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Stanford Entrepreneurship corner, Richard Scheller Developing Products that Save Lives No.3

Richard Scheller Developing Products that Save Lives No.3

We're very good at R&D at Genentech. We're very proud of that. I think that a lot of companies have lost their way in terms of their research and development and frankly don't have the quality of scientist that we have. I guess I can say that if I don't mention any particular company. So they have to look outside for their molecules. Now, if you're going to start a biotech company, you can get some scientist together. You can do some experiment. You can maybe raise enough money to get a molecule into the clinic. But remember as you start doing the later stage experiments, these experiments cost hundreds and millions of dollars and it's unlikely that any small company... I would say it's not unlikely, it is impossible nowadays that any small biotech company would be able to raise enough money to do its own large Phase III clinical trials. So the companies have to partner with larger pharmaceutical companies which have the resources to do that. So, while we have 1,300 scientist at Genentech-that doesn't include the clinical groups and so on-however many scientists we have, we will always be a small part of the overall life science industry. And I have a business development group that reports to me, just 25 people. Many have PhDs and MBA; some have MDs, PhDs and MBAs. I'm under educated compared to some of these people. And they have the world divided up into territories and we're constantly looking to in-license innovation that comes from outside of Genentech. So we're very, very conscious that we don't have all the good ideas. We don't invent all the good things. Hopefully, we're somewhat less dependent on it than some of the other pharmaceutical companies who's R&D may not be quite as good, where they, as you said, almost solely depend now on in-licensing. Some of the companies have so much money and are getting so desperate because of the drugs coming off of patents. When a drug comes off of a patent and becomes generic, if it's a simple chemical, not a protein antibody, the generic companies move in and basically, the innovator price falls by usually about ten-fold in six months. And there's huge, huge patent expiries coming in the industry. So people are quite desperate right now. So I would say a lot, but they made a ton of money off of these molecules over the last decade. So now going to the small company and say, "Look, we don't to license it. How much do you want? We'll buy you." And, yeah, that can be a very lucrative model for a start-up biotechs, if you can bring a molecule into the clinic and interest a large pharmaceutical company in the molecule and start with, let say, $20 or $50 million of capital and sell the company five or seven years later for half a billion dollars. So that's not bad. The question is how I'm sort of inward-looking and coming from academia and so on, worked in the lab, sort of been with my students and so on. But now, I have a thousand people that work for me, how do someone like me motivate folks? So, at Genentech, we work a lot on our culture. We spend a lot of time thinking about our culture. I have a leadership team. We motivate people by the fact that we are doing work that we believe will really, really help patients and sick people. And if you think about, if I think about, the kinds of molecules that we have in clinical development for things like Alzheimer's disease, asthma, cancer, infectious disease, psychiatric disorders, if our portfolio plays out reasonably successfully over the next decade, it could actually be the case that we will rather directly affect every family in the developed world. I mean, who doesn't know someone in their family that had one of those diseases? So, we really, really help patients and that is extremely motivating to me. And it's unblind, the clinical trial, especially on oncology clinical trial where you give half the patients the drug and half the patients a placebo. And the end point is how fast they die. I mean, to unblind the clinical trial like that and to see that you've made a difference is really, really... Most, I mean the room usually starts crying. It's really really... So the first thing is, meaningful work. We believe we do meaningful work and we talk about it. So I had a town hall last week so all 2,000 people. We had a patient come and talk. The patient is taking a hedgehog inhibitor. It's for a number of diseases but largely basal cell carcinoma. This guy had a disease called Gorlin's Disease. It's fairly rare but it's a basal cell disease again where you get large growths and if they're not surgically removed, they can be... Mostly they start on your face and then your trunk. He's had it his whole life, it can be fist size. And he's a salesman. And he said, "My whole life I went out doing sales and I had big scars all over." A chunk of his ear is gone. This is a targeted drug. It's a mutation in the pathway that gives rise to this disease. He takes our drug, all the lesions are gone. He hasn't had one since he started taking the drug. He was so thankful. I think that's a big, big motivator for our industry and it's maybe a little different than other industries. I mean, I'm sure I love iPhones but they don't save my-probably does save my life actually. I couldn't say that. But it's a little different. So I think that's really the number one thing. And then we motivate people through, there's always compensation. So we have three components to our compensation: salary, stock and bonus. We target salaries at the 50th percentile of the market and we have a target bonus that's at the 50th percentile. But there's tremendous upside depending on the performance of the company and the performance of the individual. Did you move a molecule into the clinic? Did you publish a bunch of great papers? Were you the lead clinical scientist on a Phase II study where the design was terrific and it worked, et cetera, et cetera. So, bonus, and of course, stock which tracks with the overall performance of the company. So, I think those would be-I can talk about that for a long time-but I think those would be the two major things.

