Economic questions (such as cost-effectiveness of alternative procedures) become more and more important in medicine due to increasing pressure to curb health care costs. Every radiologist is well-advised to open his mind to such questions and to start finding what the costs of his clinical pathway are. In countries with a fixed payment (DRG) per patient, this is a must anyhow. Physicians need to learn how to ask the right questions when building up an interventional radiology program. These questions could be: If a radiologist initiates a clinical study, it is advisable to include cost data to address potential economic questions that may arise subsequently. Similar to the advancements in clinical study design in recent years, cost-effectiveness studies are expected to improve as physicians gain greater awareness of the methodological standards associated with these studies.