Oncology treatments which have come onto the market during the last few years are extremely expensive per treatment course. This is true for biotech products, like monoclonal antibodies and the most recently approved ipilimumab, and for small molecules, like azacitidine and clofarabine, and even orally administered products like lenalidomide or various tyrosine kinase inhibitors. Why are the prices of these products so high? The manufacturing companies argue that research and development costs are very high and that the number of years protected by patent rights after approval is decreasing. Therefore the life cycle of the products is reduced and return on investment needs to be achieved in a shorter period of time. For biotech products high manufacturing costs are also a factor. However, as oncology drug treatments are developed more and more as targeted treatments for specific patients the number of patients eligible for treatment is decreasing and the number of patients treatable within the licensed indications (in-label) is limited. These so-called individualised antitumour therapies often offer only a modest gain in overall survival …