全民适用奥兹匹克？

互联网文化如何重塑全球各地的成人仪式？

How is Internet culture shaping coming of age rituals around the world?

'跟我一起准备'视频又是如何触达新受众的？

And how are get ready with me videos reaching a new audience?

你好。

Hi there.

我是伊莎贝拉·罗塞里尼。

I'm Isabella Roussellini.

在欧莱雅集团最新一期《这不是美容播客》中，我们了解到一位伦敦科技记者和一位准备十五岁成人礼的墨西哥少女如何通过美妆影响互联网。

In the latest episode of this is not a beauty podcast from L'Oreal Group, we learn about how beauty is shaping the Internet from a London based tech journalist and a Mexican teenager preparing for her quinceanera.

立即在您喜爱的播客平台收听。

Listen now on your favorite podcast platform.

这里是《纽约时报》的娜塔莉·基特罗夫。

From The New York Times, I'm Natalie Kitroef.

这里是《每日播报》。

This is The Daily.

未来一年，随着特朗普总统承诺降低药价，制药商争相推出口服剂型，像Ozempic和Mounjaro这类GLP-1药物可能对数百万美国人变得触手可及，这或将引发减肥领域的下一场革命。

In the coming year, GLP one drugs like Ozempic and Mounjaro may become way more attainable for millions of Americans as President Trump promises to lower their cost and drug makers race to release them in pill form, paving the way for what could be the next revolution in weight loss.

今天，我的同事伊莎·纳尔逊将讲述这个关于药物可及性的故事——实际上始于多年前，当时某家公司发明了这些药物的初代版本，却最终失去了对它们的控制权。

Today, my colleague Isha Nelson, on how that story of accessibility actually started years ago, when one company invented the first version of these drugs and then lost control of them.

今天是11月14日，星期五。

It's Friday, November 14.

伊莎，你一直在报道Ozempic这类新型减肥药物，我们注意到人类与这类药物的集体关系可能正面临重大转折点。

Isha, you've been covering Ozempic and this new class of weight loss drugs, and we're coming to you because it seems as though we may be approaching a real turning point in our collective relationship to these medications.

那就跟我聊聊你对此刻的看法吧。

So just tell me about how you're thinking about this moment.

是的。

Yes.

我认为我们无疑正处在一个转折点，至少正朝着这类新型减肥药的下一阶段迈进。

I think we are definitely at some sort of turning point or at least heading towards the next stage of these new class of weight loss drugs.

这些药物已上市几年，但尽管美国有上亿人被归类为肥胖患者，目前仅有几百万人使用这些药物。

They've been available for a few years now, but despite there being a hundred million Americans, for example, who are classified as obese, only a few million people are using these drugs.

因此我认为，我们正接近一个关键节点——药物可及性将大幅提升，更多人群可能开始使用。

So we are, I think, getting to this point where access will really broaden and many more people might start to use them.

这源于一个重大变化：这些药物将以片剂形式面世。

And that's because one of the big changes we can expect is that these drugs will become available in pill form.

因为目前它们只能通过注射使用。

Because at the moment, you can only use them as injections.

需要每周注射的特性可能让部分人望而却步。

They're weekly injections that might deter some people.

但我认为这些药片将彻底改变减肥药物的可及性，它们将于明年初正式上市。

But I think these pills could really revolutionize the access to weight loss drugs, and those pills just start to hit the market early next year.

这影响深远。

That's huge.

没错。

Yeah.

确实如此。

It is.

另一项能大幅提升更多美国人获取途径的举措，是特朗普总统最近宣布的一项协议。

And the other thing that could widely increase access to many more Americans is the deal president Trump recently announced.

没错。

Right.

跟我讲讲那个协议。

Tell me about that deal.

是的。

Yes.

就在上周，特朗普总统在椭圆形办公室会见了诺和诺德和礼来公司的负责人。

So last week, president Trump got into the Oval Office, the heads of Novo Nordisk and the heads of Eli Lilly.

这两位先生，他们确实是真正的明星，很荣幸能在白宫接待你们。

Well, both of these gentlemen, they're they really are stars in the truest sense, and it's an honor to have you in the White House.

这两家公司正是生产你可能听说过的减肥药物的厂商。

These are the two companies that are responsible for making the weight loss drugs that you probably know about.

诺和诺德是Ozempic和Wegovy的制造商。

So Novo Nordisk is the maker behind Ozempic and Wegovy.

还有礼来公司。

And then you also have Eli Lilly.

他们生产Mounjaro和Zepbound。

They make Mounjaro and Zepbound.

应该说，房间里有很多人。

There's a lot of people in the room, I should say.

