Optimizing the dosing of many expensive drugs can drastically reduce both costs and toxicities. The Federal Government, state governments, employers, and individual patients could collectively save tens of billions of dollars each year by simply optimizing the dosing of the most expensive prescription drugs on the market, particularly in oncology. Optimized dosing can also improve health outcomes. The next administration should, therefore, launch an effort to control the cost of prescription drugs through an evidence-based approach to optimizing drug dosing and improving outcomes. The requisite trials pay for themselves in immediate cost savings.