丹麦..老年和残障人士医疗市场

丹麦医疗技术产业现状及其优势领域  发布时间：2012/6/4 9:25:00 来源：药品资讯网信息中心  丹麦的医疗技术产业以医疗耗材用品，医疗康复辅助技术和医疗诊断领域的大型全球制造商闻名于世。丹麦拥有1000余家从事与医疗技术产业相关的行业公司，其中220余家专业医疗技术公司，拥有大约500,000种卫生保健产品，丹麦本国有从业人员20,000名，另有20,000名海外从业人员。其医疗技术产业年收入约500亿丹麦克朗，是欧洲医疗技术产品人均出口额最多的国家之一， 总收入的90-95%来自海外。丹麦大型的医疗技术公司包括丹麦癌症诊断公司Dako，康乐宝（Coloplast），奥迪康（Oticon）,唯听（Widex）和 GN。在新产品设计和诊断、治疗和护理等解决方案的不断发展过程中，许多大型公司落户丹麦，包括：Ambu International、Bayer、B-K Medical、B&O Medicom、Byrumlabflex、Dansac、Fresenius Kabi、GE Healthcare、Johnson-Johnson、Medtronic、NovoNordisk、Nunc、Radiometer Medical、Sahva、Siemens Medical Solution、Sonion、St.Jude Medical、Toshiba Medical Systems、Unomedical和William Cook Europe。丹麦医疗耗材用品、医疗康复辅助和医疗诊断产品均以其设计、功能性、高质量和用户友好性而广受好评。丹麦拥有世界上最先进的医疗辅助器械生产技术，由于丹麦完善的社会养老和伤残保障体系，促进了医疗助器械制造业的发展，从而决定了它在老年和残障人士服务领域的领先地位。例如丹麦的Oticon , Widex 和GN Resound三家公司拥有全球40%的助听器市场。富有技术的公司、具有远见的大学和有效的公共卫生系统都是丹麦医疗技术产业不断成长的保证。丹麦也为外国公司提供多种富有吸引力的商业解决方案，从与丹麦大学进行研发合作，创建欧洲总部及设计中心，寻找测试市场的战略合作，到医疗技术设备的生产演示。丹麦投资促进局（www.investindk.com）则免费帮助来丹投资者提供咨询和组建公司的一站式服务。 

总的来说，在丹麦发展医疗技术产业有以下诸多优势：
1. 丹麦在医疗技术领域的强势地位可以归功于拥有多所从事该领域前沿研发技术的世界顶级大学。丹麦的教育机构提供多种将医学与技术相结合的教育渠道，确保毕业生具备合格资质。
2. 大学、医院和商业团体间密切的合作，使得丹麦的商业环境更为流畅。丹麦医院间高度集中的研究和试验活动使它们成为强大的合作伙伴。
3. 丹麦在该产业的优势还在于与医疗技术产品使用者的密切合作。丹麦专注于开发和生产易使用、便捷、安全以及可以提高使用者生活质量的产品。这些优势促使丹麦医疗技术飞速发展，也吸引着诸多国外企业到丹麦投资。 

丹麦投资局..协助外商与丹麦公司及大学合作!!!

丹麦医疗技术产业现状及其优势领域   关于丹麦投资促进局 丹麦投资促进局（Invest in Denmark）隶属于丹麦外交部贸易委员会，负责制定外商投资政策和管理外国企业在丹麦的投资事务，帮助来丹投资者提供咨询和组建公司的一站式服务。无论外国公司在考虑选址、调整战略布局、设立创新生产基地或是寻求技术创新的合作伙伴，以及其他战略业务方案时，丹麦投资促进局都能为其提供帮助和服务，并协助他们建立与丹麦公司及大学之间的合作。丹麦投资促进局的专业服务覆盖从公司有初步意向到业务设立完成，同时与公司保持进一步的联络以确保外国投资者能够充分享受丹麦优越的投资环境。丹麦投资促进局还为客户提供信息保密，并提供专业且免费的服务，包括全球基准比较工具、针对客户需求的商务考察等。

丹麦..有超过500个生物银行 (BioBank) !!!

 丹麦--创新国度的生物技术神话     作者：生物谷 来源：生物谷 2012-6-1 13:42:22  丹麦，作为享誉世界的童话国度为世人皆知，如今其生物技术产业亦是全球领先：丹麦是欧洲第三大生物技术公司资本市场，拥有欧洲第三大商业药品开发线，是世界五大（欧洲第二）具备生物技术开发潜能的国家之一。近年来，丹麦政府也采取了一系列的积极措施鼓励本国和外国对生物技术产业的投资。

丹麦生物技术产业现状和发展历史  如今，丹麦是160余家专业生物科技公司所在地，拥有 40000余名生物技术行业从业人员，5000余位行业专业研发人员，300余家生物科技服务供应商，8所大学，7个科技园区，4所重要大学附属医院。生物技术公司主要包括诺和诺德（Novo Nordisk）、伦贝克制药（H.Lundbeck）、利奥制药（Leo Pharma）、Leo Pharma, NeuroSearch,Genmab, Bavarian Nordic 等。这些都是丹麦强大的生物技术产业的重要组成部分。  丹麦的生物技术（生化酶和微生物方面）发展起源于卡尔实验室、汉森实验室和哥本哈根大学的化学实验,一直走在世界的前端。其悠久的农产品加工业历史，酿造啤酒、奶制品加工和猪肉加工等等，早在150年前就有了专门的研发产业。随着时间的推移，研发主体也从酿造啤酒发展为微生物的研究，从奶制品的加工发展到生物酶制剂的生产，从生猪加工发展到生产胰岛素等，科研水平逐渐升高。

