Many clinicians have first-hand knowledge of what happens when their patients are unable to obtain the medications they need, at an affordable price. Widespread drug shortages and skyrocketing prices have created a crisis that could be costing lives in the US. With Intermountain Healthcare in the lead, joined by Ascension Healthcare, SSM Health, and Trinity Health, one group of health systems is actually doing something about it: forming a not-for-profit drug company to manufacture their own generic therapeutics. In an evolving health care landscape, this is a bellwether of new business models designed to improve the access and affordability of vital medicines.