Clinical trials

Transparency Matters: Clinical Trial Costs

Why transparency of clinical trial costs matters

High prices for medicines, vaccines, and diagnostics are often justified by the pharmaceutical industry by claims that it costs billions in research and development (R&D) to bring them to market.  

However, it is difficult to substantiate those claims because companies don't routinely disclose how much they spend on R&D in any detail.  

What we do know is that clinical trials are widely regarded as the most expensive part of the medical innovation cycle, and therefore likely make up a significant portion of total R&D costs.  

But there is no transparency around the actual costs of clinical trials – even when they are funded by the public sector.  

Making clinical trial costs public would: 

  • Help guide and inform decision-making and policies related to clinical trials, including where and how much to invest.
  • Promote innovation, especially from non-traditional actors. 
  • Increase accountability and maximise the impact of public funding. 
  • Enable governments and treatment providers to regulate and negotiate prices more effectively.   
  • Support efforts to increase access to medical products.


The MSF Access Campaign is hosting a series of roundtables to highlight the critical importance of transparency of clinical trial costs.  

The first roundtable took place in May 2022, and focused on the policy and legislative changes needed to improve transparency of clinical trial costs. 

Following the first roundtable we published a report to summarise the themes and the main recommendations. These include:

  • Governments should introduce legislation to mandate disclosure of clinical trial costs by pharmaceutical corporations as well as other drug developers.
  • Costs should be published in a publicly available and accessible format.  
  • Conditions should be attached to public funding of clinical trials to ensure full public disclosure of the costs.

Report from the first Roundtable

Second Roundtable

A second roundtable in the series took place on November 17, 2022. At this roundtable, the panellists were asked to focus on some of the more practical aspects of stimulating more transparency around clinical trial costs. During the roundtable, MSF launched its Clinical Trials Transparency Policy with the landmark commitment to publish a minimum set of cost items for the clinical trials it undertakes.

Note: the chat text can be found here.

Report from the second Roundtable

Initiatives aiming to improve transparency of clinical trial costs 

MSF is engaged in a number of initiatives and efforts to improve transparency of clinical trial costs, to support efforts to increase access to affordable medical products for all in need. 

  • WHA resolution on Clinical Trials:
    MSF publicly commented on this resolution and its shortfalls, and continues to engage in WHO and national consultations and efforts related to its implementation. 
  • United States legislation on clinical trial cost transparency:
    Our US team has been advocating for the government to make detailed cost information transparent for federally-funded clinical trials. In 2022, lawmakers introduced the bicameral Pharmaceutical Transparency Act, which would mandate much-needed clinical trial cost transparency, and MSF USA and allies are pushing for the bill’s passage into law.
  • MSF’s Clinical Trial Transparency Policy (CTTP):
    Recognising the critical need for more publicly available information about clinical trial costs, MSF is taking steps to publish our own clinical trial costs. The MSF CTTP was approved and published in October this year, and commits to publishing a number of key data points related to the cost of clinical trials, wherever pragmatic and possible.