丹麦生物技术优势研究领域

丹麦生物技术产业群是世界范围内的一支重要力量，其优势领域包括：
癌症﹣丹麦是欧洲癌症学术及商业研究领域最佳的医疗地之一，完全可以与波士顿和华盛顿特区相媲美。

代谢疾病﹣丹麦在代谢紊乱研究方面处于领先地位，并是肥胖防治及其相关疾病治疗的佼佼者。
炎症及传染性疾病﹣丹麦在炎症及传染性疾病的学术和工业制药领域都有着强大的基础研究能力。
中枢神经系统和神经科学﹣以医药谷为首，丹麦拥有强大的中枢神经系统（CNS）产业群，是世界唯一一个结合强大学术研究和大型商业医药公司的产业群。除了这些治疗领域，丹麦还在以下方面具有独特的优势，如个性化医学和转化医学，临床研究，生物医学信息，纳米医药包括给药解决方案，蛋白质组学和疫苗领域。
丹麦医药谷（Medicon Valley）丹麦医药谷的生物技术和制药公司  医谷(Medicon　vally)是重要的特色集群机构之一。1994年，北欧的丹麦和瑞典两国政府联手推动在丹麦哥本哈根地区和瑞典南部，成立北欧地区第一个生技医药谷--Medicon Valley。丹麦医药谷与英国剑桥、瑞士巴塞尔并列为三大欧洲最佳生物科技创新基地，是丹麦生物技术产业群的先锋，与大学院校、医院和公司都有着密切的合作。医药谷包括丹麦的哥本哈根地区和瑞典南部的Skane地区，有320万人口。与硅谷类似，医药谷的内涵是技术、人才和资金的高密度积聚，在这里集中了大批医院、大学、科学园和企业从事药物、生物和医学技术的研究和生产。
政策支持、优越环境吸引投资 近年来，丹麦采取了改善本国投资环境、吸引新兴经济体投资者、提供更多投资优惠、加强为外国企业服务等一系列促进贸易与投资的政策，尤其是有针对性地加大了对中国招商引资、扩大互利互惠合作的力度，起到了日益明显的积极作用。目前在丹麦投资的中国企业约有50家，包括中国国航、比亚迪、睿智化学、长江实业、中远集团、远景能源、明阳风电、联想集团、华为、东方海外、华大基因等众多中国知名企业均已在丹麦开展相关业务。例如从创新性药物开发方面来说，丹麦有着很多的优势：丹麦是批准临床试验最快的国家之一；丹麦的高校和企业间有着跨学科的、公共与私营部门合作研发的长期传统；；丹麦的国民卫生保健系统记录着本国所有公民"从出生到死亡"一生的健康状况，这意味着丹麦拥有超过500个生物银行和大量的医学记录……丹麦亦在中国上海设立了亚太地区丹麦投资促进局（www.investindk.com），丹麦投资促进局（Invest in Denmark）隶属于丹麦外交部贸易委员会，负责制定外商投资政策和管理外国企业在丹麦的投资事务，帮助来丹投资者提供咨询和组建公司的一站式服务。无论外国公司在考虑选址、调整战略布局、设立创新生产基地或是寻求技术创新的合作伙伴，以及其他战略业务方案时，丹麦投资促进局都能为其提供帮助和服务，并协助他们建立与丹麦公司及大学之间的合作。丹麦投资促进局的专业服务覆盖从公司有初步意向到业务设立完成，同时与公司保持进一步的联络以确保外国投资者能够充分享受丹麦优越的投资环境。丹麦投资促进局还为客户提供信息保密，并提供专业且免费的服务，包括全球基准比较工具、针对客户需求的商务考察等。（生物谷Bioon.com） 

Artificial blood vessels by growing....

Lab-grown human blood vessels could help study diseases, grow tissues for transplant     By Dario Borghino  19:24 June 1, 2012   Engineered microvessels can form bends and T-junctions, like this one. The blue dots are the nuclei of the cells in the vessel walls, and the red lines are the cell junctions. Smooth muscle cells (green) wrap and tighten around the vessels, just as they do in the human body.  A team of bioengineers at the University of Washington has developed the first structure for growing small human blood vessels in the laboratory. The vessels behave remarkably like those in a living human and offer a better and much more modular approach to studying blood-related diseases, testing drugs and, one day, growing human tissues for transplant.  The past year alone has brought remarkable advances in blood vessel regrowth in the human body, ranging from regenerating bandages that can speed up angiogenesis (the growth of new blood vessels from pre-existing ones) to new ways of fighting myocardial ischemia disease.  The University of Washington breakthrough, however, marks the first time that blood vessels are grown in the lab, allowing researchers to study much more extensively how conditions such as thrombosis and angiogenesis - but also cancer and the later stages of malaria - affect the circulatory system.  The microvessels behave remarkably like they would in the human body, sprouting new branches when in contact with stromal cells, reacting appropriately to clotting agents, and transporting blood even through sharp corners.Prof. Ying Zheng, who led the research, built the structure out of collagen, the most abundant protein in the body. She created tiny channels and injected them with human endothelial cells, which line the inside of human blood vessels. Over the course of two weeks, the endothelial cells grew throughout the structure, forming tubes through the mold's channels, just as they would in the human body. Then, brain cells were then injected in the collagen gel.  "The brain cells were injected into the gel to study how they interact with the innermost vessel cell - endothelial cells," Zheng told Gizmag. "Most of blood vessels are composed of endothelial cells and perivascular cells, and surrounding them there are stromal cells. The brain cells injected in the gel acted as perivascular cells that they coated around the endothelium, to stabilize the vessel barrier; they also acted as stromal cells to stimulate the endothelium to sprout new branches, extending the network."  The greatest advantage to this approach is that scientists can now effectively dissect what happens at the interface between the blood and the tissue, looking at how blood-related diseases progress and designing efficient strategies to contrast them."With this system we can isolate each component or we can put them together to look at a complex problem. We can isolate the biophysical, biochemical or cellular components. How do endothelial cells respond to blood flow or to different chemicals, how do they interact with their surroundings, and how do these interactions affect the vessels' barrier function? We have a lot of degrees of freedom," says Zheng.  The system could also be an accurate model for how tumors progress within the body. Cancer, in fact, secretes chemicals that cause nearby blood vessels to bulge and then sprout. Tumor cells then penetrate the bloodstream and colonize new parts of the body.  This mechanism can be modeled accurately by Zheng's system. When the researchers injected a signaling protein for vessel growth that's overabundant in cancer and other diseases, new blood vessels sprouted from the originals, and the new vessels exhibited similar characteristics to those in human cancers.  The short video below shows blood being pumped through one of the engineered vessels. This system has been injected with a compound associated with clotting, and clots were shown to form in these vessels just as they do in the human body. The blood was driven by an external gravity pump.The researchers are now using the system to further explore the blood vessel interactions that cause inflammation and clotting, but even more exciting applications are on the horizon. "This vascular structure could serve as the infrastructure to support the human transplantable tissues. This is something we are working towards in the very near future," says Zheng.  The findings are published online on this week's edition of the journal Proceedings of the National Academy of Sciences.

BMS-936559 in 2012 ASCO !

Cancer therapy that boosts immune system ready for wider testing    June 2, 2012 in Cancer  Two clinical trials led by Johns Hopkins Kimmel Cancer Center researchers in collaboration with other medical centers, testing experimental drugs aimed at restoring the immune system's ability to spot and attack cancer, have shown promising early results in patients with advanced non-small cell lung cancer, melanoma, and kidney cancer. More than 500 patients were treated in the studies of two drugs that target the same immune-suppressive pathway, and the investigators say there is enough evidence to support wider testing in larger groups of patients.Results of the Phase I clinical trials will be published online June 2 in the New England Journal of Medicine and presented at the 2012 Annual Meeting of the American Society of Clinical Oncology (Abstracts #2509 and #2510)."Based on the positive response rates to these drugs and longevity of many of these responses, we believe that new clinical trials should move forward," says Suzanne Topalian, M.D., professor of surgery and oncology at Johns Hopkins. Preliminary analysis shows that, among responding patients who were followed for more than one year, responses were maintained for more than one year in two-thirds of those treated on one trial and in half of those in the other trial.The immune-based therapies tested in the two clinical trials, both made by Bristol-Myers Squibb, aim not to kill cancer cells directly, but to block a pathway that shields tumor cells from immune system components able and poised to fight cancer.