There are ethical issues everyday. There are a lot of ethical issues around the clinical trials. For example, you have a drug that you're pretty sure is going to work and we're required in a number of cases by the FDA to have a placebo group. And nobody wants to be in the placebo when we're doing a survival trial. Nobody wants to be in the placebo group, and one could question whether it's ethical to even have a placebo group or whether you should just put everyone on the drug and compare it to historical standards, which of course is not as good an experiment, that's for sure. But these are real folks that you're treating. So a lot of our issues around our clinical trials are basically determined by the FDA, where I tell us, "No placebo control, no approval, no drug for anybody." So we're required in a lot of cases and we often-often-we sometimes disagree with the FDA on whether it's ethical to have a placebo group. But in the end, they're the regulators and they would rather be really, really sure that you have a drug that makes a difference that you can then market to hundreds of thousands or million people than to... And maybe for some folks, not to get the drug early on and to be sure in the end that it's a good drug. So a lot of our ethical issues around our clinical trials are determined by the regulatory agencies and we basically just have to follow what they say. Now, in terms of drugs and their use in the third world, we wouldn't, frankly, try and make a drug for a third world country disease because it's not profitable. And fortunately, there are groups like the Gates Foundation now that are putting that kind of money into those kinds of clinical development work, that are starting to think more about that. But we can't justify to the people that buy our stock everyday that we are going to spend $1.5 billion and then give it away. Now that's for better or for worse, and that's not the way the rest of the world functions nowadays. If it's free enterprise, it's going to determine what drugs are made. And it's a growth hopefully driven business, I have to justify at the end that there's some return on the investment that I make. In the United States, for example though, it was really a bit of a fallacy that our health care system was so terrible. I mean, in terms of prescription drugs, if you have insurance, insurance pays. If you have insurance and you have to make a co-payment and sometimes on an expensive drug, the co-payment can be more money than someone will have. So if you couldn't afford the co-payment, we paid it. And if you didn't have any insurance and you needed the drug, we just gave people the drug. So somebody want to do a... 60 Minutes wanted to do a story once on one of our expensive cancer drugs and to find somebody that was dying because they couldn't get the drug and make us look bad. But you know what, they couldn't find anyone who wasn't getting the drug. So that drug, we've given away, I don't remember what the number is, billion dollars worth of free drug. We spend a lot of money every year on co-payments for folks. So we believe that, least in the Western world where we operate, everybody has access to our drugs, even if we just give it to them for free.

