我不是药神，我只是一名金融实验员

大家好，我是M君，一个集经验

与才华于一身的良心小编。

最近，电影《我不是药神》刷爆朋友圈，这部电影也被媒体称为十年以来最佳国产片。电影讲述了主人公在机缘巧合之下，成为了印度仿制药的代理商，在解救贫困癌症患者的同时获利颇丰，而后因为利益与人产生一系列纷争，并引起警察关注，最终被抓入狱的故事。

世界上疾病有很多，光癌症就有两百多种，但是却没有那么多匹配的医药能够帮助到遭受病痛的患者。是科学还不够发达吗？不完全是。能够救命的药物也许现在正躺在实验室里。Roger Stein是MIT金融工程实验室的一名实验员，他从金融的角度，解释了医药研发为何不能满足需求，并且给出了可行的解决方案。请看TED演讲 -- A bold new way to fund drug research。

Day Day Up

https://v.qq.com/txp/iframe/player.html?vid=a0175qoarwa&width=500&height=375&auto=0

So this is a picture of my dad and me, at the beach in Far Rockaway, or actually Rockaway Park. I'm the one with the blond hair. My dad's the guy with the cigarette. It was the 60's. A lot of people smoked back then. In the summer of 2009, my dad was diagnosed with lung cancer. Cancer is one of those things that actually touches everybody. If you're a man in the US, you've got about a one in two chance of being diagnosed with cancer during your lifetime. If you're a woman, you've got about a one in three chance of being diagnosed with cancer. Everybody knows somebody who's been diagnosed with cancer.

这张照片是我和我爸爸在Far Rockaway的海滩上，或叫Rockaway公园，我是金头发的那个, 那个拿着烟的是我爸爸。那是在六十年代，很多人吸烟，在2009年的夏天，我爸被诊断出了肺癌。癌症听上去让每个人难过，如果你是一名美国男性，在你的一生中，会有二分之一的机会被诊断出癌症；如果你是一名女性，那么你有三分之一的机会被诊断是癌症。每个人的身边都会有人被诊断出癌症。

Now, my dad's doing better today, and part of the reason for that is that he was able to participate in the trial of an experimental new drug that happened to be specially formulated and very good for his particular kind of cancer. There are over 200 kinds of cancer. And what I want to talk about today is how we can help more people like my dad, because we have to change the way we think about raising money to fund cancer research.

现在，我爸爸好了很多。有一部分原因是他参与了一种新药的尝试，那药是用特别配方做成的，对他那种癌症很有效。世界上有两百多种癌症，那么我今天的主题就是为了帮助像我爸爸那些癌症患者, 我们必须改变为癌症筹资的方式。

So a while after my dad was diagnosed, I was having coffee with my friend Andrew Lo. He's the head of the Laboratory for Financial Engineering at MIT, where I also have a position, and we were talking about cancer. And Andrew had been doing his own bits of research, and one of the things that he had been told and that he'd learned from studying the literature was that there's actually a big bottleneck. It's very difficult to develop new drugs, and the reason it's difficult to develop new drugs is because in the early stages of drug development, the drugs are very risky, and they're very expensive. So Andrew asked me if I'd want to maybe work with him a bit, work on some of the math and the analytics and see if we could figure out something we could do.

在我爸爸被诊断出癌症后不久，我和我的朋友Andrew Lo在一起喝咖啡，他是MIT金融工程实验室的头，我也是实验室的一员。当时我们在谈论癌症，Andrew一直在做各种研究，有人告诉过他一个问题，他也从文献中得知研究新药的过程中会遇到瓶颈，导致研究新药非常困难，而困难的原因在于新药研究的早期阶段研究药品投资风险大, 而且十分昂贵。Andrew问我是否想要和他合作，在数学分析方面看看我们能做些什么。

Now I'm not a scientist. You know, I don't know how to build a drug. And none of my coauthors, Andrew Lo or Jose-Maria Fernandez or David Fagnan -- none of those guys are scientists either. We don't know the first thing about how to make a cancer drug. But we know a little bit about risk mitigation and a little bit about financial engineering, and so we started thinking, what could we do? I'm going to tell you about some work we've been doing over the last couple years that we think could fundamentally change the way research for cancer and lots of other things gets done. We want to let the research drive the funding, not the other way around.

