In terms of where _prices_ are set, that negotiation is a function of efficacy relative to other things in the market right? If it ends up treating cancers that each already have a reasonably effective treatment, maybe the pricing isn't that high -- but if it is effective in cases where currently there are no options, the price should be high?
But for something that potentially works against a range of cancers, should we expect to see a sequence of more specific trials (i.e. one phase 1 for basic safety, a bunch of phase 2s for efficacy on specific cancer types, a sequence of phase 3s in descending order of estimated market value? And in 10 years, Alice and Bob with different cancers will pay radically different amounts for almost exactly the same treatment but with small variations in some aspect of the formulation so they can be treated as distinct products?
They have entire teams of people who figure out the viability and pricing of therapeutics before the first dollar is spent, with estimates getting refined the further you get along in the cycle.
Other countries use insurance, so once again the end cost is essentially irrelevant.
This is one of the issues with the modern cancer cures, thst they are very specific to the cancer, the patient, need one off lab work for each patient and this makes them very expensive and not affordable to many. Despite having public healthcare the managers of it still need to decide what to spend their limited funds on.
You're right about the specificity - Hep C is a bigger-population target than a lot of cancers are - but a lot of the new approaches are looking to be inherently more "personalized" to compensate.
I think it matters because oftentimes insurance companies won't cover treatments if a cheaper form of treatment exists. It doesn't matter if the old treatment is less effective or a much worse outcome for a patient. This is especially true for "new" treatments.