One man in three and one woman in four will develop cancer before their 75th birthday. In Belgium, cancer is the second major cause of disease burden after cardiovascular diseases and it is unlikely this will change in the foreseeable future. Increasingly better but more expensive cancer therapies are becoming available. Needless to say, in these times of austerity, the public budget for cancer treatment is under pressure. How can we ensure all patients continue to have access to these expensive but potentially life-saving medicines at a price society can afford, while at the same time encouraging pharmaceutical companies to innovate?