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Richard Scheller Developing Products that Save Lives No.3 Richard Scheller||||||| Richard Scheller Entwicklung von Produkten, die Leben retten Nr.3 Richard Scheller Desarrollando productos que salvan vidas nº 3 Richard Scheller Desenvolver produtos que salvam vidas N.º 3 Ричард Шеллер Разработка продуктов, которые спасают жизни №3 Richard Scheller Utveckla produkter som räddar liv Nr.3 Richard Scheller Hayat Kurtaran Ürünler Geliştirmek No.3

We're very good at R&D at Genentech. |||||||Genentech'te We're very proud of that. I think that a lot of companies have lost their way in terms of their research and development and frankly don't have the quality of scientist that we have. |||||||||||||||||||franchement||||qualité||scientifique||| ||||||şirketler|||||||||||araştırma ve geliştirme||açıkçası||||||||| I guess I can say that if I don't mention any particular company. |||peux||||||||| So they have to look outside for their molecules. ||||||||moleküllerini aramak Now, if you're going to start a biotech company, you can get some scientist together. |||||||biyoteknoloji şirketi||||||| You can do some experiment. ||||Deney yapabilirsin. You can maybe raise enough money to get a molecule into the clinic. |||toplamak|yeterli miktarda||||||||klinik denemeleri But remember as you start doing the later stage experiments, these experiments cost hundreds and millions of dollars and it's unlikely that any small company... I would say it's not unlikely, it is impossible nowadays that any small biotech company would be able to raise enough money to do its own large Phase III clinical trials. |||||||dernière||||||||||||||||||||je dirais|||||||||||||||||||||||||||| |||||||daha sonraki||deneyler|||||||||||muhtemel değil||||küçük biyoteknoloji şirketi|||||değil|muhtemel değil||||günümüzde||||biyoteknoloji şirketi||||||toplamak||||||||Faz III denemeleri||klinik deneyler|klinik deneyler So the companies have to partner with larger pharmaceutical companies which have the resources to do that. |||||||plus grandes||||||||| ||||||||ilaç şirketleri|||||kaynaklar||| So, while we have 1,300 scientist at Genentech-that doesn't include the clinical groups and so on-however many scientists we have, we will always be a small part of the overall life science industry. ||||||||||||||||||||||||||||||globale||| ||||||Genentech'te|||||klinik araştırma|||||||||||||||||||genel olarak|||endüstri sektörü And I have a business development group that reports to me, just 25 people. ||ai|||||||||| Many have PhDs and MBA; some have MDs, PhDs and MBAs. ||doctorats||MBA|||MD|||MBA |||||||Medical Doctors||| ||Doktora dereceleri||MBA|||Tıp Doktorları|Doktora dereceleri||MBA dereceleri I'm under educated compared to some of these people. |moins||||||| |daha az eğitimli||kıyasla||||| Tengo poca educación en comparación con algunas de estas personas. Я недостаточно образован по сравнению с некоторыми из этих людей. And they have the world divided up into territories and we're constantly looking to in-license innovation that comes from outside of Genentech. ||||||||territoires|||||||||||||| ||||||||bölgeler|||||||lisans almak|yenilikçi fikirler||||||Genentech'ten dışarıdan So we're very, very conscious that we don't have all the good ideas. ||||farkındayız||||||||fikirler Так что мы очень, очень хорошо понимаем, что у нас не все хорошие идеи. We don't invent all the good things. ||icat etmek|||| Hopefully, we're somewhat less dependent on it than some of the other pharmaceutical companies who's R&D may not be quite as good, where they, as you said, almost solely depend now on in-licensing. ||||||||||||||||||||||||||||||||||licences ||biraz||||||||||ilaç şirketleri|||||||||||||||||yalnızca|||||lisans anlaşması Будем надеяться, что мы несколько меньше зависим от него, чем некоторые другие фармацевтические компании, исследования и разработки которых могут быть не столь хороши, поскольку они, как вы сказали, сейчас почти полностью зависят от внутреннего лицензирования. Some of the companies have so much money and are getting so desperate because of the drugs coming off of patents. ||||||||||||désespérées|||les|||||brevets ||||||||||||umutsuz hale geliyor||||ilaçların patent süresi dolması||patent süresi dolmak||patent süresi dolmak Algunas de las empresas tienen mucho