Crowned by a potential cure for severe hemophilia A, that could become the most expensive drug ever, a new list of 11 medicines expected to generate $1 billion-plus in annual sales by the end of 2024 or earlier throws into stark relief the growing tension between medical innovation and society's ability to pay for it. The 2020 Cortellis Drugs to Watch list, including medicines both approved and likely to be, points to a future of ongoing conflict between payers and industry spurred by fundamental disagreements.

Not only did newly emergent Kyverna Therapeutics Inc. burst out of the gate with a $25 million series A, but it enhanced its entrance with a deal from Gilead Sciences Inc., one of the company’s initial funders, potentially worth $587.5 million.