The costs should not be the major determining factor in determining the location as to where clinical trials are held. Organizations should be putting their main focus on as to which location is relevant to their study or would allow for the research to be completed successfully. If they put more emphasis as to which location would be most cost effective, that does not necessarily ensure that the study will be done with the best results. As others have mentioned, if research is being done into a certain disease, it would make sense to have the study done in a location that has shown evidence to this disease, whether it be an expensive or cheap location. I do not think that organizations put the cost as the main aspect when considering locations for the study. The organizations look more into which location would make more sense for the study being done and if there is multiple locations, then maybe they will consider which one is more cost efficient out of all of them.