Although the budget process may vary among PBRNs, the most important aspect of budget development is to include the PBRN core team in the process to ensure that the budget is appropriate and realistic.

Deciding who will hold the primary budget and who will serve as subcontractors may depend on whether the PBRN and/or the principal investigator are affiliated with an academic institution or a nonprofit organization.

Ideal timing for a rough draft of the budget is no later than 6 weeks before a grant due date and a final budget, including subcontracts, no later than 3 weeks before the due date.

Nonprofit PBRNs may provide budgeting advantages to a grant, such as lower indirect cost rates or efficient strategies for paying incentives and honoraria to patients and practices.

It is important that a trial budget includes costs that are particular to working in a PBRN (eg, practice honoraria, PBRN infrastructure costs, site visits).

Linking practice payments to milestones is a good way to structure a budget.

When budget cuts or changes are required, it is important that both the academic research project team and the PBRN core team make these decisions together.

It is critical that the academic research project team meets its obligations to both the PBRN and the practices participating in the trial to maintain willing practice partners for future trials.