奥兹医生也在场。

Doctor Oz is there.

RFK小罗伯特在那里。

RFK junior is there.

参与这些谈判的其他几位工作人员也在场。

Several other members of staff who have worked on these negotiations are there as well.

而特朗普总统，你知道的，他称这东西为'肥胖药'。

And president Trump, you know, he calls this the fat drug.

我管他叫'肥胖药'。

I call him the fat drug.

然后

And

他环顾房间，开始询问

he looks around the room and he starts asking

霍华德，你用过这玩意儿吗？

Do you take any of this stuff, Howard?

还没。

Not yet.

好吧。

Okay.

很好。

Good.

你知道谁在用这个吗？

You know, who is taking this?

天啊。

Oh my god.

我们有史蒂夫，史蒂夫在哪？

We have Steve where's Steve?

她在这里吗？

Is she here?

白宫的公关负责人？

Head of public relations for the White House?

他正在接受。

He's taking it.

这无疑是减少服用这些药物禁忌的一种方式。

This is certainly one way to reduce the taboo of taking these drugs.

是啊。

Yeah.

是啊。

Yeah.

直接告诉大家谁在服用就行了。

Just tell people who is who's on it.

没错。

Exactly.

特朗普总统还召集这些公司的负责人到办公室，宣布他们将降低药价并大幅增加这些减肥药物的可及性。

And president Trump got the heads of these companies into his office to announce that they were gonna lower drug prices and massively increase access to these weight loss drugs.

重要的是，联邦医疗保险和医疗补助终于将为数百万肥胖患者支付这些减肥药物的费用。

Significantly, Medicare and Medicaid will finally cover the cost of these weight loss drugs for millions of patients suffering from obesity.

所以在此之前，你无法通过联邦医疗保险获得这些减肥药物。

So up until now, you couldn't get these weight loss drugs through Medicare.

所以你可以获得诺和泰（Ozempic），这是一种针对糖尿病销售的药物，但医疗保险此前禁止使用纯减肥药物，而这项协议将改变这一现状。

So you could get Ozempic, which is the drug that is marketed for diabetes, but Medicare prohibited access to drugs that are purely for weight loss, and this deal will change that.

特朗普总统是被遗忘的美国人的朋友。

President Trump is the friend of the forgotten American.

肥胖本质上是一种贫困病，而这些药物过去只有富人才能享用。

Obesity is a disease of poverty, overwhelmingly, and these drugs have only been available for people who have wealth.

小罗伯特·肯尼迪和奥兹医生都谈到特朗普总统是为美国被遗忘的群体发声的。

RFK junior and doctor Oz, they talk about president Trump being here for the forgotten man of America.

我们正在推动这些药物的普及化，履行道德使命确保所有美国人都能获得治疗以避免...

And we are democratizing access to these medications and dealing with a moral imperative to make sure that all Americans have access to avoid

奥兹医生提到的一点是

And one of the things doctor Oz says is that

总统先生，根据公司数据我们的预估是到中期选举前美国人将累计减重1350亿磅。

Mister president, our estimate based on the company numbers as well is Americans will lose a £135,000,000,000 by the midterms.

但我不用磅来衡量。

But I don't measure it in pounds.

我用拯救的生命数量来衡量。

I measure it in save lives.

他预计到中期选举前美国人能累计减重1350亿磅。

He expects Americans to be able to lose a £135,000,000,000 by the midterms.

我认为这应该是个笔误，因为如果是1350亿磅，意味着每个美国人明年要减掉400磅。

Now I'm assuming that's a mistake because if it were billions, that means each American would have to lose £400 by next year.

哇哦。

Woah.

这看起来很有野心。

That seems Ambitious.

相当困难。

Pretty difficult.

所以我推测他指的是1.35亿。

So I'm assuming he meant a 135,000,000.

这仍然是个很大的数字。

Which is still a lot.

而且目前看来有几个原因，很快就会有更多美国人能获得这些药物。

And it sounds like for a couple of reasons at this point, pretty soon, we could be seeing many more Americans gaining access to these drugs.

这确实是最新进展，这些药物快速广泛普及的故事已经持续多年了。

And that very much, right, is just the latest beat in what has been now a years long story of these medications spreading really quickly and widely.

比如最初我们听说它们是名人用来减肥的。

Like, we started out hearing about them being used for weight loss among a listers.

当时似乎只有名人才能弄到这些药。

It seemed like celebrities were the only ones who would get their hands on them just about.

现在我知道好多人在用这些药。

And now I know so many people on them.

是啊。

Yeah.

