Economic modelling before clinical trials

Clinical trials can be expensive and technically difficult to execute. Ideally, before a trial is undertaken three questions require answering. Firstly, what is the amount of clinical uncertainty within a given area. Secondly, what is the likely achievable benefit from a given trial relative to some other alternative use of the research resources. Thirdly, given that a trial is indicated, what should its size and design be?

The first question is usually resolved through the use of a prior systematic review of the literature. Indeed, major funding agencies such as the Medical Research Council (MRC) ask whether a systematic review has been undertaken when funding decisions are made. The second issue regarding the likely benefit relative to cost is not usually considered.1 However, the inclusion of some economic modelling during the early design stages of a trial can inform not only the scale of the potential benefit of the proposed research relative …