This article studies the evolution of drug pricing by the French State since 1948. While the objectives of this policy have remained the same for 70 years — ensuring patients’ access to quality treatment, without over-burdening the budget of the Assurance maladie [health Insurance system] or compromising industrial development — its practical modalities have considerably evolved, moving from a State-based unilateral price-fixing scheme to a co-regulation of the drugs market with pharmaceutical companies. This transformation has led civil servants of the State and of the Assurance Maladie (the Economic Committee for Health Products) to deal with a growing number of players — pharmaceutical companies, independent experts, and health professionals — as well as with policies practiced in other countries. However, this has not led to a reduction in the state’s activity: on the contrary, the scope of regulation has extended to all actors and mechanisms determining the expenditure for reimbursed medicines.