PD-1/PD-L1 pathway as a target for cancer immunotherapy: Safety and clinical activity
Abstract No: 2510    Citation: J Clin Oncol 30, 2012 (suppl; abstr 2510)

Background: Blocking the interaction between programmed death-1 (PD-1), a co-inhibitory receptor expressed by activated T cells, and its ligand PD-L1 may enhance T-cell function. Here we describe the safety and activity from the first clinical study of BMS-936559 in patients (pts) with advanced solid tumors, further validating the importance of the PD-1/PD-L1 pathway as a target for cancer therapy.

Methods: BMS-936559 was given Q2 wk IV in a 6-wk cycle at doses of 0.3−10.0 mg/kg during dose escalation and/or cohort expansion; pts could receive up to 16 cycles (48 doses).

Results: As of August 1, 2011, 162 pts with melanoma (MEL, n=53), non-small-cell lung (NSCLC, n=50), colorectal (n=18), renal cell (RCC, n=17), ovarian (n=17), and pancreatic (n=7) cancer were treated. Median therapy duration was 11 wks (max 99 wks). Common related adverse events (rAEs; ≥5% pts) included fatigue, diarrhea, infusion reaction, arthralgia, rash, and pruritus. The incidence of grade 3-4 rAEs was 8.6%. AEs of special interest included hypothyroidism, hepatitis, sarcoidosis, endophthalmitis, and myasthenia gravis; there were no drug-related deaths. Clinical activity was observed in MEL, RCC, and NSCLC. Objective responses (ORs; RECIST 1.0) were observed in heavily pretreated pts. ORs were durable; among 16 pts with ORs, 7 had responses lasting ≥1 yr. Two other pts had ongoing ORs with durations of 2.3 and 8.5 mo at data lock. Several pts had prolonged stable disease. Some pts had a persistent reduction in overall tumor burden in the presence of new lesions but were not categorized as responders. In NSCLC, ORs were observed irrespective of histology.

Conclusions: BMS-936559 was active and generally well tolerated in pts with NSCLC, RCC, and MEL. In conjunction with data from anti-PD-1/BMS-936558 trials, this study concurrently validates the importance of the PD-1/PD-L1 pathway for cancer immunotherapy and supports further clinical development of anti-PD-1/PD-L1 directed therapy.

癌症基因篩檢 超過15000m元 再考慮吧 !!

Researchers find that not all patients will pay for genetic testing    June 1, 2012 in Cancer  More than one-fifth of people who have received referrals to test for cancer-causing genes say they will only undergo testing if their insurance covers the cost—just as more insurers are instituting cost-sharing for medical services like genetic testing, according to new findings from Fox Chase Cancer Center in Philadelphia released at this year's 2012 Annual Meeting of the American Society of Clinical Oncology on Saturday, June 2. Even though patients may pay thousands of dollars for some types of genetic testing, if they learn they carry mutations that put them at risk of other cancers in the future, that money will be well-spent, says study author Jennifer M. Matro, M.D., a medical oncology fellow at Fox Chase. Patients who are more at risk of certain cancers will know to schedule regular screening and check-ups so they can catch tumors at their earliest stages, when treatment is easier—and less expensive, she notes."Cancer care is becoming more personalized, but there are costs to that," says Matro. "The goal of genetic testing is to give patients the best opportunity to detect their cancers earlier, which can save costs in the long run."But given how expensive genetic testing can be, Matro recommends that researchers learn more about which patients are most at risk and truly need testing, to spare those who may not carry enough compelling risk factors. "We need to discover more risk factors for genetic mutations, so we can spare those patients who really don't need to pay for genetic testing.""Genetic testing is now routinely integrated into cancer care," says Matro. If someone develops a colorectal cancer, for instance, a reflex preliminary screening test is done on the tumor to identify patients at risk for Lynch syndrome, which would put them at risk for other gastrointestinal cancers, endometrial, and renal cancers, among others. If the test is positive, the patient is then referred for additional testing to diagnose Lynch syndrome. If the screen is negative, no additional testing is done. This preliminary screen is generally covered by all insurers, but patients may be asked to pay some of the cost if additional testing is needed.To determine whether these costs affect patients' decisions to obtain genetic testing, Matro and her colleagues at Fox Chase reviewed data collected from 406 people whose doctors suspected they may have cancer-causing mutations, based on their personal and/or family history.The researchers found that 82 people—21.3%—said they would undergo genetic testing only if it was paid for by their insurance. Among those willing to pay some out of pocket costs, nearly 90% provided a limit for how much they would pay; most limited out of pocket costs to $500 or less. Not surprisingly, people who were more worried about their risk of cancer and had more positive attitudes towards genetic testing were more willing to pay higher costs. Interestingly, women, people who were less educated, and those with more first-degree relatives who had cancer were less likely to agree to high co-pays for genetic testing.It's likely in some cases that simple cost is the issue, Matro speculates, since people with less education may also make less money, and women may not be the primary bread-winners in their household, so have less access to money. "It's counterintuitive that people with more relatives who had cancer would be willing to pay less for genetic testing," she concedes. "Perhaps they assume the test will be positive, so don't want to be saddled with a hefty co-pay. Alternatively, they may feel confident navigating the healthcare system after helping family members with cancer, and believe they can handle whatever diagnosis they eventually receive."Provided byFox Chase Cancer Center 

FDA to let women try new breast drugs earlier

 Sunday, June 3, 2012By Julie Steenhuysen  CHICAGO (Reuters) - Regulators are moving the goal posts in testing new drugs for breast cancer in the hopes of giving more women with aggressive, early-stage cancers the chance to try breakthrough drugs while they have the best shot at a cure.  A new guidance document issued this week by the U.S. Food and Drug Administration will allow drug companies to test their medications for a few months on women with highly aggressive breast cancers before they have surgery, instead of waiting until the drug has been proven first in gravely ill patients.  "We're looking at introducing drugs into a very early stage of breast cancer, where a patient has a primary tumor and the chemotherapy is given before surgery," Dr. Richard Pazdur, director of the FDA's cancer drug office, said in an interview at the American Society of Clinical Oncology meeting in Chicago.  "The aim of this therapy would be to cure the woman of breast cancer," Pazdur said. "It's moving a very promising drug into a early stage of the disease with a curative intent."  If a drug succeeds in eradicating the cancer to the point where there is no sign of it in the breast or lymph nodes - something called pathologic complete response - companies could win accelerated approval.  That represents a significant change from the current approach, in which promising drugs only are tested in earlier stage cancers after they have first proven to be safe and effective in advanced, metastatic cancer.  "If you are a patient with early stage breast cancer and you hear about a great new drug for metastatic breast cancer, it's probably not going to be available to you under the current model for a decade," said Dr. Tatiana Prowell, a cancer specialist at Johns Hopkins in Baltimore and a medical officer for the FDA.  Prowell and Pazdur wrote about the guidelines in the current New England Journal of Medicine. 

PART OF PUSH AT FDA  The change is part of a push at the FDA to spur innovation and get more effective drugs to the patients who need them.  "We really do want to be very forward-leading," FDA Commissioner Dr. Margaret Hamburg said in a briefing with Reuters on Thursday.  "We understand the importance of taking an advance in science as quickly as we can to the patients who need them, always being mindful of our responsibility of looking at the issues of safety and efficacy."  FDA is taking a risk with the new strategy, which will expose women with much earlier-stage disease to potential safety issues of new medications.  Traditionally, by the time new drugs are tried on women with earlier-stage disease they have been tested in thousands of women with much more advanced disease, for whom the risk of trying the drug is balanced with its potential for prolonging their lives.