我不是一个科学家，我不懂怎样制药。我的合作者Andrew Lo Jose ，Maria Fernandez和David Fagnan ，所有人都不是科学家。我们甚至不知道制药第一步该干什么。但我们略知如何降低风险，和一点儿金融工程，所以我们开始想，我们能干嘛呢？我要告诉你们的是，我们这几年做的工作，从本质上改变了癌症研究和其他事物的做法。我们想让研究促进筹资而不是资金赞助研究。

So in order to get started, let me tell you how you get a drug financed. Imagine that you're in your lab -- you're a scientist, you're not like me -- and you've developed a new compound that you think might be therapeutic for somebody with cancer. Well, what you do is, you test in animals, you test in test tubes, but there's this notion of going from the bench to the bedside, and in order to get from the bench, the lab, to the bedside, to the patients, you've got to get the drug tested. And the way the drug gets tested is through a series of, basically, experiments, through these large, they're called trials, that they do to determine whether the drug is safe and whether it works and all these things. So the FDA has a very specific protocol. In the first phase of this testing, which is called testing for toxicity, it's called Phase I. In the first phase, you give the drug to healthy people and you see if it actually makes them sick. In other words, are the side effects just so severe that no matter how much good it does, it's not going to be worth it? Does it cause heart attacks, kill people, liver failure? And it turns out, that's a pretty high hurdle. About a third of all drugs drop out at that point. In the next phase, you test to see if the drug's effective, and you give it to people with cancer and you see if it makes them better. And that's also a higher hurdle. People drop out. And in the third phase, you test it on a very large sample, and you're trying to determine what the right dose is, is it better than what's available today? If not, then why build it? When you're done with all that, what you have is a very small percentage of drugs that start the process actually come out the other side. So those blue bottles -- those blue bottles save lives, and they're also worth billions, sometimes billions a year.

那么现在，我就告诉你们，怎样让新药研究得到资助。想象你在你的实验室里，不像我，你是个科学家，你发明了一种你认为能对某些癌症起作用的化合物，那么下一步是在动物身上测试，在试管里测试，这里有一个贯例，是让这种药从实验室应用到临床。为了让这种药从实验室应用到临床，到病人，你必须测试药性。测试药性需要进行一系列大量的试验，通过这些大量的试验，来确定药是否安全，以及它是否有用等等。所以美国食品和药物管理局有一套特定的标准。在测试的第一阶段，是测试药物的毒性，被称作为第一阶段。在第一阶段，把药分发给健康的人群来测试药物是否让他们生病。换句话说，如果副作用大于药品有效性，不管药多好，也不值得研发。药物是否会引起人们的心脏病发作，让人死亡， 肝功能衰竭，诸如此类。结果表明，这一阶级是一个巨大的障碍，三分之一的药物在此阶段被淘汰。下一阶段，是测试药物有效性。这一阶段是给那些罹患癌症的病人服用此药，看疗效如何。这又是一个巨大障碍，很多病人不愿参与在第三阶段。把药用于大量人群来确定用药量， 同时和现有药品有效性做比较，如果不如意，干嘛要生产它。当完成了所有步骤，只有一小部分药物通过了测试。所以，就只有这些蓝瓶的能救人。他们价值几十亿，有时候甚至每年几十亿。

So now here's a question: if I were to ask you, for example, to make a one-time investment of, say, 200 million dollars to buy one of those bottles, so 200 million dollars up front, one time, to buy one of those bottles, I won't tell you which one it is, and in 10 years, I'll tell you whether you have one of the blue ones. Does that sound like a good deal for anybody? No. No, right? And of course, it's a very, very risky trial position, and that's why it's very hard to get funding, but to a first approximation, that's actually the proposal. You have to fund these things from the early stages on. It takes a long time.

问题出来了，如果我问你，例如，做一次性的投资，两亿美元，买其中的一瓶药 初始投资两亿，一次性买其中一瓶。我不会告诉你是哪一瓶，十年后，我会告诉你，你买的是否是蓝瓶的。对大家来说，这听上去划算吗？ 不是，对吧。而事实上这是一种风险很大的投资，这就是药物研究很难得到资助的原因。但是就概算来说，这确实是这个提议，你必须从早期开始投资，而且花很长的时间。

So Andrew said to me, he said, "What if we stop thinking about these as drugs? What if we start thinking about them as financial assets?" They've got really weird payoff structures and all that, but let's throw everything we know about financial engineering at them. Let's see if we can use all the tricks of the trade to figure out how to make these drugs work as financial assets.

所以Andrew对我说 “如果我们不把这种产品当做药物来看呢？” 如果我们把这种投资当做是其他的金融资产来看待，他们只是有一个很反常的收益结构而已，那么利用我们知道的所有关于金融工程的知识，通过市场交易的技巧，把研发这些药物视作金融产物。

Let's create a giant fund. In finance, we know what to do with assets that are risky. You put them in a portfolio and you try to smooth out the returns. So we did some math, and it turned out you could make this work, but in order to make it work, you need about 80 to 150 drugs.

