Major advances have occurred in the treatment of multiple myeloma, including several new drugs that typically cost more than $100,000 per year. Although the gains in myeloma therapy improve overall survival considerably, they are available to only a fraction of the population of patients with myeloma in the world because of regulatory barriers and cost. Myeloma is an example of what is happening in cancer on a much larger scale. Many of the problems discussed call for a wider discussion across all cancers, but they are amplified in myeloma because of the need for multidrug regimens that combine three or more expensive new drugs for prolonged periods of time. In this article, the reasons for the high cost of cancer drugs and possible solutions are examined. The lack of correlation of value and price, the remarkable rise in prices of existing old medications over time, and the lack of access to lifesaving drugs across various countries are also discussed.