  To help mitigate these risks, the new guidance document will apply to women with an especially deadly form of breast cancer called triple-negative breast cancers.  Most breast tumors are called estrogen-receptor positive, because they are fueled by the hormone estrogen. About 20 percent are HER2-positive, because a protein called HER2 is involved. A third type is driven by the hormone progesterone. 

These types of cancer have good treatments.  Then there are basal-like or triple-negative tumors, so named because they lack estrogen, progesterone or HER2 receptors needed for most breast cancer drugs to work.  Triple-negative breast cancers tend to grow and spread more quickly than most other types of breast cancer, and they occur more often in younger women and in African-American women. 

"NOT FOR EVERY PATIENT"  "This is not for every patient. It should be for patients that are most likely to benefit and also those that are at highest risk of having a recurrence of the disease," Pazdur said.  Trials would be structured so that women are treated with either chemotherapy or chemotherapy plus an experimental drug for a few months prior to surgery.  If no sign of the cancer is found during surgery, the woman has achieved a complete pathological response. Researchers would then compare response rates in the two groups, and if the drug has helped cure significantly more cancers, it would be given a provisional type of approval called accelerated approval.  Drug companies would continue to follow women for several years to see if their cancers come back, and if women continue to be disease-free, companies could get full approval for the treatment. FDA is accepting comments about its draft plan through the end of July. 

Reaction so far has been positive.  "We clearly need new approaches to getting stuff to the early-disease setting," said Dr. George Sledge, co-director of breast cancer program at the Indiana University Simon Cancer Center and immediate past president of ASCO. 

FASTER ACCESS TO NEW DRUGS?  He said the new approach is not a perfect solution to the problem, but it's a good first step.  "It recognizes that we want to try to move drugs up front into an early disease setting as soon as possible - not wait until the patient is beat up and out of chances and out of hope before we throw a drug at the patient and hope it does something."  Leerink Swann analyst Howard Liang said the new approach could potentially speed access to several breast cancer drugs in development, including treatments by Roche, GlaxoSmithKline , Celgene Corp, Onyx Pharmaceuticals, Bayer, Boehringer Ingelheim, Eli Lilly and Co, Eisai Co Ltd and Puma Biotechnology Inc.  FDA is basing much of its plan on a clinical trial known as I-SPY 2, a Phase II breast cancer trial being conducted by the Biomarkers Consortium, a public-private partnership run through the Foundation for the National Institutes of Health.  The trial, being run by Dr. Laura Esserman at the University of California at San Francisco and Dr. Donald Berry of MD Anderson Cancer Center in Houston, relies on specific genetic signatures or biomarkers in tumors to select those who might benefit from testing with this new approach.  The trial uses an approach called adaptive design, in which researchers continuously monitor which patients are responding to drugs and try to give drugs to those most likely to respond.  "If a therapy is doing well in a particular subset of patients, it gets a higher probability of being assigned to a patient in that subset," Berry said.  The design allows the team to test new treatments with far fewer participants and in half the normal time, cutting back on the costs of developing treatments.  Hamburg said she is meeting with the board at the ASCO cancer meeting this week to discuss this and other approaches to innovative clinical trial design.  "We feel more powerfully than ever before that how the studies are structured from the get-go really matters for our ability to do our job in an effective and efficient manner," she said.  "We really do want to be part of the scientific discussions early on to help shape how research is done."  Breast cancer is the second-leading cause of cancer death in women, exceeded only by lung cancer, according to the American Cancer Society.  (Editing by Eric Walsh)Reuters Health 

神隆新增5項美國FDA的DMF (2012)

神隆下半年3大新藥上市 肥胖症打前鋒 搶每年6億美元商機！ 鉅亨網記者胡薏文 台北2012-06-04  神隆(1789-TW)今年第3季起，將有肥胖症藥、乳癌、肌肉萎縮性側索硬化症（漸凍人）等新藥上市，其中光是肥胖症部分，根據湯森路透估計，商機一年即可高達6億美元。神隆由於目前產能已經滿載，積極在兩岸進行擴產動作，台南新廠新增2條生產線，擴產逾3成，預估第4季可完工投產，今年下半年營運「小爆發」後，明年爆發動能更強。神隆今年預定上市的新藥產品共有7項，並新增5項美國FDA的DMF；新產品包括抗阿茲海默症藥物、黃體素避孕藥均於首季上市，其中抗凝血劑客戶尚與原廠訴訟中，而延遲上市進度，不過神隆下半年上市的新藥商機更大。神隆積極規畫生產線的垂直整合，提升全球競爭力，神隆目前已是全球前10大原料藥廠，其中高活性抗癌針劑居龍頭地位，同時搶攻大陸市場，也陸續傳出捷報，大陸前20大藥廠中，神隆已打入其中6家。神隆在台灣新增的2條生產線中，一條專門生產抗癌新藥，另一條則是專供類固醇，也將是台灣規模最大的類固醇生產線。法人看好神隆隨兩岸新產線陸續加入，可紓緩目前產能吃緊現象，下半年營運將可「小爆發」，明年在新藥、新產能均到位，業績將可展現更強的爆發動能。

Taiwan experts developing unique drug from Antarctic specimens

 2012/06/04 20:54:17Taipei, June 4 (CNA) A member of the first Taiwanese team to conduct research in Antarctica said Monday that new medicine can hopefully be developed from an anti-inflammatory substance found in some of the specimens the group brought back.The compound was found in sponges and sea urchins, which were among the 600-plus specimens collected over the last three years by an expedition team formed by the National Museum of Marine Biology and Aquarium and local universities.Research on the anti-inflammatory compound has reached the animal testing phase and the researchers plan to submit the results to international journals, said Sung Ping-jyun, director of the Institute of Biotechnology at National Dong Hwa University, one of the participating schools.Researchers are analyzing the structure of the substance and a potential new drug may take as long as 10 years to manufacture, said Wen Zhi-hong, deputy director of the Operation Center of Industry and University Cooperation at National Chung Shan University, who added the research project was in its first year.While in Antarctica, the group worked with researchers from China in specimen collection of 49 species, according to the museum.Moreover, the team also discovered some penguin tissue samples contained dioxin, a toxic chemical compound, which could have entered the birds' systems directly through pollution or indirectly through the food chain, Sung said.

幼兒用 Acetaminophen (普拿疼;乙醯胺酚) 需更加注意肝衰竭 !