这些药物在极短时间内变得非常流行且对部分人群相当普及，所以你会听到这么多人讨论，认识这么多服用者。

These drugs have become really popular and quite widely available to some people in a very small amount of time, which is probably why you're hearing so many people talk about it, why you know so many people taking these drugs.

要真正理解正在发生的这种普及化，你需要了解诺和诺德——我一直在报道的这款药物背后的丹麦公司。

And to really understand this democratization that is starting to take place, you need to understand Novo Nordisk, which is the Danish company behind the drug that I've been covering.

在某种程度上，这关乎他们如何管理——有时是管理不善——这款药物的推广过程，因为增加供应和提升可及性的努力始终是故事的核心。

And to some extent, how they've managed and at times mismanaged the rollout of the drug because efforts to increase supply, efforts to increase access have really been at the heart of the story the whole time.

那么，我们是如何走到今天这一步的？

So what is that story of how we got here?

诺和诺德是一家已有百年历史的公司，在几乎整个发展历程中，它只专注于一件事：糖尿病治疗。

So Novo Nordisk is this company that has been around for a hundred years, and for almost all of that time has been doing one thing, which is diabetes treatments.

它一直在生产胰岛素。

It has been making insulin.

时至今日，全球约一半的胰岛素供应仍来自该公司。

And to this day, it still makes about half of the world's insulin supply.

但在上世纪八十年代，GLP-1被发现。

But in the nineteen eighties, GLP ones are discovered.

这是人体内一种有助于调节血糖水平的激素。

And it's a hormone in your body that can help manage glucose levels.

将GLP-1制成药物面临的难题是其作用时间极短。

And the problem that is had in trying to make GLP ones into a medicine is that it's just really short acting.

一旦注入人体，它会立即消失。

You know, you put it into humans and it vanishes instantly.

因此诺和诺德的科学家们（当然不仅限于他们）重点攻克的问题之一就是如何延长其作用时间。

So one of the things Novo Nordisk scientists and others, you know, this is not just happening in one place, but one of the things they're trying to figure out is how to make it long lasting.

最终他们成功研制出能维持足够药效的制剂，实现每日注射一次即可。

Eventually, they do come up with a way to make it last long enough so you can have a daily injection.

由此诞生的药物就是后来众所周知的利拉鲁肽（Victoza）。

And you end up with this drug that becomes known as Victoza.

从来没听说过。

Never heard of it.

说实话，我一点也不惊讶。

I'm honestly I'm not surprised.

Victoza虽然发现于1997年，但直到2010年才上市。

Victoza, though it's discovered in 1997, doesn't hit the market till 2010.

尽管他们开始注意到它的减肥效果，当时仍仅用于治疗糖尿病。

And even though they start to see the weight loss effects of it, it is still only for diabetes.

直到2014年他们才推出相同药物但用于减肥，那就是Saxenda。

Not until 2014 do they have the same drug but for weight loss, and that becomes Saxenda.

你听说过这个吗？

Did you hear of that one?

没有。

No.

但这名字真够特别的。

But what a name.

其实我也不知道这些名字是怎么想出来的。

I don't actually know how they come up with these names.

我倒是挺想弄明白的。

I would maybe love to find out.

所以这种药能帮助人们减肥，但效果比较温和。

So you have this drug that is allowing people to lose weight, but it's moderate weight loss.

你知道，大约只能减重5%，这可能就是当时没怎么听说它的原因。

You know, only about 5% of weight loss, which is probably why you don't hear much about it at the time.

现在公司意识到他们有所发现，因为这减肥效果相当不错。

Now the company is aware that it's onto something because this is pretty good weight loss.

另外一点是它没有这些讨厌的副作用。

And the other thing is it doesn't come with all these nasty side effects.

那时候，尤其是九十年代，减肥药的名声很差。

Back then, especially in the nineties, weight loss drugs had a bad reputation.

这个时期的药物存在各种副作用。

This is a time when these drugs have all sorts of side effects.

有时它们相当危险。

Sometimes they're pretty dangerous.

有时效果并不理想。

Sometimes they're not very effective.

而且，当时的文化环境也大不相同。

And also, the culture is very different.

肥胖并不被视为一种疾病。

Obesity isn't considered a disease.

一切都关乎意志力、饮食和运动。

It is all about willpower, diet, and exercise.

所以人们不会考虑如何用医学手段治疗肥胖。

So people aren't thinking, how should you medically treat obesity?

但他们没有放弃，背后的团队也没有放弃。

But they do not give up on this, and the team behind it do not give up on this.

他们继续寻找方法让这些药物的效果更持久。

And they keep looking for a way to make these drugs last even longer.

这就是我们如何了解到司美格鲁肽，你会知道它是因为它就是诺和泰。

And that's how we get to semaglutide, which you will know because that is Ozempic.

