Therapeutic breakthroughs in ATTR cardiomyopathy have ushered in a new era of treatment, with gene silencers, stabilizers, and next-generation therapies extending life and improving quality for patients once left with few options. Yet this progress has exposed a profound and growing divide—between innovation and access. This week's Editor's Page explores the striking disconnect between clinical value and global affordability, calling attention to pricing challenges, equity gaps, and the real-world implications of cost-based care limitations. By highlighting the urgency of equitable implementation alongside scientific success, the issue urges clinicians, manufacturers, policymakers, and journals to work together in shaping a future where life-changing therapies reach all who need them.