dinero y se están desesperando porque los fármacos dejan de estar patentados. У некоторых компаний так много денег, и они впадают в такое отчаяние из-за того, что лекарства вытекают из патентов. When a drug comes off of a patent and becomes generic, if it's a simple chemical, not a protein antibody, the generic companies move in and basically, the innovator price falls by usually about ten-fold in six months. |||||||brevet|||||||||||||||||||en gros||innovateur|||||||||| ||||||||||||||||||||||||||||original|||||||||| |||||||patent süresi|||jenerik ilaç||||||||protein antikor|antikor proteini||jenerik|şirketler|devreye girer|||||yenilikçi şirket||||||on kat|katına||| Cuando un medicamento deja de estar patentado y se convierte en genérico, si se trata de un simple producto químico, no de un anticuerpo proteínico, las empresas de genéricos entran en escena y, básicamente, el precio del innovador suele caer unas diez veces en seis meses. Когда лекарство выходит из-под патента и становится генерическим, если это простое химическое вещество, а не белковое антитело, компании-генерики приходят на рынок и, по сути, цена инновационного препарата падает примерно в десять раз за шесть месяцев. And there's huge, huge patent expiries coming in the industry. |||énormes|brevets|d'expirations|||| |||büyük|patent süresi dolumu|patent süresi dolumları||||sektör В отрасли истекают огромные сроки действия патентов. So people are quite desperate right now. ||||çaresiz|| So I would say a lot, but they made a ton of money off of these molecules over the last decade. ||||||||||||||||||||décennie |||||||||||||üzerinden|||moleküller||||son on yıl So now going to the small company and say, "Look, we don't to license it. ||||||||||biz|||| Так что теперь идем в маленькую компанию и говорим: «Послушайте, мы не лицензируем это. How much do you want? We'll buy you." And, yeah, that can be a very lucrative model for a start-up biotechs, if you can bring a molecule into the clinic and interest a large pharmaceutical company in the molecule and start with, let say, $20 or $50 million of capital and sell the company five or seven years later for half a billion dollars. |||||||lucratif||||||biotech||||||||||||||||||||||||||||||||||||||||| |||||||kârlı|||||başlangıç aşamasındaki|biyoteknoloji şirketleri||||||||||||||ilaç şirketi||||molekül||||||||||||||||||||||| So that's not bad. |c'est|| ||değil| The question is how I'm sort of inward-looking and coming from academia and so on, worked in the lab, sort of been with my students and so on. |||||||introspectif||||||||||||||||||||| |||||||içedönük|||||akademik çevreler||ve benzeri şeyler|||||||||||||| Вопрос в том, что я как бы смотрю вглубь, прихожу из академических кругов и так далее, работаю в лаборатории, как бы общаюсь со своими студентами и так далее. But now, I have a thousand people that work for me, how do someone like me motivate folks? |||||||||||||||||les gens |||||||||||||||||insanları Но теперь у меня есть тысяча людей, которые работают на меня, как кто-то вроде меня мотивирует людей? So, at Genentech, we work a lot on our culture. ||Genentech'te||||||| We spend a lot of time thinking about our culture. ||||||||kendi|kültürümüzü I have a leadership team. |||leadership| |||Liderlik ekibi| Tengo un equipo de liderazgo. У меня есть команда лидеров. We motivate people by the fact that we are doing work that we believe will really, really help patients and sick people. |motiver|||||||||||||||||les patients||| ||||||||||||||||||hastalar ve hastalar||hasta olan| And if you think about, if I think about, the kinds of molecules that we have in clinical development for things like Alzheimer's disease, asthma, cancer, infectious disease, psychiatric disorders, if our portfolio plays out reasonably successfully over the next decade, it could actually be the case that we will rather directly affect every family in the developed world. ||||||||||||||||||||||||asthme||||psychiatriques|troubles||||||raisonnablement|||||décennie|||||||||||||||||développement| ||||||||||||moleküller||||||klinik geliştirme||||Alzheimer hastalığı|hastalıklar|astım||||psikiyatrik rahatsızlıklar|bozukluklar|Eğer||ilaç portföyü|başarılı olursa||makul bir şekilde||||||||||||||||||||||| I mean, who doesn't know someone in their family that had one of those diseases? ||||||||||||||hastalıklar