终于，诺和泰。

Finally, Ozempic.

我们到了。

We're here.

我们来到了诺和泰。

We're here at Ozempic.

诺和泰于2017年在美国获批。

Ozempic is approved in The US in 2017.

对初用者来说它是每周注射一次，不再需要每日注射。

It's a weekly injection for starters, so no more daily injections.

它还能带来更显著的减重效果，临床试验中约15%。

And it also leads to much more weight loss, about 15% in clinical trials.

这与第一代GLP-1药物有着巨大差异。

So it's a huge difference from this first generation of GLP one drugs.

但我必须说明，此时诺和泰本应仅针对糖尿病处方。

But I should say, at this time, Ozempic is supposed to be prescribed for diabetes and diabetes only.

但由于它产生了显著的减重效果，你开始看到医生超适应症开处方。

But because it's leading to this big weight loss effect, you start to see doctors prescribing it off label.

没错。

Right.

我记得这正是诺和泰突然引爆全国关注的时候。

I remember this was when Ozempic suddenly exploded into our national consciousness.

就像奥斯卡颁奖礼上，人们拿它开玩笑。

It was like at the Oscars, there were jokes about it.

突然间，它似乎无处不在。

It seemed like it was everywhere, all of a sudden.

哦，关于它的笑话。

Oh, jokes about it.

当我环顾这个房间时，不禁想问：Ozempic适合我吗？

When I look around this room, I can't help but wonder, is Ozempic right for me?

没完没了地追问哪位名人用了它或没用。

Endless queries about kind of which celebrity was taking it or not.

没错。

Right.

所有人都在撒谎。

Everybody lying.

每个人都装模作样说‘哎呀瘦了，可怜兮兮的’。

Everyone's like, oh, smaller, poor shit.

简直让人想叫他们闭嘴。

Like, shut the ass up.

对。

Right.

对。

Right.

你明明在用Ozempic。

You're on Ozempic.

你知道，感觉就像它养活了一百万个小报头条。

You know, felt like it fed a million tabloid headlines.

我的抗衰老医生把它随便发给任何人。

My antiaging doctor just hands it out to anybody.

对吧？

Right?

谁没用过Ozempic？

Who wasn't Ozempic?

谁没用过？

Who wasn't?

大量的TikTok视频。

Loads and loads of TikTok videos.

如果你刚开始使用Ozempic，这是你需要知道的一切。

Here's everything you need to know if you are starting Ozempic.

人们记录他们在Ozempic上的旅程。

People documenting their journeys on Ozempic.

我三月份开始服用Ozempic。

I start taking Ozempic in March.

距离我第一次注射Ozempic已经正式过去52小时了。

I am officially fifty two hours past my first Ozempic injection.

然后我开始迅速减重。

And I just start dropping pounds left and right.

但直到2021年，他们才获得FDA批准将同一种药物用于肥胖症，那就是Wegovy。

But it's not until 2021 that they get FDA approval for the same drug but for obesity, and that's called Wegovy.

尽管我们在社交媒体上随处可见，这家公司备受关注的原因，实际上人们称其为‘神奇药物’的原因，除了减肥效果外，它还有许多其他益处。

And while we're seeing it all over social media, the reason this company is getting a lot of attention and actually the reason why people call this a miracle drug is because it has a lot of other benefits alongside weight loss.

已知它能降低心脏病发作、中风以及其他心血管问题导致的死亡风险。

It is known to lower the risk of heart attack, stroke, and death from other cardiovascular issues.

它可以治疗严重的肝脏疾病、睡眠呼吸暂停和肾脏疾病。

It can treat severe liver disease, sleep apnea, kidney disease.

目前，他们甚至正在研究其对治疗阿尔茨海默病的效果。

And at the moment, they're even studying its effect on treating Alzheimer's.

没错。

Right.

这正是我们开始频繁听说这家公司处于极其强势地位的节点。

And this is the point at which we start hearing a lot about the company just being in this incredibly strong position.

对吧？

Right?

我记得当时有头条新闻说它一度支撑了整个丹麦经济。

I remember there were these headlines about how this was, like, propping up the entire Danish economy at one point.

完全正确。

Absolutely.

我是说，这种药物的销量——尤其是对美国患者而言——如此巨大，以至于公司的市值一度与丹麦经济规模相当。

I mean, the sales of this drug, and I have to say to US patients, were so enormous that the company's market value was equal in size of the Danish economy.

正是它当时让丹麦经济免于陷入衰退。

It was the thing that was keeping the Danish economy out of recession at the time.

