Access challenges associated with high-cost pharmaceuticals have jump started discussion of solutions ranging from state-based boards reviewing drug price increases to harnessing Medicare’s purchasing power for “price negotiation” to old-fashioned price-setting. Consumers, increasingly frustrated with high costs for complex generics such as the EpiPen and novel, million-dollar therapies like Zolgensma, are demanding government action. High-cost pharmaceuticals may be classified into three groups: new modalities, such as gene therapy; old generic, small molecule drugs; and biologics. We focus here on biologics and explore potential solutions.