Often a patient will say to me, “I want the most expensive medicine.” “Isn’t the expensive one better?” The price of chemotherapy drugs does sometimes make patients wonder. The cheapest drugs cost only a few tens of dollars or even a few dollars to use once, while the most expensive drugs cost tens of thousands of dollars. Take colorectal cancer as an example. The classic regimen for colorectal cancer, FCF, consists of two drugs, calcium folinic acid and fluorouracil. The regular dosage of these two drugs adds up to just over a hundred dollars a time. However, the first-line treatment option available for advanced colorectal cancer is Epiduo + chemotherapy. It costs about 30,000 RMB for one time. So, is the more expensive chemotherapy drug the better? Of course not. For example, for patients with colorectal cancer, if it is early to mid-stage, only FCF regimen is needed after surgery. For advanced Epiduo + chemotherapy, K-ras gene mutation testing is required and only recommended for eligible patients. If a patient is only an early to mid-stage post-surgical bowel cancer patient, there is absolutely no need for expensive regimens. Many classical chemotherapy drugs in oncology are not expensive, such as cisplatin and epoetin, which are tens or more than one hundred dollars a piece. The price of new generation chemotherapy drugs is high, often hundreds or thousands of dollars, but with the end of the protection period of the drugs, domestic varieties have been released one after another, and most of the drugs have entered the medical insurance reimbursement list, and the price has been significantly reduced. In recent years, many molecularly targeted drugs have been marketed (e.g., Epiduo, mentioned above). These drugs are often extremely expensive, with monthly medication costs of more than 10,000 yuan. There are two main reasons for this: firstly, the preliminary research and development cost of new molecular targeted drugs is extremely expensive, and there are thousands of new drugs with potential anti-cancer effects every year. For example, crizotinib, which is used for lung cancer, only accounts for 2-3% of the lung cancer population. (In contrast, the chemotherapy drug Jianze can be used for about 80% of lung cancer patients, and doxorubicin is used for more than 90% of lung cancer patients.) This makes it impossible for these drugs to quickly recover costs with a large production volume, and it is therefore difficult to reduce prices. The high price of new drugs is not a complete substitute for classical use, and the lower price of some chemotherapeutic drugs is due to the fact that as the number of years on the market increases, research and development costs and intellectual property-related costs no longer need to be covered. The choice of chemotherapy and molecular targeted therapy drugs should be determined according to the patient’s condition, physical strength, tumor pathology and molecular typing. In clinical practice, we can see common chemotherapy regimens of several hundred dollars achieving good efficacy, and we can also see cases of uncontrolled disease after treatment with tens of thousands of dollars of drugs. In fact, price is not a factor that physicians consider when choosing a drug, but the production, cost control, and health insurance policies are often more relevant to the price of a drug. In the context of China’s national situation, what we can do as physicians is to first develop the best treatment strategy and then adjust it according to the patient’s actual financial situation to ultimately produce the most appropriate treatment plan.