Cost efficient practices for large, publicly funded, international clinical trials.

What is it about?

INSIGHT is a research network that has conducted the largest, publicly funded, international, HIV trials. Its three most recent trials included 215-318 clinical sites in 25-35 countries. Emphasizing cost control, INSIGHT streamlined governance and infrastructure and built a financial model based on performance, transparency, and accountability. Challenges are discussed, and central monitoring, regulatory harmonization, and standardized clinical trial cost reporting are recommended.

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Why is it important?

Randomized clinical trials have been essential in addressing worldwide public health questions. However rising costs may jeopardize their continued use, especially if size and duration overwhelms available resources. Organization and financial approaches that reduce cost without adversely affecting implementation, coupled with public reporting that permits cost comparisons, could help ensure the future affordability of large, international research collaborations.