When 10,000 doctors stood up and cheered for a cancer drug — America’s innovation machine made it possible
Daraxonrasib nearly doubled pancreatic cancer survival to 13.2 months — but the IRA's "Pill Penalty" threatens the system that produced it.

You might have seen, in early June, more than 10,000 oncologists and drug developers gave a standing ovation mid-presentation. The slide that moved the room showed survival curves for Revolution Medicine’s daraxonrasib. For the first time, a drug showed a path to beating pancreatic cancer, nearly doubling survival.
Thanks to social media, millions more shared that moment. Over the last half-dozen years of my 25-year career in biotech, I’ve enjoyed more and more moments like this. The vast majority have been thanks to U.
S. leadership in drug innovation. But we are at an important crossroads.
American patients face high healthcare costs at home, while the rise of China and AI adds new anxieties. As America celebrates its 250th anniversary, we should reflect on what made this country the world’s engine of drug innovation and how we can sustain it for American patients. The Innovation Treadmill: America’s Hidden Longevity Machine America’s leadership in drug innovation was built on a simple bargain: reward new therapies, then force rapid generic substitution once patents expire.
Consider Pfizer’s Lipitor, a leading statin that reduces cardiovascular mortality by roughly 25%. Within months of losing exclusivity, generic substitution reduced Lipitor’s price by 90%. Lipitor’s story applies to nearly every drug.
Companies have, on average, 14 years to recover over a billion in development costs before products lose exclusivity. That keeps them racing to generate the next breakthrough. We call this dynamic the “Innovation Treadmill”.
The Innovation Treadmill needs to provide sufficient incentives for innovators to pursue novel therapies, which can make the ~10% of branded drugs expensive. When insurance provides coverage, the average American’s share of $120 per month provides access to all medicines past and present. As a result of the Innovation Treadmill, the U.
S. has dominated global drug innovation. American patients get early access to the most novel medicines.
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