Montana just built a legal side door to sell experimental drugs — no terminal diagnosis required

Montana just fired the starting gun on the most radical right-to-try experiment in the United States. As of last week, any biotech company with a drug that’s cleared Phase 1 testing — sometimes in as few as 10 healthy people — can pay $12,500, get a new review board’s blessing, set their own price, and start selling. The first clinic is expected by year’s end.

The rules, finalized Saturday by the state’s Department of Health and Human Services, break from every other right-to-try law on the books. You don’t need to be dying to access these treatments. Theoretically, anyone who signs an informed consent form and can pay is eligible, from rare disease patients out of options to perfectly healthy longevity enthusiasts chasing preventive therapies. That’s by design. State senator Ken Bogner, who sponsored the 2023 expansion, told MIT Technology Review he wanted to shift focus “more on preventative medicine” rather than “just treating diseases once they show up.”

This didn’t come from the usual libertarian think tanks or patient advocacy groups. The entire framework was drafted and driven by longevity activists. Niklas Anzinger, a tech entrepreneur who previously tried to build a similar hub in a Honduran special economic zone called Próspera, worked with unnamed biotech companies to write the operational bill that passed this spring. “Now we think that Montana is a better model, because it’s building on … existing regulatory precedents,” Anzinger said. He and Infinita’s US lead, Stephen Martin, recruited the first independent review board months before the ink was dry on the state’s rules.

That board — named the Montana ETRB and announced this week — includes a Montana-certified doctor, scientists, and an ethicist. Matt Kaeberlein, a scientist on the panel, insists the process will be “very rigorous” with “appropriate oversight.” But Harvard Medical School’s Aaron Kesselheim sees an obvious hazard: selling unproven treatments with zero FDA supervision. “I would be concerned,” he said — the kind of understated warning you’d expect from someone watching a state essentially franchise out drug approval. The real question isn’t whether the board will rubber-stamp applications. It’s what happens when the first patient pays full price for a therapy that doesn’t work, or worse.