How Vertex came to invent Trikafta is an exceptional story. Few medicines are as effective, or as life-changing, as this one is expected to be. The basic research that led up to the moment took a generation, but development moved incredibly fast once the biology of cystic fibrosis was cracked. Trikafta is likely to save lives, yet it comes with a high price — $311,000, likely covered by insurance. Its arrival has seemed certain from the outside for years, yet several times, it almost didn’t happen.