У кого в семье нет знакомых, страдающих одним из этих заболеваний? So, we really, really help patients and that is extremely motivating to me. ||||||ve||||motive edici|| And it's unblind, the clinical trial, especially on oncology clinical trial where you give half the patients the drug and half the patients a placebo. ||non aveugle||||||oncologie||||||||||||||||placebo ||reveal treatment|||||||||||||||||||||| |ve bu|açık etiketli|||klinik deneme|||onkoloji klinik denemesi|klinik deneme|||||||hastalara||||||||plasebo ilaç Y no es ciego, el ensayo clínico, especialmente en el ensayo clínico oncológico donde se da a la mitad de los pacientes el fármaco y a la otra mitad un placebo. And the end point is how fast they die. И конечная точка - это скорость их смерти. I mean, to unblind the clinical trial like that and to see that you've made a difference is really, really... Most, I mean the room usually starts crying. |||dévoiler|||||||||||||||||||||||| Я имею в виду, что разоблачить клиническое исследование и увидеть, что вы изменили ситуацию, это очень, очень... Большинство, я имею в виду, что комната обычно начинает плакать. It's really really... So the first thing is, meaningful work. ||||||||significatif| Это действительно очень... Итак, первое - это осмысленная работа. We believe we do meaningful work and we talk about it. So I had a town hall last week so all 2,000 people. Así que tuve un ayuntamiento la semana pasada por lo que las 2.000 personas. We had a patient come and talk. |||Bir hasta||| The patient is taking a hedgehog inhibitor. |||||hérisson|inhibiteur |||||kirpi inhibitörü|inhibitör El paciente está tomando un inhibidor de erizo. Пациент принимает ингибитор ежа. It's for a number of diseases but largely basal cell carcinoma. ||||||||basocellulaire||carcinome ||||bir dizi|hastalıklar|||temel||karsinom Es para varias enfermedades, pero sobre todo para el carcinoma basocelular. Он применяется при ряде заболеваний, но в основном при базальноклеточной карциноме. This guy had a disease called Gorlin's Disease. ||||||de Gorlin| ||||||Gorlin's| ||||hastalık||Gorlin Hastalığı| It's fairly rare but it's a basal cell disease again where you get large growths and if they're not surgically removed, they can be... Mostly they start on your face and then your trunk. ||||||||||||||tumeurs|||||chirurgicalement|||||||||||||| |oldukça|nadir görülen||||bazal hücre||hastalık||||||büyümeler|||||cerrahi olarak||||||||||||||gövde Es bastante rara, pero se trata de una enfermedad de células basales en la que aparecen grandes tumores que, si no se extirpan quirúrgicamente, pueden... En la mayoría de los casos empiezan en la cara y luego en el tronco. Это довольно редкое заболевание, но это базальноклеточное заболевание, при котором появляются большие наросты, и если их не удалить хирургическим путем, они могут... В основном они появляются на лице, а затем на туловище. He's had it his whole life, it can be fist size. |||||||||poing| |||||||||yumruk büyüklüğünde| Lo ha tenido toda su vida, puede ser del tamaño de un puño. Она у него всю жизнь, может быть размером с кулак. And he's a salesman. |||Ve o bir satıcı. И он продавец. And he said, "My whole life I went out doing sales and I had big scars all over." ||||toute||||||||||||| |||||||||||||||yaralar|| Y dijo: "Toda mi vida salí a vender y tenía grandes cicatrices por todas partes". A chunk of his ear is gone. |kulak parçası||||| У него отвалилась часть уха. This is a targeted drug. |||Hedeflenmiş| Se trata de un fármaco dirigido. Это целевой препарат. It's a mutation in the pathway that gives rise to this disease. ||mutasyon|||yolak|||||| Es una mutación en la vía que da lugar a esta enfermedad. Это мутация в пути, которая приводит к этому заболеванию. Bu hastalığa yol açan, yolakta meydana gelen bir mutasyondur. He takes our drug, all the lesions are gone. ||||||lésions|| ||||||lezyonlar|| Он принимает наш препарат, и все поражения исчезают. İlacımızı aldı, tüm lezyonlar gitti. He hasn't had one since he started taking the drug. İlacı almaya başladığından beri bir tane bile içmedi. He was so thankful. |||Çok minnettardı. I think that's a big, big motivator for our industry and it's maybe a little different than other industries. ||||||büyük bir motivasyon|||sektörümüz için|||||||||sektörler I mean, I'm sure I love