我们先创建一个巨额基金。在金融界，我们知道怎样处理高风险资产：把它们放在投资组合中，试着增加平稳的回报，我们做了一些数学分析，结果可行，但是真正运作起来，需要八十到一百五十种新药。

Now the good news is, there's plenty of drugs that are waiting to be tested. We've been told that there's a backlog of about 20 years of drugs that are waiting to be tested but can't be funded. In fact, that early stage of the funding process, that Phase I and preclinical stuff, that's actually, in the industry, called the Valley of Death because it's where drugs go to die. It's very hard to for them to get through there, and of course, if you can't get through there, you can't get to the later stages.

但是现在有个好消息，市面上有大量新药等待测试。我们被告知大概有积压了20年的药品等着被测试，但是沒有得到资金。事实上，初始阶段的筹资，如第一阶段和临床前测试，在这个行业里被称为"死亡之谷" ，因为这些阶段就是药物被淘汱的主要时期，对新药来说很难通过这些阶段。当然，如果不能通过这些阶段，也就不能进入下一阶段。

So we did this math, and we figured out, OK, well, you need about 80 to, say, 150, or something like that, drugs. And then we did a little more math, and we said, OK, well, that's a fund of about three to 15 billion dollars. So we kind of created a new problem by solving the old one. We got rid of the risk, but now we need a lot of capital, and you can only get that kind of capital in the capital markets. Venture capitalists and philanthropies don't have it. But we have to figure out how to get people in the capital markets, who traditionally don't invest in this, to want to invest in this stuff. So again, financial engineering was helpful here. Imagine the megafund starts empty, and what it does is it issues some debt and some equity, and that generates cash flow. That cash flow is used, then, to buy that big portfolio of drugs that you need, and those drugs start working their way through that approval process, and each time they go through a phase of approval, they gain value. Most of them don't make it, but a few of them do, and with the ones that gain value, you can sell some, and when you sell them, you have money to pay the interest on those bonds, but also to fund the next round of trials. It's almost self-funding. You do that for the course of the transaction, and when you're done, you liquidate the portfolio, pay back the bonds, and you can give the equity holders a nice return.

所以我们做了数学分析，我们发现，需要八十到一百五十种新药，或者类似那样的东西， 然后我们做了进一步分析，大概需要融资三十亿到一百五十亿，所以我们又从一个怪圈跳进另一个怪圈，我们可以解决风险问题，但是我们现在需要大量资金，只有一个地方可以获得如此多的资金，即"资本市场" 。风险投资家没有那么多资金，慈善家也没有，我们得想办法让那些在金融市场中通常不热衷投资此类项目的人们甘愿对此进行投资。再一次金融工程起到很大作用。想象一下, 这个宠大的基金本身并无价值，它做的只是发售债券和股票，来产生现金流量，当有了现金以后，买进所需的药物投资组合，然后药物就可以如期通过测试阶段，每一次他们抵达下一阶段，他们的价值得到提升，大部分做不到，只有少数能做到，那些增值的药物可以出售，此时，获得的利润可以付利息，而且有余钱进行下一阶段的测试，几乎是财政自给，如此循环下去，当一切完成了，清算这组投资组合，清偿债务，发放股息，给了股东很好的收益。

That was the theory, and we talked about it, we did a bunch of experiments, and then we said, let's really try to test it. We spent the next two years doing research. We talked to hundreds of experts in drug financing and venture capital. We talked to people who have developed drugs. We talked to pharmaceutical companies. We actually looked at the data for drugs, over 2,000 drugs that had been approved or denied or withdrawn, and we also ran millions of simulations. And all that actually took a lot of time. But when we were done, we found something that was sort of surprising. It was feasible to structure that fund such that when you were done structuring it, you could actually produce low-risk bonds that would be attractive to bond holders, that would give you yields of about five to eight percent, and you could produce equity that would give equity holders about a 12 percent return. Now those returns aren't going to be attractive to a venture capitalist. They want to make those big bets and get those billion dollar payoffs. But it turns out there are lots of other folks that would be interested. That's right in the investment sweet spot of pension funds and 401(k) plans and all this other stuff.

但那只是个理论，我们也谈论了一段时间，做了一些实验，我们很想把它付诸于实际。我们用了两年时间做市场调研，我们的团队和上百个药物金融和风险投资的专家谈过，我们和发明药物的科学家谈过，我们也和药物公司谈过。实际上我们研究了药物的数据，超过两千种被通过或淘汰或放弃的，我们进行了几百万的数据模拟，当然花费了大量时间。当我们完成时，我们发现结果令人吃惊，实际上我们的想法是可行的。这个基金模式能产生出低风险的债券，对于债券持有者来说很有吸引力，投资收益在百分之五到八，对于股票， 股东可获得百分之十二的投资收益，但是对风险投资者来说回报还不够，风险投资者是那些压的赌注很大，并且得到几十亿回报的人。但结果表明，仍然有很多人对药物投资兴趣浓厚。对退休基金和退休福利计划等等来说，这是最佳的投资计划。

So we published some articles in the academic press, in medical journals, in finance journals. But it wasn't until we actually got the popular press interested in this that we began to get some traction.

