The issue we are most familiar with is when it comes to the end of a clinical trial will participants still have access to the trialled drug when the trial concludes (I know well a heart-wrenching story of a family who lost access to a life saving treatment). Device-based trials raise completely different questions: Can it/should it be removed? If so, what are the risks and who pays? But if not, who monitors and services the device? And who pays for that?