这些数字非常惊人，销量巨大，这类药物广受欢迎。

Like, these were huge numbers, huge sales, a lot of popularity for these drugs.

但实际上，这种受欢迎程度也成了公司的一个问题。

But, actually, the popularity also becomes a problem for the company.

我想，这正是诺和诺德公司希望完全避免的部分。

And this is the part of the story that Novo Nordisk, I imagine, wished it could avoid altogether.

我们马上回来。

We'll be right back.

嗨。

Hi.

我是艾希莉。

This is Ashley.

我和男友住在旧金山。

I live in San Francisco with my boyfriend.

我们希望能正式共享我的《纽约时报》订阅账号，并拥有各自的登录权限。

We would love to officially share my New York Times subscription with separate logins.

我们都热爱烹饪，喜欢待在厨房里，但我属于那种追求30分钟内高效完成晚餐的女生。

We both love cooking, love being in the kitchen, but I'm a thirty minute and under efficient dinner girly.

我想要的是烤盘一锅出料理。

I want a sheet pan meal.

他则非常讲究细节。

He is very elaborate.

他想要深入讲述烹饪故事。

He wants to get into the storytelling.

我希望能够保存我的简易食谱并标记已完成菜品，而让他拥有独立账户会非常理想。

I wanna be able to save my easy meals and check off the ones that I've completed, And I think him having his own profile would be great.

艾希莉，我们听到你的声音了。

Ashley, we heard you.

隆重推出《纽约时报》家庭订阅计划。

Introducing the New York Times Family Subscription.

你将拥有专属账号，而讲究的先生也能获得他的账号，还能再添加两位成员。

You get your own login, and mister elaborate gets his, plus room for two others.

了解更多详情，请访问nytimes.com/family。

Find out more at nytimes.com/family.

所以在休息前，你提到一个反直觉的观点：这种药物的广泛使用反而成为诺和诺德公司的挑战。

So before the break, you said something counterintuitive, which is that the massive uptake of this drug becomes a challenge for Novo Nordisk.

你这话是什么意思？

What did you mean by that?

这怎么会发生呢？

How'd that happen?

确实如此。

Absolutely.

要知道，诺和诺德公司根本没预料到会如此受欢迎。

You know, Novo Nordisk, they don't see this popularity coming.

必须记住诺和诺德是家百年老企，一直生产胰岛素——销量稳定，增长平稳。

You have to remember that Novo Nordisk is a 100 year old company that was making insulin, which is steady volumes, steady growth.

但平心而论，谁都没预料到这种情况。

But to be fair to them, no one sees this coming.

分析师没有，投资者没有，其他制药公司也没有。

Analysts don't, investors don't, other pharmaceutical companies don't.

所以大家都在追赶。

So everyone is playing catch up.

因此，在他们推出Wegovy并大受欢迎后，他们根本没有足够的药物来满足所有这些需求。

So after they've launched Wegovy and it's wildly popular, they just don't have enough of the drugs to meet all of this demand.

一种用于治疗糖尿病的药物在互联网上随处可见，成为快速减肥的新方法。

A medicine used to treat diabetes is all over the Internet as the newest way to lose weight and to lose it fast.

现在这种超说明书使用正在影响最需要它的糖尿病患者的供应。

Now that off label use is affecting the supply for those who need it most, diabetes patients.

一些药店表示他们根本无法进货。

And some pharmacies say they just can't get it in stock.

要知道，诺和诺德公司面临着巨大的需求增长，而他们没有足够的生产能力来满足。

You know, Novo Nordisk, this is a huge increase in demand for them, and they don't have the production capacity to meet it.

这对公司来说是一些真正棘手问题的开始。

And this is the beginning of some really difficult problems for the company.

比如什么？

Like what?

挑战在于，由于这些药物变得如此受欢迎，人们不仅用于糖尿病治疗，还出于超说明书用途，有人担心这些药物会出现供应不足，最终被列入FDA短缺药品清单。

The challenge is that because these drugs become so popular and people are using them for diabetes but also for off label reasons, There is a concern that there's not gonna be enough of these drugs out there, and so they end up on an FDA shortage list.

美国食品药品监督管理局已授权其他公司生产这些药物的非品牌版本。

The Food and Drug Administration gave permission to other companies to make non brand name versions of those drugs.

允许复方药房生产该药物的仿制版本。

Allowing compounding pharmacies to essentially make generic versions of the drug.

这实际上为所谓的复方药物打开了大门。

And that essentially opens the door for something called compounding.

联邦法律允许州特许的复方药房配发本质上仿制FDA批准药物的药品。

Federal law allows state licensed compounding pharmacies to dispense drugs that are essentially a copy of FDA approved medications.

