Pharmaceutical innovations—particularly those that cure chronic or life-threatening diseases—create enormous value for society by preventing deaths, improving lives, and lowering health care costs. Witness the medicines that cure hepatitis C (HCV) and those that hold great promise to cure other diseases, such as certain types of cancer.

But the pharma industry’s predominant economic model—charging per treatment at the time of care—can limit society’s ability to reap the full benefits of a cure. The problem: a mismatch in the timing of payment versus the timing of benefits. The prevailing model front-loads the payment to pharmaceutical companies while the treatment’s value to society accrues over time, sometimes decades.

The advent of cures creates a true pricing dilemma for pharmaceutical companies and those that pay for medicines. If drugs were priced today to reflect only the value that accrues over time, the resulting (high) prices would strain payers, prompting some of them to limit patient access. Conversely, treating all patients as fast as possible—and in doing so, accelerating eradication—requires prices so low that developing certain cures would become far less economically attractive, particularly compared with the economics of drugs that treat chronic diseases.

Is it possible to solve this dilemma and align the incentives of pharmaceutical companies, payers, and patients?