ISSUE: To approach the proper balance between affordabil­ity and future availability of medicines in the inter­est of public health, Making Medicines Affordable offers a set of eight specific recommendations, with interlinked imple­mentation actions in the biopharmaceutical sectors, regarding: federal government negotiation of prices, access to off-patent drugs, consumer information, insurance benefit designs, the Orphan Drug Act, and reimbursement incentives. What are the key rationales behind these recommendations? Can we be confident – and how could we evaluate – whether implementing them would achieve a desirable balance between affordability and innovation? OVERVIEW: Over the past several decades, the U.S. biopharmaceutical sector has been very successful in developing and delivering effective drugs for improving health and fighting disease. Many medical conditions that were long deemed untreatable can now be cured or managed effectively. Yet this success has come at a cost: Spending on prescription drugs has been rising dramatically, to the point that many people have difficulty paying for the drugs that they or their family members need. Drug costs are a significant part of the nation’s total spending on health care. With support from a host of sponsors, the National Academies of Sciences, Engineering, and Medicine conducted a study to recommend policy actions that address drug price trends, improve patient access to afford­able and effective treatments, and encourage innovations that address significant needs in health care. The resulting report, Making Medicines Affordable: A National Imperative, provides several strategies to tackle the rising costs of prescription drugs without discouraging the development of new and more effective drugs for the future.