得它失败了。

And it's failed, I think.

我觉得它一直在追赶。

I think it's playing catch up.

在远程医疗行业里它落后了，而且最近Four Corners节目谈到妇科医生西蒙·戈登的时候，也提到了这一点。

It's behind the eight ball in the telehealth industry, but also recently Four Corners when they talked about Simon Gordon, the gynecologist.

有消息透露，很多人——包括医疗专业人士和社区成员——都向AHPRA举报过，但都被驳回了。

It was revealed that multiple people, health professionals, community members had made reports to AHPRA which had been dismissed.

AHPRA知道这件事吗？

Is is AHPRA aware of this?

那你们怎么重新赢得行业和社区的信任呢？

And how do you claw back people's trust with within the profession and the community?

我可以告诉你的是，我一年多前被任命为CEO，第一年我花了很多时间出去跟社区里的人、医生和社区成员交流。

What I can share with you is I was appointed as CEO just over a year ago, and I spent my first year getting out and speaking to many, many people in the community, practitioners, community members.

过去五年里，确实有一些人对我们失去信任和信心，部分原因是我们作为监管机构，对某些问题的回应速度不够快。

There were certainly some concerns over the last five years about, you know, some losing trust and confidence, and and some of that related to how quickly, as a regulator, we responded to particular issues.

我们确实非常重视这一点。

And we've really taken that seriously.

我们推出了一项全新的五年战略，重点涵盖多个领域，其中关键的一点就是预防伤害。

We've we've rolled out a brand new strategy for the next five years, which is focused on a range of areas, but one of the key areas here is harm prevention.

她的角色就是要主动出击，尽早识别风险，并深入介入处理。

Her role must be getting out there on the front foot, identifying risks early, and leaning in.

在过去十二个月里，我们一直在投资更先进的技术和工具，确保我们有能力做到这些，我觉得我们正在取得非常显著的改进。

Over the last twelve months, we've been investing in better technology and tools to make sure that we're equipped to do that, and I think we're making some really incredible improvements.

你的意思是，你们正在针对减肥针剂的可及性开展多项调查。

You're saying that you're doing multiple investigations in terms of the weight loss injection space and accessibility.

你觉得在监管方面，要过多久才能看到这方面的潜在影响和改变？

How long do you think it will be until we see potential impact and change in this area in terms of regulation?

那些正在收听节目、对此感到担忧的听众，他们应该怎么做呢？

And what should people who are listening, who have concerns in this realm, what should they be doing?

你觉得我们最终能公开了解到这些调查的结果吗？

And do you think we'll ever know publicly what the results of these investigations are?

因为我觉得听众们可能在想，我是不是该去投诉？投诉之后我能知道结果吗？

Because I think people are listening going, oh, is it worth me putting in my complaint, and will I know the outcome?

我非常鼓励大家，如果发现处方或广告方面存在合理的问题，就向我们反映。

I really encourage people to come to us when they can say that there's a legitimate issue as it relates to prescribing or advertising.

这虽然只是我们获取信息的渠道之一，但确实非常重要。

It's not the only signal that we have, but it's a really important signal.

收到投诉后，我们就有了充分的证据，可以据此采取行动。

And when we have complaints, that gives us a body of evidence that allows us to act.

但即使你像Rachel那样没收到AHPRA的回复，既然她觉得监管机构已经搁置了这件事，你觉得还有必要去跟进吗？

But even if you don't get a response from AHPRA like Rachel, is it still worth it when she thinks it's been parked by the regulator?

当然有必要。

Absolutely.

另外得说明白一点，我们受特定法律法规的约束，哪些话能说、哪些不能说，哪些事能做、哪些不能做，都有明确规定。

And and to be clear, we are bound by particular legislation, what we can and can't say, and what we can and can't do.

所以有时候，我们可能无法向提交投诉的人反馈具体的处理结果。

And so, just because, there are times when we might not be able to provide back to the person that's given us a complaint exactly what outcome has been achieved there.

但这并不代表我们没有采取行动。

But it doesn't mean that we're not taking action.

