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Drugs that act by modifying a patient’s genes are close to approval in the United States, and one is already available in Europe. The developments mark a triumph for the field of gene therapy, once considered controversial.

But with estimated price tags of at least US$1 million per patient, how will anyone pay for these treatments? The question is just one in a broader debate about how to finance a range of super-expensive drugs that are now available, thanks to an explosion in genetic and molecular-biology research over the past 20 years.

“Advances in science are presenting a social affordability question like never before,” says economist Mark Trusheim at the Massachusetts Institute of Technology in Cambridge. “Do we want to convert the science into therapies that we actually would have to pay for?”

Trusheim spoke at the Biotechnology Innovation Organization (BIO) meeting in San Francisco, California, on 6–9 June, which featured much discussion about how society will pay for the rising costs of new drugs. At the American Society of Clinical Oncology meeting in Chicago, Illinois, on 3–7 June, dozens of talks and...