In Reply In commenting on our Viewpoint,1 Cuddy et al describe the real price of tafamidis for patients with transthyretin amyloid cardiomyopathy (ATTR-CM) cared for at their institution. The findings underscore that insurance coverage for prescription medications and patient assistance programs run by pharmaceutical companies do not shield patients from high drug prices. David Mitchell, founder of Patients for Affordable Drugs, has stated, “drugs don’t work if people can’t afford them”2; “innovation and new drugs should not come at prices that bankrupt people…when they are struggling to maintain their health.”3