I propose a new authority category for the Pharmaceutical Benefits Scheme (PBS)--authority to prescribe only within a controlled trial. This would benefit both the PBS and the pharmaceutical companies, but the main winners would be the Australian population, who would obtain better value for money spent by the PBS. Drugs which show promise, but for which conclusive evidence of advantage over standard therapy is lacking, or drugs for new indications, could be prescribed within a randomised trial. PBS support would fund a substantial portion of the trial costs. This proposal would greatly boost local and international investment in Australian medical research.