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John W. Yarbro, MD, PhD; Lee E. Mortenson, MS
Association of Community Cancer Centers Rockville, Md

JAMA. 1985;254(8):1032.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

We agree with Dr Wizenberg that Dr Davis¹ did not address the core of the issue. Dr Davis suggests that patient care costs of patients on clinical trials are research costs. These patients would be getting treatment even if data were not being collected on the effect of the treatment, so these are really patient care costs. She states that the law prohibits her from paying research costs, but then she states that Medicare is currently paying these costs up to the prevailing DRG. Dr Davis essentially argues that if the care of patients in clinical trials costs more, this should be paid by community hospitals as a "loss leader." This is a strategy used by supermarkets, but is a questionable strategy on which to base the future of our national biomedical research program.

Moreover, our current data suggest that conventional cancer care may be a breakeven . . . [Full Text PDF of this Article]

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