There is also the minor issue of private equity sucking the air out of the goddamn room for orphan/rare indications. Losing count of the number of investigators that have had their parent orgs purchased by PE firms which then inflate trial fees to the point that they fail BADLY in industry benchmarking software with no rationale provided for the increase and no recourse available. Waiting impatiently for the carnival of bullshit that's going to kick off the first time the OIG flags this shit as a false(?) positive for overt corruption.