Justin，关于透明度这个问题，你说你目前可能有50个调查在进行中。

Justin, just on the issue of transparency, because you might be investigating, as you said, 50 investigations at the moment.

我猜其中应该有一些涉及医用大麻的案件。

I assume there's some in medicinal cannabis.

有些从业者一直在被调查。

There's practitioners who are constantly being investigated.

说到透明度，大家可以在AHPRA官网上输入名字查询，但系统不一定能直接显示该医生或机构正在接受调查。

In terms of transparency, people can go onto the AHPRA website, type in a name, and it may not necessarily come up that they're under investigation.

无论是诊所、远程医疗诊所，还是具体的执业医师，情况都是如此。

Clinic, the telehealth clinic, or the practitioner.

我就在想，当我们挑选医疗服务提供者时，难道我们不应该有权获得足够的信息，以便做出明智的选择吗？

I'm just thinking, you know, when I go and choose a health care professional, don't we deserve transparency to make an informed decision on who we see?

我们在这里需要平衡的，一方面是关乎公共安全的重大责任，另一方面也要兼顾对从业者或医疗机构的程序公正。

What we will be always balancing here is our really important paramount responsibility about public safety, but also with procedural fairness for a practitioner or for a practice.

过去一年里，我们收到了12500起针对从业者的投诉，并且我们会对这些投诉展开调查。

In the last year, received 12 and a half thousand complaints about practitioners, and we'll investigate those complaints.

不过，并不是所有的投诉最终都能证实从业者存在某种不当行为。

Not all of them, though, end up in demonstrating that there had been some kind of poor practice from the practitioner.

因此，在调查过程中，确保对从业者有一个公平的处理流程是非常重要的。

And so it's important that we have a fair process for the for a practitioner when we're investigating them.

如果我们公开发布信息说他们正在接受调查，我认为这会在调查结束前就让他们几乎等同于有罪了。

If we were to publish something to say that they're under investigation, I think there's a real risk that we would be almost guilty, before an investigation has been complete.

不过，一旦我们采取了行动，就会在公共登记册上公布，让大家都看得到。

Once, though, we have taken action, we do publish that in the public register for everybody to see.

对此我有不同看法，贾斯汀。

See, I would argue with that, Justin.

你知道那位阿尔莫达里斯医生吧，媒体应该都报道过他，据说他涉及多起医疗过失诉讼，其中一些已经和解了。

So, you know, doctor Almodaris, I think people will have seen in the media, who has allegedly had multiple medical negligence lawsuits, some of which have been settled.

但如果你去查这位执业者的AHPRA档案，上面什么也没有。

If you go on to that practitioner's AHPRA profile, there's nothing there.

所以即使有潜在的行动或者已经有一些法律结果，对选择医疗专业人员的患者来说，也不一定透明。

So even if there is potential action or there has been some sort of legal outcome, it's not necessarily transparent for patients who are choosing their health professional.

我的意思是，我不能谈论个别从业者，可能在网上也不会谈。

I I mean, I can't talk, and I probably won't online talk about individual practitioners.

但是，再次强调，按照标准做法，实际上根据法律，当AHPRA和我们的委员会对从业者采取了行动，那会出现在公共登记册上。

But, again, as a standard practice, and under the law, actually, where AHPRA has and our boards have taken action against the practitioner, that will appear on the public register.

我不能谈论那些具体情况。

I can't talk about those particular circumstances.

我很乐意去查看一下。

I'm happy to go and have a look at that.

但那就是我们做的。

But that is what we do.

而且最近还扩大了范围。

And that's even been expanded recently.

我们现在会公布更多关于性行为不端等问题的新信息。

We're now publishing further information around issues such as sexual misconduct and other things as well.

我们正在尽力提供尽可能多的信息。

We're trying to provide as much information as we can.

贾斯汀，澳大利亚健康从业者监管机构（AHPRA）的首席执行官。

Justin, chief executive officer of the Australian Health Practitioner Regulation Agency or AHPRA.