iPhones but they don't save my-probably does save my life actually. |||||||||||||cela||ma|| ||||||iPhone'lar||||||||||| Конечно, я люблю айфоны, но они не спасают мою жизнь - возможно, даже спасают. I couldn't say that. But it's a little different. So I think that's really the number one thing. Поэтому я думаю, что это действительно главное. And then we motivate people through, there's always compensation. ||||||||tazminat So we have three components to our compensation: salary, stock and bonus. ||||bileşenler|||ücret paketi|maaş|hisse senedi||prim Así que tenemos tres componentes en nuestra remuneración: salario, acciones y primas. Таким образом, у нас есть три составляющие вознаграждения: зарплата, акции и бонус. We target salaries at the 50th percentile of the market and we have a target bonus that's at the 50th percentile. ||||||percentile|||||||||||||| ||maaşlar||||yüzdelik dilim||||||||||||||yüzdelik dilim Мы устанавливаем зарплату на уровне 50-го процентиля рынка, а целевой бонус - на уровне 50-го процентиля. But there's tremendous upside depending on the performance of the company and the performance of the individual. ||büyük ölçüde|büyük avantaj|||||||||||||birey Но есть огромные преимущества в зависимости от производительности компании и производительности отдельных лиц. Did you move a molecule into the clinic? ||||molekülü||| Вы перенесли молекулу в клинику? Did you publish a bunch of great papers? Were you the lead clinical scientist on a Phase II study where the design was terrific and it worked, et cetera, et cetera. ||||||||||||||||||a fonctionné|||| ||||klinik||||Faz|||||||harika||||||| So, bonus, and of course, stock which tracks with the overall performance of the company. |||||||izler|||genel performans|||| Итак, бонус и, конечно же, акции, которые зависят от общих показателей компании. So, I think those would be-I can talk about that for a long time-but I think those would be the two major things.

There are ethical issues everyday. ||etik|| Этические проблемы возникают каждый день. There are a lot of ethical issues around the clinical trials. |||||||||klinik|klinik deneyler For example, you have a drug that you're pretty sure is going to work and we're required in a number of cases by the FDA to have a placebo group. ||||||||||||||||obligés||||||||||||| ||||||||||||||||||||||||FDA||||plasebo grubu| And nobody wants to be in the placebo when we're doing a survival trial. ||veut|être|||||||||| ||||||||||||hayatta kalma|deneme çalışması И никто не хочет быть в плацебо, когда мы проводим исследование выживаемости. Nobody wants to be in the placebo group, and one could question whether it's ethical to even have a placebo group or whether you should just put everyone on the drug and compare it to historical standards, which of course is not as good an experiment, that's for sure. ||||||||et|||||||||avoir|||||||||||||||comparer|||||si|||||||||il|| ||||||plasebo grubu||||||||etik açıdan uygun|||||plasebo grubu|||||||||||||karşılaştırmak||||standartlar|||||||||deney||| Никто не хочет быть в группе плацебо, и можно задаться вопросом, этично ли вообще иметь группу плацебо или лучше просто посадить всех на препарат и сравнить с историческими стандартами, что, конечно, не является хорошим экспериментом, это точно. But these are real folks that you're treating. ||||insanlar|||tedavi ettiğin Но это реальные люди, которых вы лечите. So a lot of our issues around our clinical trials are basically determined by the FDA, where I tell us, "No placebo control, no approval, no drug for anybody." |||||||||||||||||||||||||||pour|personne ||||||||||||belirlenir|||||||||plasebo kontrolü|||onay||||herhangi biri Поэтому многие наши проблемы, связанные с клиническими испытаниями, в основном определяются FDA, где нам говорят: "Нет плацебо-контроля - нет одобрения, нет лекарства - нет лекарства". So we're required in a lot of cases and we often-often-we sometimes disagree with the FDA on whether it's ethical to have a placebo group. ||||||||||||||sommes en désaccord|||||||||||| ||||||||||||||katılmamak|||||||etik açıdan uygun||||plasebo grubu| But in the end, they're the regulators and they would rather be really, really sure that you have a drug that makes a difference that you can then market to hundreds of thousands or million people than to... And maybe for some folks, not