It's not a waste of money to do a larger trial to show efficacy. A larger trial is better powered, and better evidence.
That's the reason to keep the proper controls - gives much better evidence of efficacy of the drug that may eventually go to market.
Going the cheaper route for poor evidence is nothing more than cutting corners.
If they had of done adequate controls, I wouldn't have anything to complain about (regarding the trial).
Ann: FDA Supports Accelerated Approval Pathway for Heart Failure, page-407
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