Lack of access to high‐cost medications is a complex issue at the intersection of economics, medicine, politics, and ethics, and it poses a significant threat to global health care. The problem is even more significant in low‐ and middle‐income countries, such as those in Latin America, where governments and individuals struggle to pay for products that are priced at several times the level of their per capita gross domestic product. In this review, we examine the determinants for increasing drug costs and how Latin American countries face this burgeoning crisis. We emphasize that a number of opportunities and strategies to reduce costs and improve access exist and should be identified and implemented, ideally within a regional approach with multiple stakeholders involved and based on systematic and transparent cost‐effectiveness analyses. Cancer 2017;123:1313–1323. © 2016 American Cancer Society. Limited access to high‐cost cancer medications poses a significant threat to global health care, particularly for low‐ and middle‐income countries. Systematic and transparent cost‐effectiveness analyses are needed to devise equitable oncology drug pricing schemes. See also pages 1292‐7.