to get the drug early on and to be sure in the end that it's a good drug. ||||||régulateurs||||||||||||||||||||||||||||||||||||||||||||||||||||||| ||||||düzenleyiciler||||tercih ederler||||||||||||||||||||||||||||||||||||||||||||||||||| So a lot of our ethical issues around our clinical trials are determined by the regulatory agencies and we basically just have to follow what they say. ||||||||||||belirlenir|||düzenleyici|kurumlar|||||||||| Now, in terms of drugs and their use in the third world, we wouldn't, frankly, try and make a drug for a third world country disease because it's not profitable. |||||||utilisation|||||||franchement|||||||||monde||maladie|parce que||| ||||||||||||||açıkçası|||||||||||üçüncü dünya hastalığı||||kârlı Что касается лекарств и их использования в странах третьего мира, то мы, честно говоря, не стали бы пытаться создать лекарство от болезни в стране третьего мира, потому что это невыгодно. And fortunately, there are groups like the Gates Foundation now that are putting that kind of money into those kinds of clinical development work, that are starting to think more about that. |Neyse ki||||||Gates Vakfı|Vakfı|||||||||||türler|||klinik geliştirme çalışmaları||||||||| И, к счастью, сейчас есть такие группы, как Фонд Гейтса, которые выделяют деньги на подобные клинические разработки и начинают больше думать об этом. But we can't justify to the people that buy our stock everyday that we are going to spend $1.5 billion and then give it away. ||açıklayamayız|haklı çıkarmak|||||||hisse senedi||||||||||||| Now that's for better or for worse, and that's not the way the rest of the world functions nowadays. ||||||pire|||||||||||| ||||||||||||||||||günümüzde Хорошо это или плохо, но весь остальной мир сегодня устроен иначе. If it's free enterprise, it's going to determine what drugs are made. |||entreprise|cela||||||| |||serbest girişim||||belirlemek||ilaçlar|| Si es libre empresa, determinará qué medicamentos se fabrican. And it's a growth hopefully driven business, I have to justify at the end that there's some return on the investment that I make. |||||drivé|||||||||||||||||| |||büyüme odaklı|||||||gerekçelendirmek||||||||||||| Это бизнес, основанный на надежде на рост, и в конце концов я должен обосновать, что вложенные средства окупаются. In the United States, for example though, it was really a bit of a fallacy that our health care system was so terrible. ||||||||||||||fallacie||||soins de santé|||| Amerika'da||||||||||||||yanılgı||||||||kötü durumda В Соединенных Штатах, к примеру, действительно было немного ошибочно считать, что наша система здравоохранения настолько ужасна. I mean, in terms of prescription drugs, if you have insurance, insurance pays. |||||||||avez|||paye |||||Reçeteli ilaçlar|reçeteli ilaçlar||||sigorta|sigorta| Что касается рецептурных препаратов, то если у вас есть страховка, то она платит. If you have insurance and you have to make a co-payment and sometimes on an expensive drug, the co-payment can be more money than someone will have. |||||||||||katkı payı||||||||||||||||| So if you couldn't afford the co-payment, we paid it. And if you didn't have any insurance and you needed the drug, we just gave people the drug. ||||||||||||||donnions||| ||||||sigorta||||||||||| So somebody want to do a... 60 Minutes wanted to do a story once on one of our expensive cancer drugs and to find somebody that was dying because they couldn't get the drug and make us look bad. ||||||||||||||||||||||||||mourait|||||||||||mal ||||||||||||||||||kanser ilacı||||||||ölmekte olan||||||||||| But you know what, they couldn't find anyone who wasn't getting the drug. So that drug, we've given away, I don't remember what the number is, billion dollars worth of free drug. |||||||ne|me souviens|||||||||| Así que esa droga, hemos regalado, no recuerdo cuál es la cifra, mil millones de dólares en droga gratis. We spend a lot of money every year on co-payments for folks. |||||||||ortak ödemeler|katkı payları|| So we believe that, least in the Western world where we operate, everybody has access to our drugs, even if we just give it to them for free. |||||||Batı dünyası|||||||erişim hakkı||||||||||||| Por eso creemos que, al menos en el mundo occidental donde operamos, todo el mundo tiene acceso a nuestros medicamentos, aunque se los demos gratis.