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" ... In the past, clinicians heralded breakthroughs like the LATITUDE study and the STAMPEDE trial with encomiums on the beauty of clinical trials. Vats of vintage champagne were spilled in celebration of lives saved. Now, instead of penning an essay on how abiraterone will transform the prostate cancer landscape, I feel nudged into writing on its potential financial toxicity. You can read that however you would like--I find it sad. Insurance companies will reflexively fight this new indication, but the force of the data is uniquely compelling, and they will have to acquiesce. The money will be found in the pocketbooks of patients who may well find their premiums rising for yet another reason. ... "