The workshop on the financing of clinical trials discussed a broad range of issues. The following points were made: 1. Hidden costs are borne by academic medical centers in the unreimbursed support of clinical trials (authorized or informal). 2. Some current therapies, especially plasmapheresis, are very costly. (A single plasmapheresis treatment may cost approximately $800, a substantial portion of which is for albumin replacement. At that rate, fortnightly apheresis for one patient would cost $19,000/yr.) 3. Third parties pay for some unproved treatments—knowingly or unknowingly—and do not have efficient mechanisms for detection and review. 4. Precedent has been established in cardiac transplantation for selective reimbursement of certain centers for experimental treatment. However, most nongovernmental third parties hold that reimbursement should be available to all providers once it is approved for reimbursement. A few third parties have agreed to pay for costs of selected clinical trials, including control treatment.