Acetaminophen overdoses in children can be life-threatening but are avoidable    June 4, 2012 in Medications  Acetaminophen, a widely available over-the-counter medication, can cause liver toxicity in children if doses are exceeded, and more public education is needed to warn of potential adverse effects, states an article published in CMAJ (Canadian Medical Association Journal)."Acetaminophen overdose is a major cause of acute liver failure and is the most common identifiable cause of acute liver failure in children," writes Dr. Rod Lim, Department of Pediatrics, Children's Hospital, London Health Sciences Centre, London, Ontario, with coauthors. "Repeated supratherapeutic dosing [above the recommended dose], accidental overdose due to error and intentional ingestion can all result in acute liver failure and even death."The authors cite a case study of a 22-day-old baby in which the parents misunderstood the correct dose of acetaminophen and administered too much analgesic for a circumcision. After the procedure, when the doctor instructed the parents to give another dose, they discovered the error. In this case, N-acetylcysteine with dextrose was given intravenously, and the child recovered within about 24 hours after ingesting the medication.N-acetylcysteine is the standard treatment for liver toxicity related to an overdose of acetaminophen and is usually successful if started within eight hours after ingesting the drug.Medication errors involving children are a serious issue, and dosing is complicated by the need to dose by the child's weight and convert this dose to a volume because many medications for children are in liquid form. A report from the US poison control centres and the American Academy of Pediatrics, which analyzed 238 instances of serious medication errors in children under age six, found that 11% of children who are given pharmaceuticals experience a medication error such as an incorrect medication, incorrect dose or method of administering. Acetaminophen overdose was the most common single agent responsible for a life-threatening event, longer-term illness or death.A better approach is needed to prevent these avoidable, and life-threatening, errors."Although physicians and pharmacists should continue to educate parents and caregivers regarding the medications prescribed, one-to-one communication cannot be the sole approach to reducing errors in medication administration," write the authors. "Error reduction on a large scale requires systems-based interventions and prevention."

Healthy habits can prevent disease

 June 4, 2012 in Health  Five new studies provide evidence to support simple steps we can take to prevent illness and improve our overall health. In the June issue of The American Journal of Medicine, researchers report on fish consumption to reduce the risk of colon cancer; the effectiveness of hypnotherapy and acupuncture for smoking cessation; regular teeth cleaning to improve cardiovascular health; the effectiveness of primary care physicians in weight loss programs; and the use of low-dose aspirin to reduce cancer risk.Colorectal cancer is the third leading cause of cancer death in the Western world. Research linking fish consumption and the risk of colorectal cancer has been inconclusive, although people who live in countries with high levels of fish consumption are known to develop the disease less frequently. Now, scientists from Xi'an, China, have reviewed the literature and find that eating fresh fish regularly reduces the risk of colorectal cancer by 12%. They evaluated 41 studies on fish consumption and colorectal cancer risk published between 1990 and 2011 and tracked cancer diagnoses. The protective effect of fish consumption is more prominent in rectal cancer than in colon cancer. The risk reduction for rectal cancer was as much as 21%, whereas the reduction for colon cancer was 4%."Despite the fact that colon and rectal cancer share many features and are often referred to as 'colorectal cancer,' they tend to demonstrate many different characteristics," notes lead author Daiming Fan, of the Fourth Military Medical University. "One possible reason for the difference may be because colon cancers are generally more molecularly diverse, whereas rectal cancers mostly arise via a single neoplastic pathway."Mark J. Eisenberg, MD, MPH, of McGill University, in Montreal, Quebec, and colleagues report that the use of unconventional smoking cessation aids, including acupuncture and hypnotherapy, results in substantial increases of smoking cessation. A meta-analysis of 14 trials found that smokers who underwent hypnotherapy were 4.55 times more likely, and those who underwent acupuncture were 3.53 times more likely, to abstain from smoking than those who did not. Aversive smoking may also help smokers quit; however, there were no recent trials investigating this intervention.Regular tooth scaling is associated with a decreased risk for future cardiovascular events. A study by H-B. Leu, MD, of Taipei Veterans General Hospital, Taiwan, and colleagues examined 10,887 subjects who had undergone tooth scaling, and 10,989 subjects who had not received tooth scaling. During an average follow-up period of seven years, the group that had undergone tooth scaling had a lower incidence of myocardial infarction, stroke, and total cardiovascular events. Increasing frequency of tooth scaling correlates with a higher risk reduction.A study by William C. Haas, MD, of East Carolina University, Greenville, NC, and colleagues finds that physicians in primary care practices can be as effective as weight loss clinics in helping the moderately obese lose weight. Patients received behavioral modification sessions and a diet plan partially or fully supplemented by meal replacements at either a primary care clinic or a weight loss center. Primary care clinics were as effective as weight loss centers at reducing weight, and better at reducing body fat. Regardless of location, participants completing 12 weeks of treatment lost an average of 11.1% of their body weight. Participants who selected full meal replacement had better results.Low-dose aspirin, a common strategy for preventing cardiovascular disease, can also reduce nonvascular deaths, including cancer deaths. A meta-analysis of 23 randomized studies by Edward J. Mills, PhD, MSc, of the University of Ottawa, Ontario, Canada, and colleagues offers conclusive evidence that low-dose aspirin offers cancer preventive effects, and showed significant treatment effects after approximately four years of follow up.

ASCO: Afatinib Slows Relapse in NSCLC

This report is part of a 12-month Clinical Context series.  By Michael Smith, North American Correspondent, MedPage Today Published: June 04, 2012  Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner  Take PosttestAction Points This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. An investigational oral drug (afatinib) delayed disease relapse for nearly a year in patients with advanced NSCLC and mutations in the gene for the epidermal growth factor receptor (EGFR). Note that patients receiving afatinib also had improved quality of life and had less cough and shortness of breath.  CHICAGO -- An investigational oral drug delayed disease relapse for nearly a year in some patients with advanced non-small cell lung cancer (NSCLC), a researcher said here.  In lung adenocarcinomas that harbor mutations in a key receptor, the tyrosine kinase inhibitor (TKI) afatinib outperformed standard chemotherapy with cisplatin and pemetrexed (Alimta), according to James Yang, MD, of the National Taiwan University in Taipei.  Patients receiving the study drug also had improved quality of life and less cough and shortness of breath, Yang told reporters at the annual meeting of the American Society of Clinical Oncology (ASCO).  The findings come from a large phase III trial involving 354 patients with stage IIIB or IV NSCLC that had mutations in the gene for the epidermal growth factor receptor (EGFR), Yang said.  Currently, two TKIs are approved to target EGFR mutations: gefitinib (Iressa) and erlotinib (Tarceva).  But Yang said afatinib differs from those to TKIs in that it is irreversible. "When it binds to EGFR, it doesn't bail out," he said.  He added that the drug also targets other receptors in the same family as EGFR, which might give it broader anti-cancer activity.  The trial's primary endpoint was difference in progression-free survival (PFS), Yang said, and after a median follow-up of 8 months, the median time to relapse was 11.1 months among patients getting the drug.  In contrast, the median PFS for those receiving chemotherapy was 6.9 months, yielding a hazard ratio for relapse of 0.58, which was significant at P=0.004.  Among patients with the two most common EGFR mutations -- deletion 19 or L858R -- the benefit was even greater: 13.6 months before relapse versus 6.9.  Adverse events were similar to those seen with other EGFR inhibitors, Yang said, and 7.9% of afatinib patients dropped out because of toxicity, compared with 11.7% of those in the chemotherapy arm.  He added that patients reported better quality of life in the afatinib arm, mainly because of better control of such symptoms as cough and shortness of breath.  The study is "exciting" for two reasons, commented Sylvia Adams, MD, of New York University Langone Medical Center, who was not part of the study but who moderated the ASCO press conference.  Afatinib represents a new generation of tyrosine kinase inhibitors" and blocks the entire family receptor that includes EGFR, she told MedPage Today.  The drug will probably be approved as first-line therapy for disease with EGFR-mutated NSCLC, she said, but the broader activity might lead to wider use.  The results are also exciting because there was a clear clinical benefit for patients in terms of better PFS and quality of life, she said.

