Peer-reviewed evidence and the numbers behind the survey's treatment timeline and funding model.
Pragmatic clinical trials test treatments in real-world healthcare settings using existing medical records and routine care, rather than creating expensive artificial research environments.
The landmark RECOVERY trial at Oxford University demonstrated this approach at scale. Embedded in routine NHS care, it enrolled 40,000+ patients across 176 hospitals and produced three treatment findings within 100 days.
It recruited its first patient on March 19, 2020, and announced the dexamethasone mortality result 89 days later. The result is estimated to have saved over 1 million lives.
RECOVERY cost about per patient, compared with a $41,413 median for pivotal drug trials—about . A separate review of 64 embedded trials found a $97 median.
About rare diseases have no FDA-approved treatment. About diseases get their first effective treatment each year. At that rate, clearing today's treatment backlog takes years.
per year funds as many patient trial slots.
About $500 per RECOVERY participant versus a $41,413 pivotal-trial median.
per year funds as many patient trial slots, cutting the disease eradication timeline from years to years.
RECOVERY's identification of dexamethasone as an effective treatment saved over 1 million lives globally.
March 19 to June 16, 2020; RECOVERY produced three treatment findings within 100 days.
Pragmatic trials are legal. Doctors can generally prescribe approved drugs off-label, but a systematic study adds research duties: an FDA investigational new drug application unless exempt, ethics review, consent, privacy approval, safety reporting, contracts, data systems, and a research sponsor. Insurance may cover routine care without paying for the research work.
Universal access needs reusable study plans, central ethics review, simpler rules for low-risk comparisons, reliable funding, connected health records, and a shared trial network to handle monitoring, reporting, and liability.
Federal Right to Try covers some patients with life-threatening conditions who cannot join a relevant trial. Montana's 2025 SB 535 also created licensed experimental-treatment centers; final rules took effect July 25, 2026. These laws expand treatment access, but they do not require treatment supply, payment, trial enrollment, randomization, or useful comparative evidence.
If 51% of people publicly verify their support, governments can see an election-scale mandate for laws and public funding that let patients join trials through their physicians.