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Are Clinical Trials Cost-effective?

Mark R. Goldstein, MD
JAMA. 1990;263(11):1491-1492. doi:10.1001/jama.1990.03440110053014.
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To the Editor.—  In the October 6 issue of JAMA, Dr Detsky1 performed a cost-effective analysis of seven selected clinical trials and calculated the incremental cost-effectiveness for performing these trials, expressed as dollars per life-year extended. He concluded that this selected group of clinical trials was a good investment and suggested that government policymakers consider this information when allocating funds for medical research. I agree with Dr Detsky that the selected trials were a good investment but disagree that they were cost-effective from the standpoint of number of years of life saved.The combined cost of all seven trials selected was $272 million. Two primary prevention trials selected, the Lipid Research Clinics-Coronary Primary Prevention Trial and the Multiple Risk Factor Intervention Trial, cost $260 million and, therefore, represent 96% of the total cost of all seven trials selected. Unfortunately, life was not extended in either of these primary prevention


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