Simon D Roger and D Goldsmith of the Gosford Hospital in Gosford, Australia, tried to determine the balance between costs surrounding FOBs (including relatively extensive developmental programmes and subsequent price to the market) and the necessity to ensure efficacy and safety.

Their principal findings were that it is important that FOBs are sufficiently tested to ensure patient safety is not compromised. Conducting such a development programme followed by sound pharmacovigilance is very challenging and costly. They concluded that cost-savings associated with FOBs may be limited.