COMMENT 11 April 2019 One aspect of the ongoing debate about drug pricing is the added therapeutic benefit of new drugs compared with existing — and potentially cheaper — therapies. Here, we discuss the merits and pitfalls of proposals that are being discussed with regard to the role of regulatory agencies in establishing added therapeutic benefit. Harald Enzmann & European Medicines Agency (EMA), Amsterdam, Netherlands; Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany.