What does a clinical trial cost? The reported numbers from 5,413 US trials
Sponsors disclosed $5.8B in research payments across 5,413 US trials. The median trial shows $272K, but per patient is the better benchmark.
Ask what a clinical trial costs and you get two kinds of answers: A consultant says “it depends,” while a blog quotes a 2014 government study, usually the $4M, $13M and $20M per-phase averages, without mentioning the vintage.
Better data exists. CMS requires drug and device makers to disclose the research payments they make to US physicians and teaching hospitals, and those payments carry trial registry numbers. Match them to ClinicalTrials.gov and you get a cost figure for 5,413 US trials, $5.8B in total, tied to specific studies you can look up.
The median trial in that set shows $272K in disclosed research payments, while half fall between $46K and $1.1M. However, the single most useful thing the data demonstrates is that the per-trial number is the wrong place to look.
What these numbers are, and what they are not
Every figure in this article is disclosed industry research spending: the dollars sponsors reported paying US physicians and teaching hospitals in connection with a specific trial. That makes it a floor on what the trial cost, not a full budget. CRO fees, non-US sites, lab work, drug supply and anything routed outside the disclosure rules are incremental costs
Why publish a floor? Because it is the only per-trial cost figure that exists in public data. Survey-based estimates cannot be checked, while this one can, down to the NCT number. We cover what the floor captures and what it misses in where the data comes from.
The distribution: a short head and a long middle
Disclosed trial spending is broad, not top-heavy. The largest single trial in the set is $12.1M, which is a Lilly phase 3 for insulin efsitora with 928 patients. The top 10 trials together hold just 2.1% of the money, and the top 100 hold 17%. Compare that to hospital M&A or sponsor R&D budgets, where a handful of deals carry the year. The medians describe a market with thousands of participants, which is what makes them usable as reference points.
About 60% of trials came in under $5K per enrollee, and the bottom of the range gets very low, because some trials match to only a handful of disclosed payments. Treat the medians and upper percentiles as the benchmark and the extreme low end as reporting noise.
Phase 1 and phase 3 cost the same per trial
Per trial, the phases barely differ. Median disclosed spend is $455K for phase 1, $293K for phase 2, $463K for phase 3.
Per patient, they differ by a factor of five. The median phase 1 trial enrolls 42 people, so its disclosed spend comes to $10.6K per enrollee, while a phase 3 trial spreads a similar floor of dollars across hundreds of patients and lands at $2.1K per enrollee at the median. Phase 2 is in the middle at $4.0K.
Early-phase work is expensive per patient because the cohorts are tiny and each patient gets intensive attention. Late-phase work looks cheap per patient because scale absorbs it. If you benchmark a trial by its total and ignore enrollment, you will misprice both ends. Full percentile tables by phase are in cost per patient by phase, and the metric itself is defined in cost per enrollee.
Therapeutic area is a very important factor too
At phase 1, where per-patient spending peaks, cardiometabolic trials top the table at $17.9K per enrollee, while neurology is $14.4K, rare disease $12.2K, immunology $12.0K.
The surprise is oncology. Cancer research holds more disclosed trial money than any other area, $1.77B, about 30% of the total, across 1,555 trials. Per patient it sits near the bottom at phase 1: $7.7K against a $10.6K cross-area median. Part of that is how cancer trial money is spread, with a lot of it flowing through academic and cooperative-group channels the disclosure rules do not capture. We unpack the oncology numbers in oncology trial cost.
Who is spending it
The same dataset rolls payments up by sponsor, which is where the competitive intelligence is: total disclosed spend, trial counts and phase mix for every reporting company. We are publishing the sponsor rankings as their own piece.
How to use a floor without embarrassing yourself
A floor is a benchmark, not a quote. Used correctly it does three jobs.
For finance and corporate development, it anchors the low end. If your budget model for a phase 2 asset assumes less per patient than sponsors disclosed for comparable trials, the model is wrong, and you found out before a partner did.
For clinical operations, it is a sanity check on vendor pricing. A bid should exceed the disclosed floor for similar trials by a sensible multiple. When it exceeds it by 30x, you have a negotiating position with a citation attached.
For diligence, it is fast comparative context. What a target's trials show against phase and area medians tells you something about study intensity before management does.
What it will not do is predict a full budget. Independent estimates put median full study costs at roughly $1M for phase 1 and $2.5M for phase 3, multiples of the disclosed floor, and pivotal trials have been estimated near $41K per patient. The floor is the piece you can verify. Price from it, not to it.
Common questions
How much does a clinical trial cost? The median US trial shows $272K in disclosed industry research payments, with half of trials between $46K and $1.1M. Full budgets are multiples of that: published estimates for complete study costs range from about $1M at phase 1 to $20M+ for large phase 3 programs.
How much does a clinical trial cost per patient? Median disclosed spend is $2,906 per enrollee across all trials: $10.6K in phase 1, $4.0K in phase 2, $2.1K in phase 3. Per-patient cost falls as phase advances because enrollment grows faster than spending.
Why do cost estimates vary so much? They measure different things. Surveys estimate full budgets, academic studies reconstruct pivotal trials, and this dataset counts disclosed payments. Within any phase the spread is also wide: phase 3 spans $272 to $15.7K per enrollee from the 25th to 90th percentile, so a phase label alone prices nothing.
Is this the full cost of a trial? No, and that is deliberate. These are the industry research payments sponsors disclosed to CMS for US physicians and teaching hospitals. They exclude CRO fees, non-US sites and academic or government funding. It is a defensible floor, not an audited budget.
Data notes
Figures come from CMS Open Payments research payment records matched to ClinicalTrials.gov by NCT number 2020–2024 (January 2026 file release). The matched set covers 5,413 US trials with $5.8B in disclosed payments; 4,015 carry a drug-development phase, and phase benchmarks exclude registries and no-phase device studies. All figures are medians unless stated. Cost per enrollee is disclosed payments divided by reported enrollment. About 7% of trials have multiple reporting funders. Sponsors' disclosed totals understate true spend by construction; treat every figure as a floor.
This article is a market-data benchmarking resource derived from publicly available CMS Open Payments and ClinicalTrials.gov data. Reported figures are disclosed industry research payments and represent a floor on trial cost, not a complete budget, a price quote, or financial advice. Trial budgeting decisions for any specific study remain the judgment of qualified professionals. Healthcare DealHub is not affiliated with CMS or the US government.