The Costs of Clinical Trials

Clinical trials are expensive. It is not that their aggregate costs are high. Although over $1 billion per year goes for clinical trials, this represents only about 0.3% of national health expenditures.¹ But clinical trials cost a lot per study— often millions—and so have a high profile in public discussions about the costs of biomedical research.

Are clinical trials cost-effective? In this issue of JAMA, Detsky² examines this question. Using the methods of cost-effectiveness analysis,^3,4 he weighs the costs of clinical trials against their effectiveness, then compares the results with commonly accepted costs of medical care. The costs are those of the trials themselves, both the fixed costs of supporting the research team and the variable costs related to the number of patients studied. Effectiveness is expressed as lives saved as a result of the new information from the trial, taking into account the number of people