您正在收听ABC广播国家台的《健康报告》节目。

On ABC Radio National, you're with The Health Report.

你提到了睡眠不足对你孩子的影响，我得说我自己处理得一点都不好。

Now you mentioned the impacts of sleep deprivation with your children, and I have to say I didn't deal with that at all well.

无论是怀孕期间还是产后，我都是一个不太能忍受睡眠不足的人，所以我不做轮班工作。

In either pregnancy or postpartum phase, I am just not a person who deals well with a lack of sleep, and that's why I am not a shift worker.

我实际上选择了全科医学，这样我就不用半夜起床了。

I actually chose general practice, so I would never have to wake up in the middle of the night.

这对我的身体和大脑都不好。

It's just not good for my body or my brain.

《柳叶刀》妇产科杂志上发表了一篇文章，真是令人大开眼界。

There's a piece that's been published in The Lancet, Obstetrics and Gynecology, which is eye opening.

我们平时总爱开玩笑说，哎呀怀孕的时候太累了，睡眠也不好，生了新生儿后半夜要起来上千次。

And all these jokes that we tend to make about, oh, I'm so fatigued, and my sleep is off in pregnancy, and I'm up a thousand times in the night with the newborn.

结果发现，这其实对母亲的代谢健康和心血管健康都有不少风险。

It turns out it can actually have a lot of risks when it comes to metabolic health and cardiovascular health for the mother.

而且，这对婴儿也可能产生潜在的影响。

But there are also potential implications for the infant.

我还跟这篇论文的作者之一海伦·柯林斯聊过，她是路易斯维尔大学心脏代谢科学中心的助理教授。

And I spoke to one of the authors of this piece, Helen Collins, who's assistant professor at the University of Louisville Center for Cardiometabolic Science.

我们的研究发现，这种情况从怀孕早期——也就是孕早期就开始了。那时候身体里的各个器官都在扩张，并且不得不适应怀孕带来的各种需求。

Our research is finding that this starts as early as the first trimester of pregnancy where all the organs in the body are expanding and having to adapt to the demands of pregnancy.

孕早期是睡眠容易受到干扰、非常脆弱的阶段。

First trimester is a period of heightened vulnerability for sleep disruption.

接着看产后初期，我们发现这两个时期（孕早期和产后初期）都会导致代谢特征发生很大变化，比如血糖紊乱、循环中的脂质水平改变。

And then also moving along to the early postpartum period, we found that both that and the first trimester associated with a lot of changes in metabolic profiles disrupted blood glucose and circulating lipids changed.

对于那些需要倒班工作的女性来说，这种状况会进一步加重。

And this is exacerbated in women that have the jobs that include shift work.

孕妇从事轮班工作，实际上会导致母体生理出现许多不良变化。

Shift work in pregnant women is actually associated with a lot of adverse changes in maternal physiology.

我觉得海伦，孕期出现的很多睡眠紊乱其实被过度正常化了。

I feel like, Helen, a lot of the sleep disruption that happens in pregnancy is really normalized.

我记得自己怀孕的时候，跟朋友聊天都说，哎呀，睡眠完全乱了套。

You know, I remember being pregnant, you talk to your friends and you go, oh, you know, the sleep is completely off.

不过你在《柳叶刀·妇产科》上发表的那篇论文里确实提到，孕期可能成为女性生命中最危险的阶段之一，尤其是在心血管健康方面。

In your paper though, published in Lancet Obstetrics and Gynecology, you actually say this line, pregnancy has the potential to be one of the most dangerous periods of a woman's life, particularly with respect to cardiovascular health.

你能具体说说你这句话是什么意思吗？

Can you just talk us through what you mean by that statement?

我觉得这个说法挺有分量的。

Because I think it's quite a powerful one.

我们这一行的人常把怀孕比作大自然给心血管做的一次压力测试。

We in the field describe pregnancy as nature's cardiovascular stress test.

