Ⅰ.阅读理解
阅读下列短文，从每题所给的A、B、C和D四个选项中，选出最佳选项。
“New and improved.” These words are put in so many marketing campaigns that we tend to accept them as linked.But many new drugs aren’t an improvement over the best existing drug for a given condition，and the fast drug-approval processes in recent years have added to the uncertainty about their advantages.
A recent report in the British Medical Journal，“New Drugs：Where Did We Go Wrong and What Can We Do Better？” analysed the issue.The authors looked at 216 drugs approved between 2011 and 2017; 152 were newly developed，and 64 were existing medicine approved for new uses.Only 25% offered a major advantage over the established treatment，and fully 58% had no confirmed added benefit to reduce symptoms or improve health-related quality of life.
“This doesn’t mean there’s no added benefit，” lead author Wieseler said.“It just means we have no positive proof.Either we have no studies or have studies not good enough.” Wieseler and her co-authors work for a German institute which evaluates new treatments and advises on whether the country’s health care system should pay a premium(占) for them.Such organizations，known as health technology assessment (HTA) agencies，work a little differently in the US，says Sean Tunis，a researcher in Baltimore：“If payers think a new drug isn’t better than an existing drug，these agencies will require that hospitals try the cheaper drug first.”
Germany’s HTA demands trials to prove that a new treatment beats the existing standard.This isn’t always practical.For one thing，such studies can be expensive and time-consuming，with no guarantee of success.Secondly，it can discourage companies from attempting to develop new alternatives.This is already happening.Drug developers are increasingly focused on areas where there are no good treatments to compete with，such as rare diseases.
This lack of meaningful data to guide patients is a major point of Wieseler’s paper—With accelerated approval，there are more products approved，with a greater amount of uncertainty about risks and benefits.But there are other solutions besides drug trials.One idea is to require postmarket studies to track the effectiveness of newly approved drugs—a step too often neglected.
1．What message does the recent report convey?
A．Many new drugs have no improved advantages.
B．The approval processes for new drugs are too fast.
C．Improved drugs have advantages over old ones.
D．Before 2017 no improvement was made to drugs.
2．What will US HTA agencies do when no advantage is found in new drugs?
A．Remove government premium on them.
B．Get hospitals to use the cheaper drugs.
C．Arrange financial support for the patients.
D．Put new drugs on further trials and studies.
3．What’s the disadvantage of Germany’s HTA trial demands?
A．Making drug companies think of illegal ways to cut cost.
B．Pushing companies to try alternatives for existing drugs.
C．Getting patients to depend on the government for support.
D．Holding companies back from improving existing drugs.
4．What is the best title for the text?
A．The Advantage of Existing Drugs
B．Misunderstanding of New and Old Drugs
C．A Dilemma with New Drug Alternatives
D．People’s Preference for New or Old Drugs
【答案】 1.A 2.B 3.D 4.C
【解析】 这是一篇说明文。文章主要讲述了英国一项研究表明，与传统药物相比，市面上不断推出的新药大部分并不具有新的疗效。作者分析其中原因并指出，因为相关机构的要求，加上新药耗时费钱，因此药品公司干脆转向研究罕见病的药品，而不是对已有的药品进行改良。
1．细节理解题。根据文章第二段可知，英国《医学期刊》的一篇报道对2011到2017年上市的药品的研究发现，其中58%的新药与已有的药物相比，没有任何得到证实的新增加的药效。故最近的报告传达了许多新药没有改进的优势的信息。结合选项，故选A。
2．细节理解题。根据文章第三段可知，美国的卫生技术评估机构的功能与德国不同，如果付费方(病人)认为某种新药不比已有的药品更好，那么“他们(评估机构)就会要求医院先试用便宜一些的药品”。故选B。
3．推理判断题。根据文章倒数第二段可知，德国卫生技术评估机构要求有药物试验来证实改良后的新药比原先的药品更好，这需要大量的金钱和时间。由此可以推断出，德国HTA的试验的缺点是不利于公司对已有药品进行提升。故选D。
4．标题判断题。全文讲述药品研发的窘境：传统药物的更新未必有新的疗效，即使有新疗效，相关机构的要求使这个更新过程漫长而且费用高，于是很多药企干脆转向研究罕见病的新药，这就使已有药品的更新面临窘境。故C项A Dilemma with New Drug Alternatives“新药物的两难选择”作为标题，符合题意。故选C。