T-DM1 Spares Women From Some, But Not All, Serious Side Effects

By Charlene Laino WebMD Health NewsReviewed by Laura J. Martin, MD  June 4, 2012 (Chicago) -- A new targeted cancer drug delayed the worsening of metastatic breast cancer, possibly with fewer side effects than traditional treatments, according to results of a late-stage study.  Called T-DM1, the new drug combines Herceptin with a potent chemotherapy drug. It's been called a "magic bullet": Herceptin homes in on cancer cells and delivers the cancer-killing agent directly to its target without damaging nearby cells.  The study involved nearly 1,000 women with metastatic breast cancer that was continuing to get worse despite treatment with Herceptin and a common chemotherapy drug.  Half the women got T-DM1 and the other half got Tykerb and Xeloda, a standard treatment for women who aren't helped by Herceptin.  T-DM1 delayed the time to the disease progressing by about three months. Among women who received T-DM1, the average time before the disease got worse was about nine-and-a-half months vs. about six-and-a-half months for those getting the standard drugs.  Although a few months might not sound like much, it can be a huge gain for seriously ill patients who are running out of options, say doctors studying the drug.  It is still too early to know for sure that T-DM1 will prolong lives, but the early data suggest that it will, says researcher Kimberly Blackwell, MD, of Duke University.  For the most part, women taking T-DM1 did not suffer the often debilitating side effects associated with chemotherapy, such as diarrhea, nausea, vomiting, and hair loss, she tells WebMD.  Still, the drug is not without toxicity: About 41% of women on T-DM1 suffered a serious side effect vs. 57% of those getting standard treatment.  About 13% of women getting T-DM1 had lowered blood platelet counts, which can increase the risk of bleeding. But there were very few cases of bleeding.  The findings were presented here at the annual meeting of the American Society of Clinical Oncology.

High blood caffeine levels in older adults linked to avoidance of Alzheimer's disease

June 4, 2012 Tampa, FL (June 4, 2012) Those cups of coffee that you drink every day to keep alert appear to have an extra perk – especially if you're an older adult. A recent study monitoring the memory and thinking processes of people older than 65 found that all those with higher blood caffeine levels avoided the onset of Alzheimer's disease in the two-to-four years of study follow-up. Moreover, coffee appeared to be the major or only source of caffeine for these individuals.Researchers from the University of South Florida and the University of Miami say the case control study provides the first direct evidence that caffeine/coffee intake is associated with a reduced risk of dementia or delayed onset. Their findings will appear in the online version of an article to be published June 5 in the Journal of Alzheimer's Disease, published by IOS Press (http://health.usf.edu/nocms/publicaffairs/now/pdfs/JAD111781.pdf). The collaborative study involved 124 people, ages 65 to 88, in Tampa and Miami."These intriguing results suggest that older adults with mild memory impairment who drink moderate levels of coffee -- about 3 cups a day -- will not convert to Alzheimer's disease -- or at least will experience a substantial delay before converting to Alzheimer's," said study lead author Dr. Chuanhai Cao, a neuroscientist at the USF College of Pharmacy and the USF Health Byrd Alzheimer's Institute. "The results from this study, along with our earlier studies in Alzheimer's mice, are very consistent in indicating that moderate daily caffeine/coffee intake throughout adulthood should appreciably protect against Alzheimer's disease later in life."The study shows this protection probably occurs even in older people with early signs of the disease, called mild cognitive impairment, or MCI. Patients with MCI already experience some short-term memory loss and initial Alzheimer's pathology in their brains. Each year, about 15 percent of MCI patients progress to full-blown Alzheimer's disease. The researchers focused on study participants with MCI, because many were destined to develop Alzheimer's within a few years.Blood caffeine levels at the study's onset were substantially lower (51 percent less) in participants diagnosed with MCI who progressed to dementia during the two-to-four year follow-up than in those whose mild cognitive impairment remained stable over the same period.No one with MCI who later developed Alzheimer's had initial blood caffeine levels above a critical level of 1200 ng/ml – equivalent to drinking several cups of coffee a few hours before the blood sample was drawn. In contrast, many with stable MCI had blood caffeine levels higher than this critical level."We found that 100 percent of the MCI patients with plasma caffeine levels above the critical level experienced no conversion to Alzheimer's disease during the two-to-four year follow-up period," said study co-author Dr. Gary Arendash.The researchers believe higher blood caffeine levels indicate habitually higher caffeine intake, most probably through coffee. Caffeinated coffee appeared to be the main, if not exclusive, source of caffeine in the memory-protected MCI patients, because they had the same profile of blood immune markers as Alzheimer's mice given caffeinated coffee. Alzheimer's mice given caffeine alone or decaffeinated coffee had a very different immune marker profile.Since 2006, USF's Dr. Cao and Dr. Arendash have published several studies investigating the effects of caffeine/coffee administered to Alzheimer's mice. Most recently, they reported that caffeine interacts with a yet unidentified component of coffee to boost blood levels of a critical growth factor that seems to fight off the Alzheimer's disease process."We are not saying that moderate coffee consumption will completely protect people from Alzheimer's disease," Dr. Cao cautioned. "However, we firmly believe that moderate coffee consumption can appreciably reduce your risk of Alzheimer's or delay its onset."Alzheimer's pathology is a process in which plaques and tangles accumulate in the brain, killing nerve cells, destroying neural connections, and ultimately leading to progressive and irreversible memory loss. Since the neurodegenerative disease starts one or two decades before cognitive decline becomes apparent, the study authors point out, any intervention to cut the risk of Alzheimer's should ideally begin that far in advance of symptoms."Moderate daily consumption of caffeinated coffee appears to be the best dietary option for long-term protection against Alzheimer's memory loss," Dr. Arendash said. "Coffee is inexpensive, readily available, easily gets into the brain, and has few side-effects for most of us. Moreover, our studies show that caffeine and coffee appear to directly attack the Alzheimer's disease process."In addition to Alzheimer's disease, moderate caffeine/coffee intake appears to reduce the risk of several other diseases of aging, including Parkinson's disease, stroke, Type II diabetes, and breast cancer. However, supporting studies for these benefits have all been observational (uncontrolled), and controlled clinical trials are needed to definitively demonstrate therapeutic value.A study tracking the health and coffee consumption of more than 400,000 older adults for 13 years, and published earlier this year in the New England Journal of Medicine, found that coffee drinkers reduced their risk of dying from heart disease, lung disease, pneumonia, stroke, diabetes, infections, and even injuries and accidents.With new Alzheimer's diagnostic guidelines encompassing the full continuum of the disease, approximately 10 million Americans now fall within one of three developmental stages of Alzheimer's disease -- Alzheimer's disease brain pathology only, MCI, or diagnosed Alzheimer's disease. That number is expected to climb even higher as the baby-boomer generation continues to enter older age, unless an effective and proven preventive measure is identified.

