A clinical trial is a research program that tests a new medicine to see if it is safe and works well. When a new medicine (or drug) is first discovered, you cannot get it by prescription. Researchers must first test it in a laboratory with animals. Then, they must do a clinical trial in a hospital or clinic to test it in people. They test it to see if it is safe and to see how much of the medicine (or what dose) is enough to work.

The Food and Drug Administration (FDA) (http://www.fda.gov) is a government agency that decides if a new drug is safe enough to give to patients by prescription. It looks at the results of the clinical trials to make this decision. Testing drugs for hepatitis C is very important, and clinical trials are a way to find new and better medicines. All medicines that you can now get for hepatitis C were first tested in clinical trials.

Clinical trials follow a set of rules called a protocol. The protocol says who can participate, how long the study is, and which tests need to be done.

Clinical trials are managed by doctors and are usually run by nurses or other health care professionals. The clinical trial staff will follow your progress closely and can help tell your regular doctor what is happening with your treatment.

Trials are also checked by an institutional review board (IRB). This is a group of people who reviews the clinical trial regularly to protect your rights, safety, and well-being.

When you are in a clinical trial, you may need to see the doctor more often and sometimes stay overnight in the hospital. This is because they want to check the effects of the medicine carefully. Because clinical trials are research, they will often test the real drug against a placebo (or sugar pill). Usually you will not know if you are taking the medicine or the placebo until the clinical trial is over.

Before you start a clinical trial, you will go through a screening process. This is to make sure that it is safe for you to start taking the medicine. The staff will ask you about your health history, and you may have a blood test, urine test, or others (such as a physical exam or a heart test).

You will also go through a process called informed consent. The doctors and nurses will explain exactly what will happen during the clinical trial. They will answer your questions and tell you about the risks and benefits of the clinical trial. They will ask you to sign a document called a consent form. When you sign this form, you are saying that you understand what is going to happen and that you agree to participate. Even after you have started a clinical trial, you are free to quit at any time for any reason. Quitting early will not affect your medical care in the future.

No. It will not cost you anything because you are helping the researchers to test a new medicine. Sometimes you may even get extra money to pay for your time or travel.

Clinical trials can last from a few weeks to several months. After the treatment is over, they will usually ask you to come back for some follow-up visits. The follow-up period may be as short as a few weeks or as long as six months and helps to make sure that you are safe.

There are four different types of clinical trials: Phase I, Phase II, Phase III, and Phase IV.

It usually takes about 10 years for a drug to be developed and approved for prescription. Many people would like to take the newest medicine as soon as it is proven to work. However, even after a drug has been successful in a Phase III trial, it still may take six to 12 months before that drug is approved for prescription.

Trials are paid for by government agencies, pharmaceutical (or drug) companies, individual doctors and hospitals, or clinics. Most hepatitis C clinical trials are paid for by the companies that make the drugs. The doctors and nurses will tell you who is paying for the study before you begin a trial.

Not necessarily. Most clinical trials have eligibility criteria. These are rules about who can participate, based on health, age, and maybe other things. They are designed to keep you safe and to help you get the best results. If you do not meet these criteria, you will probably not be able to participate. If you do qualify for a trial and decide to participate, you should be willing to follow the guidelines of the study.

Before you start a clinical trial, you should think about the positive and negative things that may happen.

Many trials are being conducted at VA medical centers across the country. There are trials in all Phases, studying many different drugs. Ask your VA doctor about what trials may be appropriate for you.

The decision to participate in a clinical trial is an important personal choice. It is a good idea to know as much as possible about the trial before beginning. You may want to have a list of questions for the health care providers and study coordinators when you meet with them. You may also want to talk with your regular doctor, friends, and family to help you make your decision.

• ClinicalTrials.gov
  (http://www.clinicaltrials.gov/)
  ClinicalTrials.gov provides regularly updated information about federally and privately supported clinical research in human volunteers. Site gives information about a trial's purpose, who may participate, locations, and phone numbers for more details.
• Centers for Disease Control and Prevention: Viral Hepatitis
  (http://www.cdc.gov/ncidod/diseases/hepatitis/index.htm)
  Information on all types of viral hepatitis from the CDC's National Center for Infectious Diseases. Site features related CDC guidelines and recommendations as well as training materials, slide sets, fact sheets, and key CDC hepatitis documents.