因此我们在学术刊物上发表了一些文章，在医学期刊上发表文章，在财经期刊上发表文章，但是直到在一些主流媒体上发表了相关文章，我们才真正开始得到一些关注。

We wanted to do more than just make people aware of it. We wanted people to get involved. So we took all of our computer code and made that available online under an open-source license to anybody that wanted it. And you guys can download it today if you want to run your own experiments to see if this would work. And that was really effective, because people that didn't believe our assumptions could try their own and see how it would work.

我们不只是想让人们意识到此问题，而且想让人们参与到其中，所以我们把编程的计算机代码放在了网上，我们申请了开放源代码的许可，这样大家就都能使用了。大家现在就可以下载来试试看这个模型是否可行。实际上它很有帮助，因为试用的人们也许不相信我们的假设，但现在可以自己测验它的可行性。

Now there's an obvious problem, which is, is there enough money in the world to fund this? I've told you there's enough drugs, but is there enough money? There's 100 trillion dollars of capital currently invested in fixed-income securities. That's a hundred thousand billion. There's plenty of money.

现在有一个显著的问题，那就是世界上有那么多钱来资助这些项目吗？我们已经知道我们有足够多的试验药物，但是有足够的钱吗？我们有一百兆的资金，现在存在于固定收益证券中，那可以是一百兆啊，太多钱了！

But we realized it's more than just money that's required. We had to get people motivated, involved, and get them to understand this. And we started thinking about all the different things that could go wrong. What are all the challenges that might get in the way? And we had a long list. We assigned a bunch of people, including ourselves, different pieces of this problem. And we said, could you start a work stream on credit risk? Could you start a work stream on the regulatory aspects? Could you start a work stream on how you would manage so many projects? And we had all these experts get together and do these different work streams, and then we held a conference. The conference was held over this past summer. It was an invitation-only conference. It was sponsored by the American Cancer Society and done in collaboration with the National Cancer Institute. We had experts from every field we thought would be important, including the government, and people that run research centers, and for two days they heard the reports from those five work streams, and talked about it. It was the first time the people who could make this happen sat across the table from each other and had these conversations.

但是我们意识到需要的不仅仅是钱，我们必须让大家有信心来参与进来，大家也必须要懂得相关知识。所以我们开始思考可能会出错的地方，在做的过程中会遇到什么挑战，我们列了一张很长的单子，其中囊括很多人，包括我们自己，细化可能出现的问题。我们提出，能不能在信贷危机方面开展工作？ 能不能在监管调控下展开工作？ 能不能同时处理很多项目？我们的专家在一起合计，并且分管不同工作，在今年夏天，我们开了一个会，是一个只有邀请者才可参与的会议，会议是由美国癌症协会赞助的，由国家癌症学会协办，我们汇集了各方精英， 包括政府和那些研究中心负责人等等，整整两天，我们坐在一起听取对五种工作研究的报告，他们还做了进一步探讨。这是第一次让这件事情成真的人们坐在一起讨论可行性。

Now these conferences, it's typical to have a dinner, and at that dinner, you get to know each other, sort of like what we're doing here. I happened to look out the window, and hand on my heart, on the night of this conference -- it was the summertime -- and that's what I saw, a double rainbow. So I'd like to think it was a good sign.

会后有个常规晚宴。在晚宴上我们彼此了解，就像我们现在在这儿一样。我恰好看了看窗外，我是很真诚地说这番话，在晚宴当天，我看了窗外，那还是夏天，我看到了叠虹，我想那是个好兆头。

Since the conference, we've got people working between Paris and San Francisco, lots of different folks working on this to try to see if we can really make it happen. We're not looking to start a fund, but we want somebody else to do this. Because, again, I'm not a scientist. I can't build a drug. I'm never going to have enough money to fund even one of those trials. But all of us together, with our 401(k)s, with our 529 plans, with our pension plans, all of us together can actually fund hundreds of trials and get paid well for doing it and save millions of lives like my dad.

自从那次会议以后，在巴黎和旧金山的专家们开始一起合作，很多人一起研究这个项目，看是否会成真。我们不是在拉赞助，但是我们希望别人能这样做，因为，再次重申，我不是科学家，我不会制药，我也没有那么多钱去资助哪怕只是其中一个试验，但是我们在一起合作，用我们的养老金计划，用我们的529个方案，用我们的退休金，我们大概能赞助几百个试验，也能收到很好回报，然后拯救像我爸那样的许多病人。

Thank you.

谢谢大家。

我只是一条分割线

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