The shift to curative treatments promises to transform the entire healthcare ecosystem. Patients whose conditions were previously managed through ongoing, long-term medication can now be cured through specific courses of treatment. However, while this might transform their lives, it also has a disruptive effect on the wider market. Craig Wylie, Thomas Unger, Ulrica Sehlstedt, Vikas Kharbanda, Rebecka Axelsson-Wadman and Satoshi Ohara at Arthur D. Little observe how curative therapies can shift payers’ expenditure, increasing the importance of first-mover advantage for pharmaceutical companies, and changing care models for healthcare providers.