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Linda Smith learned last summer that she was losing significant cartilage in her knees, a consequence of a lifetime spent skiing, running and playing ultimate Frisbee.

Osteoarthritis was diagnosed, and she wanted to avoid surgery. So the 56-year-old Californian began looking for a research study that might offer an alternative. She scoured the government-run website ClinicalTrials.gov, and focused on stem-cell therapy — a promising but unproven approach for her condition.

She thought she had scored with StemGenex Medical Group, a company in La Jolla, Calif., and called for more details about a study it was doing. The screener asked a long list of questions, then dropped a bomb: If Smith wanted in, she’d have to pay “associated” costs. Total charge: $14,000.

“I was outraged,” said Smith, a retired hospital administrator who knew enough about clinical studies to realize that the price tag was unusual. Most trials are free, and some even pay people to take part because of the possible risks and inconvenience involved.

But ClinicalTrials.gov, maintained by the National Institutes of Health, says nothing about any charges...