The cost of a study is dependent on the location of the study, however, the prime reason for a study conducted outside of the U.S is not cost. The research must be associated with the region the study is being conducted. Along with the regulations that need to be followed within that area. Yes, the cost of research within the U.S.A is costly but moving to a developing country to conduct a study is not solely due to cost. There is the advantage of a decrease in cost to conduct studies in developing countries, but the resources might not equate to the standards that the U.S FDA upholds. Therefore, there are cost advantages and disadvantages when deciding the location to conduct a study. Cost should not be the leading factor for picking a destination for a study.

Outside of the budget and resource issues that others above have pointed out, it would be interesting to consider conducting a clinical study depending on where the issue you are tackling is most prevalent. For example, if you are conducting clinical trails on a drug that targets malaria, you can argue that you should conduct the clinical trial on subjects in the Sub-Saharan Africa region where malaria is the major burden of disease. The results would provide more substance and intended results as opposed to conducting a clinical trial on a subject within high income developed country.

More and more companies are outsourcing their clinical trials due to the advantages in cost efficiency. But that isn't the only advantage. The countries are able to provide fast recruitment of patients, good data quality, and GCP compliant activities. These advantages attract big companies to European and Asian countries.