We're doing more and more, especially in the rare disease community and with drugs in which there are no alternatives, to ask companies to set up bridging programs, to make guarantees that if your patient comes off the therapy and it's not yet approved, you continue to fund until there's an actual decision in terms of reimbursement.
We are also doing more in terms of insisting on crossover drugs. Take a small patient population with a debilitating disease. What if you're in the placebo group? How do we get patients to want to do that? We're asking companies to guarantee that there will be a crossover. Once the trial gets to a certain point, where it's clear that it's working, they have an obligation to take a patient off of placebo and to put them on the drug. With small patient populations, we can do some of that, but that's the right thing to do. We really reinforce that. They can't do it for life, but we really reinforce it until we get a good decision on the reimbursement.