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Mega-randomized clinical trials for blockbuster drugs.

Many commonly used medications lack information regarding their adverse effects, effectiveness relative to other treatment options, and mortality benefits. In his Viewpoint, Dr Ioannidis1 suggested requiring pharmaceutical companies to fund mega-randomized clinical trials (RCTs) for medications with more than $1 billion in annual sales, using as an example a trial with 20 000 patients, 4 years of follow-up, and mortality as an outcome.