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A funding model for public-good clinical trials

The cost of clinical trials is rising but is still much less than the cost of not doing trials

Clinical trials have led to significant advances in health outcomes. For example, much of the continued decline in cardiovascular mortality since 2000 has been attributed to the evidence that established the various treatment strategies now in common use.1 However, as the costs of both medical care and clinical trials continue to rise, are our current clinical trials good value for money? In this article, the last in a series based on the MJA Clinical Trials Research Summit, we discuss the need for an innovative funding model for investigator-led clinical trials.

Through clinical trial evidence, treatments that are expensive yet no more effective than cheaper alternatives can be abandoned, while more cost-effective treatments or programs can be introduced. Studies casting doubt on widely practised and costly clinical interventions demonstrate the value of investigator-initiated research. Recent Australian examples include trials of vertebroplasty for osteoporotic vertebral fractures, which showed no advantage compared with a sham procedure,2 and of craniectomy for closed head injury,…