这为其他公司和药房提供了一种途径，可以购买Ozempic和Wegovy中的活性成分——即司美格鲁肽，并能以更低价格出售。

Which is a way for other companies and pharmacies to buy in the active ingredient in Ozempic and Wegovy, that's called semaglutide, and they can sell it crucially, at a lower price.

复方仿制药与品牌药之间的成本差异每月可高达300美元。

The cost difference between the compounded generics and the name brand can be as much as $300 a month.

本质上，该公司正在失去其生产垄断权，导致这些被允许销售的仿制版本大量涌现。

Essentially, the company is losing their monopoly on making them, and you get all these knockoff versions that are allowed to be sold to people.

是啊。

Yeah.

现在市面上已经出现了这种药物的其他版本。

There are other versions of this drug out there now.

这在一定程度上打破了诺和诺德对该药物生产和销售的独占权。

It kind of lifts the exclusivity that Novo Nordisk has on making and selling these drugs.

这对诺和诺德来说似乎是件大事，因为如你所说，该公司花费数十年时间研发这些药物。

This seems like a pretty big deal for Novo Nordisk because the company, as you've told us, had spent decades working to develop these drugs.

诺和诺德投入了大量资金和时间。

It's just a lot of money and time that Novo had invested.

通常来说，药物专利会给诺和这样的公司留出时间，让其最终收获投资回报。

And normally, drug patents give a company like Novo time to, you know, finally reap the benefits of that investment.

确实如此。

Exactly.

从技术上讲，诺和诺德实际上并未失去专利，但由于药物短缺的特殊情况，联邦法律确实允许企业生产专利药物的仿制版本。

Now, technically, you know, Novo Nordisk has not actually lost its patent, but it is an unusual situation in the sense that because of this shortage, the federal law does allow companies to produce versions of a patented drug.

虽然我们之前在其他药物上也见过类似情况，但分析师告诉我，这次情况非常特殊，因为这款药物实在太受欢迎了。

And so while we have seen this before and it's happened with other drugs, what analysts tell me is that this is a really unusual scenario because it's such a popular drug.

由于该药物除了减肥外还具有多种健康效益，可以满足不同需求，这为其他公司提供了巨大动力进行复配生产——毕竟市场上存在大量寻求索马鲁肽的患者群体，尤其是那些希望以低于诺和诺德直售价获取该药物的人群。

And because it can be used for many different reasons as long side weight loss because we talk about these other health benefits it has, there are so many incentives for other companies to do this compounding because there is a big market out there of patients who are looking for semaglutide, and especially looking for semaglutide if it's cheaper than what they can get it at directly from Novo Nordisk.

与此同时

And in the meantime

减肥

Weight loss

持续了这么久

for so long.

我曾感到束手无策

I felt stuck.

市场上出现了竞争对手

A competitor comes onto the market.

但Zepbound意味着转机

But Zepbound means change.

Zepbound适用于肥胖症成人患者，可帮助减重并维持效果

Zepbound is for adults with obesity to help lose weight and keep it off.

礼来公司的这款药物于2022年上市

Eli Lilly's drug comes on the market in 2022.

最初他们推出的是用于糖尿病治疗的Mounjaro，其作用机制与诺和泰治疗糖尿病类似

Initially, they have Mounjaro, which is for diabetes in the same way that Ozempic is for diabetes.

一年后的2023年，礼来获得FDA批准推出肥胖症治疗药物Zepbound

And a year later in 2023, Eli Lilly get FDA approval for Zepbound, which is an obesity drug.

这是一个重大变化，因为诺和诺德从多年来市场上唯一获得FDA专利批准的药物，到现在面临着礼来公司这一强大竞争对手。

And this is a big change because now Novo Nordisk has gone from being the only patented FDA approved drug on the market for several years to having a formidable competitor in the form of Eli Lilly.

因此，诺和诺德目前既要应对自家药物复方制剂的竞争，又要面对市场上这个新出现的强大对手。

So Novo at this point is dealing with competition from the compounded versions of its own drug and from this new big player in the market.

确实如此。

Absolutely.

礼来公司的Zepbound变得非常非常受欢迎，这其中有几个原因。

Eli Lilly Zepbound becomes really, really popular, and there's a few reasons for that.

原因之一是礼来公司非常迅速地允许顾客直接购买这种药物。

One of the reasons is that Eli Lilly is very quick to allow customers to buy this drug directly.

这使得愿意自费的患者能比通过诺和诺德的Wegovy更快获得药物。

And so it helps people who are willing to pay out of pocket get access more quickly than they do through Novo Nordisk's Wegovy.

另一个原因是有些人表示他们就是更喜欢服用Zepbound。

Another reason is that some people say they simply prefer taking Zepbound.

