At the end of September, a spot of good news: Relyvrio, a new drug for treating amyotrophic lateral sclerosis—or ALS, a neurological disorder without a cure—was approved in the United States.The ALS community rejoiced; the drug’s authorization was described as a “long-sought victory for patients.”But the next day, the price of the medicine was revealed: $158,000 a year.This was far higher than what the Institute for Clinical and Economic Review, an independent nonprofit that analyzes health care costs, had estimated would be a reasonable price, which it deemed to be between $9,100 and $30,700.In the study, they looked at the 60 drugs that had been approved by the US Food and Drug Administration (FDA) between 2009 and 2018 for which there was publicly available information about both R&D spending and pricing.“Essentially, it was like investigative journalism—check all the receipts, trace back in time on what they spend,” he says."