对于有些本身就有潜在问题的女性来说，这些隐患就会被暴露出来，甚至可能诱发心血管疾病。

For some women that have underlying issues, these become exposed such that they could precipitate in a cardiovascular disease for them.

但对很多女性来说，怀孕带来的额外压力，加上她们在怀孕前健康状况不佳、饮食不够理想，或者缺乏有效的压力和睡眠管理方式。

But for many women, the additional stress, the entering pregnancy, not in the best health or not having the best diet or ways of managing stress or sleep.

在这项研究中，如果女性在进入孕期时本身就带着这些额外的压力因素，再加上怀孕本身就像一场心血管的压力测试，这就可能成为压垮骆驼的最后一根稻草，促使血糖调节失衡等问题的出现。

In the case of this paper, if they go into pregnancy and with those additional stressors on board in combination with nature's stress test of pregnancy, then that could create a tipping point to really push forward some of those factors such as dysregulation in blood glucose.

不过我们回到孕期睡眠这个问题，你提到睡眠可能会受到很大干扰。

If we just pick up on the sleep in pregnancy though, you've you've mentioned that it can be quite disrupted.

然后是的。

And then Yeah.

你提到这其实会导致不良的妊娠结果。

You talk about the fact that it can actually contribute to adverse pregnancy outcomes.

孕期睡眠不好会对结果产生什么影响？

How does poor sleep in pregnancy impact the outcomes?

会有哪些潜在的连锁反应？

What are the potential flow on effects?

所以，身体里很多修复过程和生理调节在睡眠阶段都会加强。

So many of the repair processes that occur in the body and physiology are heightened during our sleep phase.

所以如果睡眠被打乱，血糖就会在不该高的时候飙升，这会引发各种问题，比如导致妊娠期糖尿病、子痫前期等，还会带来其他一系列并发症。

So if sleep is disrupted, then the blood glucose is spiking when it doesn't need to be, and that can create issues and precipitate factors like gestational diabetes, the development of preeclampsia, and several other factors can come about because of that.

另外还有一点要注意，睡眠紊乱不仅会打乱休息和活动的规律，还会干扰进食和禁食的周期。

But also one other factor to bear in mind is not only sleep disrupts the rest activity patterns, but also it disrupts your feeding and fasting periods as well.

如果你本该睡觉的时候醒着，还在那时候吃东西，这会让代谢指标如血糖和血脂更加失调。

So if you're awake when you're supposed to be sleeping and perhaps you eat during that time, it could also further dysregulates metabolic factors such as blood glucose and lipids.

这些都是心血管疾病的重要风险因素。在此之前，我们不仅能看到糖尿病风险和子痫前期的增加，有些女性甚至会出现围产期心肌病。此外，对胎儿也会有不良影响，比如子宫内的睡眠紊乱和代谢异常，可能会通过表观遗传机制影响宝宝的发育，从而增加后代患心血管疾病的风险。

They're all significant risk factors for the development of heart disease, but before that we can also see changes in not only diabetes risk but also the pre eclampsia, development of peripartum cardiomyopathy in some women, but also we can see adverse impacts on the resultant offspring such that whatever happens in utero, for example, if there's disrupted sleep, disrupted metabolism, that also can epigenetically modify the growing baby such that there's an intergenerational risk of cardiovascular disease as well.

而且，如果在孕期存在这些风险因素，也会增加日后患心血管疾病的风险。

But also having these risk factors during pregnancy can also heighten your risk of cardiovascular disease later in life.

所以刚才我们主要聚焦在孕期。

So we've just focused on pregnancy there.

也就是孕期的睡眠问题。

You know, sleep in pregnancy.

但到了产后阶段，海伦，这也是我们都经历过的，睡眠又会再次受到干扰。

But then in the postpartum phase, Helen, which we've both experienced, you are sleep disrupted again.

这太正常了。

It's so normalized.

你得起来喂奶。

You're up to feed.

你起来是因为，你知道，激素的原因。

You're up because, you know, hormonal factors.

在产后这个阶段，哪些因素会影响睡眠质量？

What kinds of things impact sleep quality in that postpartum phase?

