From Interaction to Intervention: Intentional CYP Inhibition as a Scalable Strategy to Expand Access to High-Cost Therapies.

Intentional cytochrome P450 (CYP) inhibition has been proposed as a pharmacoeconomic strategy capable of reducing oncology drug costs (33-90%) while maintaining clinical efficacy. While the pharmacokinetic effects of CYP inhibition have long been recognized in antiviral and transplant medicine, recent clinical applications in oncology and haematology-particularly in cost-constrained settings-highlight its broader translational potential. Synthetic (e.g. ketoconazole, itraconazole) and natural inhibitors (e.g. grapefruit juice, curcumin) provide feasible pharmacologic options adaptable to varied healthcare infrastructures. Applications may extend beyond oncology to infectious diseases, immunosuppressive therapies, and other specialities. Despite regulatory and safety challenges-including pharmacogenomic variability and special population risks-clear frameworks are urgently needed to distinguish beneficial from hazardous interactions. Broader multicentre trials and ethical policy integration are required to establish intentional CYP inhibition as a validated global model of therapeutic equity and healthcare innovation.