German patients get the latest drugs for just $11. Can such a model work in the US?

BERLIN - Patients who come to the Havelhohe cancer clinic in the leafy outskirts of Germany's capital are often very sick.

Struggling with advanced-stage cancers, many need strong doses of expensive, cutting-edge chemotherapy that can run into the hundreds of thousands of dollars.

But like all Germans, none of the patients sitting quietly in the infusion ward here pay more than 10 euros a prescription, or about $11. "We never talk about costs," said Dr. Burkhard Matthes, a senior oncologist at the clinic.

Germany's ability to provide citizens access to the latest drugs while keeping patients' costs so low is made possible by a novel strategy launched in 2011 to rein in exploding prices that were threatening to bankrupt the nation's health care system.

Mixing free market incentives to encourage innovation with regulation and lots of transparency, Germany's drug review process gives manufacturers the chance to bring new products to market and charge higher prices - but only if they can show