I buy cheaper department store clothing and have it tailored. It fits me like a glove. The quality isn't quite the same, but the price come out in my favor.
That's the alternative I've generally taken, and it's cost effective.
The problem I'm running into these days is that clothing cuts are so constrained that there's simply not enough fabric present (shirts especially) to construct a fit. For slacks, it's that or that the alterations are sufficiently extreme that the results aren't appealing.
Most jeans cannot be tailored to any significant degree (other than inseam length).
I buy cheaper department store clothing and have it tailored. It fits me like a glove. The quality isn't quite the same, but the price come out in my favor.