因为不只是新生儿会醒，对吧？

Because it's not just the newborn waking up, is it?

还有其他生理上的变化在发生。

There are other biological things happening.

新生儿在头六到八周其实没有昼夜节律，因为他们还不习惯我们定义的白天和黑夜，因为他们习惯了子宫里的黑暗。

Newborns, they don't actually have a circadian rhythm for a round the first six to eight weeks because they're not used to what we define day and night because they are used to the womb and it's dark.

他们没有那种内在的生物钟。

They don't have that inbuilt clock.

所以他们的生物钟还没完全建立起来。

So they don't have that inbuilt clock programmed yet.

所以在产后这段时间，睡眠被打乱是夫妻双方都要面对的问题。这既包括因为频繁喂奶和夜醒导致的睡眠中断，也涉及产后体内激素和身体发生的巨大变化。

So that is something that has to be dealt with, I guess, with the mother and the father in the postpartum period, that sleep disruption that you get from the frequent feedings and wakings, but also there's a lot of hormonal changes and body changes that are occurring in the postpartum period.

另外，如果过了六周还没有继续接受产后医疗保健，那对产妇来说就是一个比较脆弱的时期。这种脆弱性不仅存在于前六周的睡眠紊乱期，甚至可能持续到产后一年。

And then also, if you're not necessarily receiving postpartum health care past six weeks, That's a period of vulnerability with women in the postpartum period regardless of sleep disruption in the first six weeks and up to one year postpartum.

很多心血管事件就发生在这个阶段。

That's when a lot of cardiovascular events occur.

对有些女性来说，这也是一个缺乏长期产后护理的时期。

That's also, in some women, a period in which they don't receive long term maternal care.

海伦·柯林斯，路易斯维尔大学心脏代谢科学中心副教授。

Helen Collins, assistant professor, University of Louisville, Centre for Cardiometabolic Science.

在ABC国家广播电台，您正在收听《健康报告》节目。

On ABC Radio National, you're with The Health Report.

我们接下来的故事，劳伦，是诺曼和我之前报道过不少的话题，标题都与戈舍瑞林有关。

Our next story, Lauren, is something that Norman and I have covered quite a bit on with headlines around Zoladex.

就是那种常用于治疗乳腺癌的药物，低剂量版本。

That is the medication that's often used in breast cancer, the lower dose version.

它已经被从药品补贴计划中移除了。

And it's been removed off the PBS.

这给患者带来了很大的焦虑和痛苦。

It's caused significant anxiety and distress for patients.

我们报道过这个故事，以及患者如何继续获得这种药物。

We've covered that story and how patients can continue to access it.

诺曼采访了管理Zoladex的阿斯利康公司。

And Norman spoke with AstraZeneca, the company who manages Zoladex.

没错。

That's right.

美国人为新药支付的价格是世界上最高的之一。

Americans pay one of the highest prices for new medications in the world.

这就是特朗普总统这项新政策背后的原因。

And that's the reasoning behind this new policy of President Trump.

我和托马斯·黄医生聊过。

I spoke to doctor Thomas Huang.

他是布里格姆妇女医院的助理教授，也是哈佛医学院的教员。

He's the assistant professor at Brigham and Women's Hospital and faculty of Harvard Medical School.

他主导了一项新的建模研究，探讨了美国药品定价政策的影响以及它将在全球范围内如何发展。

He's headed up a new modeling study, which looked at the impact of The US's pricing policy for medicines and how it's going to play out in a global space.

最基础来说，最惠国定价本质上就是价格匹配。

At its most basic form, most favored nation pricing is essentially price matching.

也就是说，对于同一家公司和同一种产品，美国希望公司能将在其他国家谈判的价格也提供给美国。

It's saying for the same company and the same product, The United States wants companies to give the price that's negotiated in other countries also to The United States.

那么澳大利亚是最惠国之一吗？

And is Australia one of the most favored nations?

这如何影响我们国家药品支付的价格？

How does that influence the prices paid for drugs in our country?

是的。

It is.