盛弘醫藥未依規定公告資訊被罰

  【2012/06/04 經濟日報】  金管會公告，盛弘醫藥公司4月11日經董事會通過向關係人取得不動產，但遲至5月10日才辦理公告申報，已違反公開發行公司取得或處分資產處理準則第30條第1項第1款規定。依證交法第規定，對盛弘醫藥之前開違規行為，處行為時負責人罰鍰新台幣24萬元。

中國直銷巨頭業績下滑!!

以前月入兩萬 如今分錢不賺 多家直銷巨頭業績下滑  2012年06月04日 09:43:16 　來源： 重慶商報 楊家坪一商場的雅芳櫃臺 記者 張永波 攝過去半年，國內直銷行業頗不平靜：3月以來，全球直銷巨頭雅芳數次調整在華直銷業務；5月中旬，完美、隆力奇、太陽神等拿照直銷企業頻頻陷入"傳銷"疑雲。業績增長放緩、直銷人員大量流失，中國直銷業陷入怪圈。記者歷時近1個月，走訪多家直銷企業及從業者，試圖探明真相。  

以前月入兩萬 如今一分錢不賺5月12日，周六。重慶楊家坪步行街人潮涌動，地處步行街最繁華地段的新世紀百貨瑞成商都，其一樓化粧品專櫃收銀臺前，排起了長長的隊伍，人聲鼎沸。  與瑞成商都隔著幾堵墻的雅芳專賣店內，店主王菲菲卻閒得發慌，她與"左鄰右舍"閒聊了近一個小時後，只好無聊地玩起了遊戲"植物大戰僵屍"，兩個多小時順利闖過兩關。王菲菲說，偶爾有人在店門口駐足，最初她還堆起笑臉熱情地招呼客人，屢遭拒絕後，她索性閉上了嘴。  "要是生意能像遊戲一樣就好了，只要認真去做，就能度過困難。"她面對記者苦笑道。  王菲菲說，到今年，她已同雅芳打了近10年交道，從雅芳小姐，到標準經銷商，到零售店主，再到如今的雅芳形象店主。很長一段時間，她都認為事業及生活已同"雅芳"融為一體。店內墻上還挂著幾個由雅芳公司頒發的獎牌，如"銷售創新獎"、"傑出銷售經理"等。不過，這一刻這些獎牌更像是對專賣店此刻窘迫的嘲笑。  最近一兩年，專賣店的生意一直在走下坡路，直銷員和顧客都在流失。"現在我必須想方設法才不至于虧本，但幾年前不是這樣的。"王菲菲的眼裏泛起一絲失落，"一個月能賣掉十幾萬產品，數千元的店鋪租金根本不是問題，每月至少能賺兩萬多元。"  上個月最後一位幫手辭職後，現在店裏只剩下她一個人，每月進貨縮水到不足3萬元，分攤租金、電費、稅費後，幾乎一分錢不賺。王菲菲苦惱地說："直銷這條路，未來的輪廓越來越不清楚，我很迷茫。"  迷茫的不只是王菲菲。新時代國珍重慶區直銷員韋川苦澀地說："招不到人！攤子鋪開了一個多月，培訓講座開了好幾場，最後確定加入的不到10人。"浸淫直銷領域數年的韋川認為，這在以前是絕不會發生的，"行業在變化，日子真的不好過！"  而對完美（中國）直銷人員劉小而言，由于其所在企業最近頻頻陷入"傳銷疑雲"，幾乎無法開展業務。  

業績大幅下降 直銷員大量流失作為化粧品行業巨頭，雅芳（中國）最大的資本是麾下數十萬銷售人員，2010年其直銷員達60多萬。而據中國直銷博客網的數據顯示，目前，雅芳在職直銷員卻不足20萬，短短一年便減少了40萬，三分之二的減員量讓人觸目驚心。  員工在減少，銷售額逐年遞減則更讓雅芳（中國）憂心。據雅芳（中國）重慶分公司一位不願具名的負責人介紹，2009年，雅芳（中國）營收尚有25億元，到2010年局勢突變。2010年第四季度，雅芳（中國）總收入僅3億元，同比下降45%，全年累計虧損高達7000多萬元；2011年雅芳（中國）業績繼續下滑，前三季度營收分別下挫32%、28%、6%，第四季度還虧了300萬元。  

除了雅芳，其實整個行業都在震蕩。  據商務部直銷行業管理信息係統顯示，目前，共有30家企業獲得了直銷經營牌照。記者登錄中國直銷博客網發現，2011年，這30家企業中絕大多數都遭遇了人才流失嚴重這一問題。  如新去年在職直銷員123名，解除推銷合同直銷員人數卻高達1175名，解除推銷合同的人數竟是在職直銷員人數的9倍之多。直銷巨頭安利，也遇到同樣的問題，其在職直銷員1153833名，解除推銷合同的人數則達3633484名。  人員流失，業績縮水。在中國開展美容院和直銷兩塊業務的克緹集團，去年總業績20億元左右，其中，直銷營收尚不足6億元，不到總營收的三分之一；隆力奇之前預期2011年業績會增長512%，創39億元營業額，但實際上其營業額僅與2010年的7.704億元持平。此外，尚赫、完美、歐瑞蓮等直銷企業的業績增長率均小于業界預期。  據中國直銷博客網統計，獲得直銷經營許可證的30家直銷企業，2011年全年的營銷業績約774.66億元，比上年增長30.61%左右。而據商務部網站相關資料顯示，早在2009年，當時的24家直銷企業營收就達600億元，比2008年23家企業的400億元業績增長了50%以上。業內人士分析，2011年新增了天獅、愛茉莉、金日等5家直銷企業，但行業營收增速卻比以往降了很多，著實奇怪。  營銷專家陳湛表示，直銷已從當年一照難求的金餑餑，變成不少直銷企業的燙手山芋。  

缺失了美譽度 慈善難挽發展頹勢去年，山東水立方公然散布了拿牌的假消息，安然納米近日也在官網上公布了直銷牌照復印件，暗示商務部已批復了第32張牌照。蹊蹺的是，第31張牌照花落誰家尚是未知數。  國內知名營銷策劃專家、直銷研究專家天問在接受記者採訪時表示，現代直銷模式已有上百年歷史，直銷者繞過傳統批發商和零售通道，直接將產品賣給顧客，減少了中間環節，消費者在以更低價格購得產品的同時，直銷商也能獲取更豐厚的利潤。"這一模式成就了雅芳、安利、玫琳凱等全球日化巨頭，贏得了不少企業推崇"。  

