In Reply We appreciate Dr Lindpaintner’s comments on our recent Viewpoint. We agree that high prices represent an important barrier to access, with drug pricing serving as one of the most salient examples of this issue. In fact, this challenge epitomizes what we term the health equity valley of death, wherein systemic factors—including those related to cost and access—hinder the equitable dissemination of medical innovation, particularly to the most vulnerable populations. Dr Lindpaintner acc...