要知道，每个人对不同药物的反应各不相同，但很多人都报告说副作用也相对较轻。

You know, everyone responds differently to different drugs, but lots of people report having kind of milder side effects as well.

因此我们看到由于这个替代选择，药物获取渠道确实在扩大。

And so we start to see access really expanding because of this alternative option.

然后今年早些时候

And then earlier this year

FDA表示，用于糖尿病和减肥的热门GLP-1类药物Ozempic和Wegovy已不再短缺。

The FDA says Ozempic and Wegovy, the popular GLP-one drugs for diabetes and weight loss, are no longer in short supply.

FDA已命令复方药房基本停止销售他们版本的这些药物。

The FDA has ordered compounding pharmacies to largely stop selling their version of drugs.

FDA表示这些药物已不再短缺，并命令复方药房停止生产。

The FDA said these drugs are no longer on the shortage list, and they told compounders to stop.

但我们实际上并未看到这种情况发生。

But we've really not seen that actually happen.

现在诺和诺德公司也试图介入此事。

Now Novo Nordisk has tried to get involved in this as well.

他们正在大量发出停止侵权令。

It is issuing lots of cease and desist orders.

并提起了所有这些诉讼。

It's starting up all of these lawsuits.

但实际上，这取决于FDA的态度——他们声称正在严厉打击，可能正在研究如何阻止这些药物进口到美国。

But really, it's in the hands of the FDA who say they are trying to crack down, who may be looking into how to stop these drugs being imported into the country.

但从复方药房的角度来看，这仍然是一个巨大的市场。

But from the perspective of the compounding pharmacies, this is a huge market that's out there still.

所以他们仍在利用其他法律漏洞寻找为患者提供这些药物的方法。

So they're still using other loopholes to find ways to offer these drugs to their patients.

目前这对公司造成了什么影响？

And what's the impact on the company at this point?

我想影响应该很严重。

I imagine it's stark.

这家公司的命运已经完全逆转。

The fortunes of this company are completely reversed.

今年夏天，诺和诺德基本上不得不向投资者说明在复方药仍存在的情况下其利润和销售额会是什么样子。

In the summer, Novo Nordisk basically had to tell investors what its profits and sales would look like assuming that compounding was still gonna happen.

股东们反应不佳。

Shareholders did not react well.

该公司股价单日暴跌20%。

The company's share price plummets 20% in one day.

哇。

Woah.

市值蒸发了700亿美元。

It wipes out 70,000,000,000 in market value.

这么多钱啊。

So much money.

如此巨额资金加上负面情绪像滚雪球般蔓延——要知道这家公司原本对这些药物的前景充满狂热期待。

It's so much money and it kind of snowballs, you know, the negative feelings around this company that had had massive enthusiasm about the promise of these drugs.

就像同一批人突然被吓坏了。

It's like those same people got spooked.

更糟的是，公司CEO引进了新人后，随即宣布大规模裁员。

So on top of that, the company, our CEO, brings in someone else and then announces huge layoffs.

要知道这公司之前还在招聘数万人，转眼就宣布要裁掉9000名员工。

You know, this was a company that was hiring tens of thousands of people who have just announced they're gonna get rid of 9,000 people.

天啊。

Wow.

过去一年左右时间里，公司股价已从峰值下跌70%。

And so over the course of the past year or so, the company's share price has dropped 70% from its peak.

这跌幅简直触目惊心。

I mean, that is a huge decline.

听到开发这种特效药的公司如今陷入如此困境，确实相当令人惊讶。

It is pretty surprising to hear that the company that created this miracle drug is in such a tough spot now.

然而它陷入困境的部分原因，正如你所描述的，实际上对消费者是有利的。

And yet the reason it's in a tough spot or part of it are things that you described that were actually good for consumers.

仿制药进入市场，礼来公司推出竞品。

Generics entering the market, Eli Lilly offering a competitor.

现在人们有了更多选择。

People have more options now.

所以我在想，这个故事的结局对诺和诺德来说是坏消息，但对消费者和公共健康可能是好消息。

And so I wonder if the upshot of this story is bad news for Novo Nordisk, but good news for consumers and potentially public health.

是啊。

Yeah.

要知道，对诺和诺德而言，作为行业先驱固然了不起，但也意味着有更大的跌落空间。

You know, for Novo Nordisk, there is something amazing in being a the pioneer here of leading the way, but it also gives you a lot of room to fall.

就像许多事物一样，当产品大受欢迎、效果显著并开创市场时，竞争就不可避免。

And as with lots of things, when it's really popular, when it's good, when it works, and when you create a market, you are bound to get competition.

