Excessive pharmaceutical pricing represents one of the most contentious issues in legal and political discourse and has recently gained renewed attention by courts, competition authorities and political forces on both sides of the Atlantic. Balancing the public demand for affordable and accessible health-care with the need for sufficient incentives and a sustainable innovation system in the field of medicines also attracts a great deal of media and scholarly attention. Facing what seems to be a revival of competition law enforcement in this highly sensitive and complex environment, it is of vital importance to keep up to date with the most recent developments. It is further crucial that the necessary debates are taking place within a well-informed and transparent environment that takes into account multiple factors, interests, responsibilities and concerns. This entails inter alia to consider various types of diseases (rare, neglected or blockbuster) treatment outcomes (cure or long dependency), as well as the economic complexities of successful innovation systems and higher societal goals such as sustainability, solidarity and fairness. Only then, will it be possible to devise well-balanced policies and guidelines that allow relevant stakeholders to align their approaches and strategies in order to achieve what society expects from the pharmaceutical innovation system: life-saving new therapies that are safe, efficient and accessible. Against this background, this article depicts and discusses some of the latest cases and the underlying legal-economic and policy considerations.