Yes - a breakthrough therapy and / or new formulation. Whether or not in a new formulation is all comes down to long term medical costs.
Imagine an insurer covering medical costs for a patient due to serious heart problems over 20-30 years.
Imagine what a drug that largely eliminates cardiotoxic effects of anthracyclines will do in terms of reducing cumulative patient care costs. Massive cost saving for insurers (or payers as they are called in the US).
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