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从实验室到百亿美元:一颗降脂药如何能卖成传奇?

March 29, 2026 · 24 min

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全球每天有超过 2 亿人在服用他汀类药物,它是目前处方量最大的药物类别之一。其中最知名的一个,叫立普妥。

立普妥的研发,在学术报告里经常被作为理性药物设计的经典案例——围绕它的研究前后诞生了四位诺贝尔奖得主,它也是人类历史上累计销售额最高的处方药之一,让辉瑞一度跻身全球最赚钱的制药企业。

但这个故事,比教科书上写的要曲折得多。从第一个他汀分子在一株真菌里被发现,到立普妥成为全球最畅销的处方药,中间隔了将近 30 年,险些在好几个节点就彻底结束了。

这期节目,不只是「立普妥是怎么被发现的」,而是一粒药从实验室走到全球 2 亿人手里,科学、资本与营销究竟是如何共同发挥作用的。

时间轴:

00:09 为什么要讲立普妥?

02:16 「胆固醇假说」是怎么建立的?从兔子实验到 Framingham 心脏研究,医学界用了近半个世纪。

04:46 主人公远藤章:筛遍六千株真菌,找到第一个他汀类化合物美伐他汀。

10:03 LDL 受体的故事,他汀类药物是如何起效的?

11:44 美伐他汀被叫停、洛伐他汀险些夭折——是什么让默克最终重启临床试验?

15:39 华纳-兰伯特和阿托伐他汀的诞生:临床价值等于市场价值吗?

17:05 辉瑞的销售机器、DTC 广告开闸、Jarvik 划船广告翻车——营销在立普妥的成功里扮演了什么角色?

21:25 900 亿美元的敌意收购,立普妥成为史上最畅销处方药。

参考文献:

Endo, A. (1992). The discovery and development of HMG-CoA reductase inhibitors. Journal of Lipid Research, 33(11), 1569–1582.

Endo, A., Kuroda, M., & Tsujita, Y. (1976). ML-236A, ML-236B, and ML-236C, new inhibitors of cholesterogenesis produced by Penicillium citrinum. The Journal of Antibiotics, 29(12), 1346–1348.

Goldstein, J. L., & Brown, M. S. (1990). Regulation of the mevalonate pathway. Nature, 343, 425–430.

Tobert, J. A. (2003). Lovastatin and beyond: the history of the HMG-CoA reductase inhibitors. Nature Reviews Drug Discovery, 2(7), 517–526.

Istvan, E. S., & Deisenhofer, J. (2001). Structural mechanism for statin inhibition of HMG-CoA reductase. Science, 292(5519), 1160–1164.

Donohue, J. M., Cevasco, M., & Rosenthal, M. B. (2007). A decade of direct-to-consumer advertising of prescription drugs. New England Journal of Medicine, 357(7), 673–681.

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