# Publish per-patient trial cost benchmarks and target halving them

Source: https://onco.cc/ideas/idea-tr1-public-trial-cost-benchmarks/  
OnCo record `idea-tr1-public-trial-cost-benchmarks` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Nobody knows what a cancer trial should cost because budgets are secret. Publishing anonymised cost per patient by trial type would expose waste and let funders set targets.

## Summary

Sponsors and sites contribute anonymised per-patient cost data by phase, design and procedure to an independent benchmark (as hospitals do for procedure costs), broken down into drug, monitoring, imaging, data management and site payments. Funders set cost-per-patient targets for public trials and require justification above the benchmark.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Transparency plus targets will reduce the median cost per patient of publicly funded phase 3 oncology trials by a third within five years without loss of data quality.
- Rationale: Cost varies severalfold for similar trials; most of the excess is monitoring, imaging frequency and site overhead that add no information. Benchmarking drove cost convergence in construction and hospital procedures.
- Proposed test: Pilot the benchmark across two cooperative groups and one sponsor; compare cost dispersion and median cost before and after publication.
- Maturity: speculative
- Actor: policy

## Sources

- Clinical Trials Transformation Initiative: https://ctti-clinicaltrials.org/

## Connected records

- institutions: [Cancer Research UK](https://onco.cc/institutions/cruk/), [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/)
- bottlenecks: [Funding follows fashion, not burden](https://onco.cc/bottlenecks/b-funding-allocation/), [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/)

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