这正是我们正在见证的。

And so that's what we're seeing.

从某种角度看，这很自然。

And in some ways, that is natural.

公司早就知道会面临竞争，现在确实如此。

The company knew that it was gonna start to face competition, and it absolutely is.

对其他人而言，你开始看到更多的可及性。

For everyone else, you start to see much more access.

我们将看到更多企业进入市场，这些药物背后的科学原理、人体对它们的反应以及药物形态都将呈现更多样化。

We'll see more entrants into the market and more variety of actually the science behind these drugs and how people respond to them and the forms that they take as well.

因此不仅是注射剂，还包括药丸、用药频率，以及它们可能产生或不会产生的副作用。

So not just injections, but also the pills, also the frequency that you'll be likely to take them for, the side effects that they might give you or not give you.

这无疑是扩大这些药物可及性的开端，实际上很难预测其边界在哪里。

So this is definitely the beginning of an expansion of access to these drugs, and it's hard to actually know where it stops.

伊莎，非常感谢你。

Isha, thank you so much.

不客气。

You're welcome.

我很喜欢来这里。

I loved being here.

我们马上回来。

We'll be right back.

《纽约时报》应用里有很多你可能没看过的内容。

The New York Times app has all this stuff that you may not have seen.

所有不同版块的标签都集中在顶部。

The way the tabs are at the top with all of the different sections.

我可以立即跳转到符合当下心情的内容。

I can immediately navigate to something that matches what I'm feeling.

我总是直奔游戏版块。

I go to games always.

正在玩填字小游戏。

Doing the mini.

正在玩Wordle。

Doing the Wordle.

我很喜欢它向我展示的丰富内容。

I loved how much content it exposed me to.

这些都是我从未想过会通过新闻应用获取的内容。

Things that I never would have thought to turn to a news app for.

这款应用必不可少。

This app is essential.

《纽约时报》应用。

The New York Times app.

所有资讯，尽在一处。

All of the times, all in one place.

立即在nytimes.com/app下载。

Download it now at nytimes.com/app.

以下是今日其他重要资讯。

Here's what else you should know today.

周四，随着历史上最长的政府停摆结束，政府部门逐步恢复运转。

On Thursday, the government slowly reopened as the longest shutdown in history came to an end.

机构工作人员重返办公室，联邦法院也恢复了正常案件排期。

Agency workers returned to their offices and federal courts resumed their normal dockets.

政府雇员预计最早将在11月20日重新收到工资支票。

Government employees expect to see paychecks again as early as November 20.

对旅行者来说还有个好消息：感恩节假期前夕，随着联邦官员取消了在40个繁忙机场进一步扩大航班限制的计划，航空交通中断情况有所缓解。

And in good news for travelers, ahead of the Thanksgiving holiday, disruptions to air traffic eased as federal officials canceled a plan to further expand restrictions on flights at 40 busy airports.

由亚马逊创始人杰夫·贝索斯创立的蓝色起源公司成功发射了新格伦火箭，并在大西洋平台实现了助推器回收。

And Blue Origin, the company started by Amazon founder Jeff Bezos, successfully launched its new Glenn rocket and landed the booster on a platform in the Atlantic Ocean.

这是该公司试图与埃隆·马斯克的SpaceX竞争的重大突破。

It was a major breakthrough as the company tries to rival Elon Musk's SpaceX.

SpaceX早在十年前就首次实现了助推器回收，但直到蓝色起源之前，还没有其他公司能在轨道级火箭上完成这一壮举。

SpaceX had landed a booster for the first time a decade ago, but no other company had pulled off the feet for an orbital class rocket until Blue Origin.

对于这家长期被视为行动迟缓、表现逊色于SpaceX的公司来说，这是项重大成就——后者如今已主导航天产业。

It was a major accomplishment for a company that's long been seen as sluggish and disappointing when compared with SpaceX, which now dominates the space industry.

蓝色起源还计划明年实施一次大型机器人登月任务。

Blue Origin is also planning a large robotic moon landing next year.

本期节目由Ricky Nevetsky、Caitlin O'Keefe和Diana Wynn制作。

Today's episode was produced by Ricky Nevetsky, Caitlin O'Keefe, and Diana Wynn.

由Lisa Chow担任编辑，配乐来自Marion Lozano和Diane Wong，Alyssa Moxley负责技术工程。

It was edited by Lisa Chow, contains music by Marion Lozano and Diane Wong, and was engineered by Alyssa Moxley.

以上就是本期《每日播报》的全部内容。

That's it for The Daily.

我是Natalie Kitrov。

I'm Natalie Kitrov.

周一见。

See you Monday.