It seemed like a good idea at the time. Run a Phase II clinical trial and reduce your costs by as much as 10-fold. A top academic medical center in India charges only $1,500 to $2,000 per case report, less than one tenth the cost at a second-tier U.S. medical center. And trends show a majority of clinical study sites are now located outside the U.S., many in developing countries, especially Eastern Europe, Russia and India.