It's a commonly held belief that economic evaluations are only as good as the supporting clinical data. As early as 1984, Professor Mike Drummond was saying that the randomised controlled trial was the 'gold standard' for clinical evidence for health economic evaluations. And while most people would still agree with this statement, debate continues to rage over the advantages and disadvantages of randomised controlled trials as a source of clinical data. At the 2nd Economics of Cancer meeting organised by EORTC*[Brussels, Belgium; September 2000], Jim Brown from the Health Economics Group at AstraZeneca, UK, took delegates through both sides of the debate before adding a note of reality.