Critics argue that Sovaldi is just the beginning of a wave of new high-priced specialty drugs that will trigger an explosion in medical spending in the years to come.

“If [Sovaldi] is prologue to future pricing decisions, we are talking about blank-check pricing that is simply not sustainable,” lamented Karen Ignagni, president and CEO of lobbying group America’s Health Insurance Plans, which has launched a furious public campaign intended to shame drugmakers.

Express Scripts, the nation’s leading pharmacy benefit manager, has also jumped into the fray. “We’ve taken a strong stand on Sovaldi, because it’s the canary in the coal mine,” said Steve Miller, the company’s chief medical officer. “If we let this price stand unchallenged and we don’t fix the system … the system will not sustain itself. And we will not stay the innovative country we are today.”

The pharmaceutical industry counters by arguing that beyond the costs associated with researching and developing new drugs and going through the arduous federal approval process, there is the tremendous long-term value created by breakthrough medicines.