Drug cost is a touchy subject, rarely addressed in medical journals. Breast cancer treatment is lengthy, tedious and expensive. Costs of anti-cancer drug are relatively higher in the United Sates (US) than Europe. The present US government plans to reduce drug costs.

Our Aims: 1- Test drug cost reduction in US over 12.5% - 75% range 2- Choose 37.5% cost reduction as appropriate measure for patients, consumers, pharma and government.

Results: Generic chemo $1,500, trastuzumab for HER2-positive cancer, depending on usage and cancer type; the total $86,955 cost was reduced to $32,608 with %37.5 reduction. Pertuzumab reduced from $99,000 to $37,125,  trastuzumab deruxtecan (T-DXd) $159,600 to $59,850. it was estimated that if 300,000 US females develop breast cancer at $100,000 drug cost, the total treatment would currently climb to $30,000,000,000 (30 billion), reduced to $15 billion at 50% cost reduction and $11,250 billion at 37.5%. A 50%-75% reduction was considered too harmful for pharma to bear and 25% too little and too late.

Conclusion: In US the proposed drug cost reduction by 37.5% would secure patients affordability, ensure pharma continued innovations and reduce costs down to European levels.