但在中國，它卻變得復雜起來。  "去年我加入天獅，最初去外面推銷產品時，幾乎沒人相信我們是一家正規的直銷企業，受了不少白眼，後來父母知道我在做直銷，都以為是傳銷，三番幾次勸我不要再做了。"天獅集團的直銷員胡天勇無奈地說。  "安利在大陸市場已走了17個年頭，2011年銷售額達250多億元，居行業銷售榜首，但美譽度的缺失自始至終都困擾著我們。"安利（中國）重慶分公司一名負責人表示，安利進入中國大陸時，直銷模式在國外已非常成熟。但在大陸卻有一些非法傳銷詐騙集團打著直銷旗號，欺騙消費者。"安利一直是背著十字架在走路，雖然現在國內直銷環境好了些，但還有不少人對直銷存有偏見。"  在記者隨機採訪的10名普通消費者中，有6人都認為直銷等同于傳銷。  記者了解到，僅去年，警方就偵破了數十起打著"天獅"名號的非法傳銷組織。"在中國做直銷，最難的就是像我們這類企業，有一點知名度，但又沒安利、玫琳凱名氣大，經常被不法分子利用，被冒充幾次後，企業的信譽就全毀了，做再多的慈善也補不回來。"天獅集團總裁李金元如是說。  "如果研究中國直銷業，你會發現一個很奇怪的現象，幾乎所有直銷企業都像是公益慈善機構，這是一種不得已而為之的'曲線救國'路線。"陳湛說。  據了解，天獅多年在全球范圍內投入慈善公益資金16億元；無限極2011年也捐資6800萬投入基建；安利則成立了專門的公益基金會。  "雖然在公益上做了很多努力，但並未形成很好的良性效應。"天獅直銷員胡天勇表示，雖然公司一再強調核心業務在直銷，但直銷領域的業績尚不足總業績的一半。  

迷失的直銷企業  

1 受累傳銷做慈善也難挽回美譽度  

2 禁止多層計酬難激發直銷員積極性  

3 企業向員工鼓吹一夜暴富忽略市場  

4 價格高脫離物美價廉基礎喪失競爭力  

5 電子商務衝擊價格優勢進一步喪失  

迷失原因  多層計酬被禁 直銷員積極性受挫  為什麼國外流行的直銷，到中國卻出現諸多不適？  上世紀90年代，國內傳銷活動猖獗，1998年出臺的《國務院關于禁止傳銷經營活動的通知》，直銷也被"一刀切"了。雅芳等直銷企業不得不轉走傳統零售渠道，改用店鋪加推銷員的模式經營。  2006年，商務部開放對直銷牌照的申請，但獲牌企業必須遵守2005年12月1日起施行的《直銷管理條例》。"這裏面矛盾就來了。"國內知名營銷策劃專家、直銷研究專家天問告訴記者，《條例》規定直銷企業只能用單層計酬，禁止了多層計酬。這即是說直銷員的報酬只能按本人銷售產品的收入計算，雅芳、安利等不得不再次調整，向"專賣店+直銷"混合模式轉型。  "多層計酬方式是通過不斷發展下線擴充業績獲得提成，同單層計酬相比，這種模式能更大程度激發直銷人員的積極性。"天問表示，多層計酬被禁止，是直銷在國內不適的一大原因。  同時，隨著部分企業的直銷隊伍日益壯大，專賣店同直銷隊伍間的矛盾開始凸顯。以雅芳為例，6000家專賣店必須承受房租、水電等負擔，成本壓力增大。因此，雅芳不得不在2008年再次由專賣店+直銷轉為全直銷模式。  "企業和人一樣，三天兩頭做大手術，想不傷元氣都難。"天問說，雅芳業績持續下滑是必然的。而安利銷售業績一直強勁增長，天問將其歸功于"迂回"戰術，比如安利規定一個月銷售超4800元的直銷員，便可申請成為經銷商，每年給予固定的獎金和促銷費用。  

脫離物美價廉 徹底喪失核心競爭力  直銷受挫，同企業自身也有很大關係。  天問認為，直銷之所以在國外運行良好，原因在于80%的人認為這是一種更便宜的消費。而國內多數直銷企業培訓員工時，充斥著快速致富的說法，很多直銷員都把直銷看作一夜暴富的機會。  一位曾供職于哈藥集團的直銷員李強盛透露，哈藥對直銷業務設置了非常誘人的獎金制度，即多層計酬，導致直銷員更側重于發展下線，而不是銷售產品，因此被媒體解讀為"變種的傳銷"。隆力奇直銷員閻婷也稱，要想加盟隆力奇直銷隊伍，首先必須交納3萬元現金，除了分享到3萬元的等值產品和全球的1.5%分紅外，立刻成為主任，收入非常可觀。  "中國直銷還有一大硬傷，那就是產品的高價。"天問補充表示，直銷模式之所以能風靡全球，最大功臣便是物美價廉，靠的是口碑傳播。而在國內，直銷企業這方面的優勢幾乎完全喪失。以某品牌400g的蛋白質粉為例，其標價282元，450g湯臣倍健蛋白質粉售價為253元，而450g的蛋白質粉在其美國網站上僅售30.75美元（約合人民幣198元）。資生堂旗下泊美品180ml舒緩爽膚水售價為150元，而玫琳凱美白係列100ml爽膚水售價在180元。  此外，電子商務對直銷的衝擊也不小。市場營銷專家陳湛認為，電子商務不用承擔店鋪租金、水電費等，與直銷相比更加便捷、透明，價格上也更有優勢。"店內一瓶100ml新活再生活肌水售價120元，但網上包郵價才70元左右。"雅芳專賣店店主王菲菲說。  在直銷發展史上，曾經歷現代營銷的兩次衝擊。一是沃爾瑪為代表的全球採購，把零售連鎖店變成了一個大平臺；二是亞馬遜為代表的電子商務。如今，沃爾瑪和亞馬遜的市值均超千億美元，而雅芳市值還不及其1/10。"可能雅芳所代表的直銷模式已經過時了。"營銷專家陳湛說。  

專家建言  放寬經營地域限制 走復合型電子商務之路  直銷行業陷入尷尬。而記者調查發現，安利、新時代國珍、天獅等很多直銷企業，都將突圍路鎖定在電子商務這棵大樹上。  "未來的直銷業將是復合型電子商務的時代。"國內知名營銷策劃專家、直銷研究專家天問認為，直銷E化，既是一種趨勢，更是一片藍海。直銷金牌培訓師王軍在接受記者採訪時也稱，通過電子商務，直銷產品的市場開發速度比線下更快，可復制性增強，更易發揮直銷的倍增優勢。  "為什麼直銷在中國會有種種尷尬？除了環境因素外，部分直銷人面對所謂致富機會時缺乏理性的做法。"直復式營銷和網際網路營銷專家何冬冬表示，電子商務能將機會在無形中放大，可能導致部分直銷人作出錯誤決策。  按《直銷管理條例》規定，直銷企業只能在規定的范圍內直銷。"這對市場發展形成嚴重制約。"中國市場學會直銷專家委員會主任艾家凱認為，目前，已產生個別企業銷售區域廣泛，大部分企業銷售區域狹小的局面，造成了不平等。這已成為我國直銷行業發展的一個瓶頸，或許取消地域限制，會重新喚起直銷市場的熱情。（應採訪者要求，文中王菲菲、胡天勇、閻婷均為化名）  本版稿件由記者 鄢銀嬋 實習生 林潼 採寫