Many voices, two sides of the same coin. A coin multiplying so rapidly that prescription drug costs are becoming unsustainable for both insurers and patients. These costs are also exacting a toll on the US healthcare system. Add to that, the fast translation of research findings to new treatments is making it hard for the US healthcare delivery system to keep up. Predictable rates of increase in medical costs, upon which current payment systems were constructed, are no longer predictable. A chorus of patients, drug makers, government parties, payers, and other organizations are all vying for their voices to be heard amid the battle cry.