tooth and nail

記事の引用からお読みください。


The Congressional Budget Office (CBO) — that scorekeeper of how federal policies will affect business, the government, and the public at large — has a preliminary report out on how House Speaker Nancy Pelosi's proposed drug pricing legislation may affect the federal budget, public health programs, and the drug industry at large.

It's a lot to parse through. Here's one topline takeaway: The CBO estimates the bill (which would allow Medicare to negotiate lower prices with private companies for some of the most expensive drugs) would save the federal program $345 billion between 2023 and 2029.

Now, here's the rub, and why pharmaceutical companies will be fighting tooth-and-nail against the legislation — the preliminary analysis also predicts a major hit to drug firms' bottom lines and innovation in the sector.

"Although CBO has not completed its analysis of the bill’s implications for new-drug development, its preliminary estimate is that a reduction in revenues over the next 10 years of $0.5 trillion to $1 trillion would lead to a reduction of 8 to 15 new drugs coming to market," according to the preliminary analysis.
(Sy Mukherjee. Could Lowering Drug Prices Hamper Drug Innovation?—Brainstorm Health. Fortune. October 14, 2019.)


日本においても最近、高額医療費、特に何千万円にもなるような高額な医薬品が保険財政に与える影響について議論が交わされていますが、米国では薬剤費を規制する法案が議論されているようです。

ここで焦点になるのはやはり、革新的な新薬に対する対価として果たしていくらが適当なのかという議論であり、その議論は製薬会社対政府という構図となってしまうようです。

記事の文中で、


pharmaceutical companies will be fighting tooth-and-nail against the legislation


というくだりがあります。

ここで使われている、"(fight) tooth-and-nail"というフレーズは、全力で戦う、必死で戦う、という意味です。

"tooth"は歯、"nail"は爪、であり、歯をむき出しにして、また爪を立てて敵に立ち向かう激しい様がイメージされます。