The only thing they needed to show in the Phase 2a is ISLA-101 can reduce the viral load and they achieved this. While it would have been better if they had had more patients in this arm, people seem to forget that ILA was completely broke when this arm was designed. If some of us hadn't stepped in last year ILA probably wouldn't have been able to complete this trial.
The way to get around the cost of the field trial is make it a Phase 2/3 trial where you get an efficacy readout early before committing large dollars to the Phase 3 stage. Another way is to partner, either with another pharma company, or local health authorities.
I should add the trial cost for a pivotal Phase 3 trial is not as high as many people think. Even the massive 2000 patient J&J trial (the one they pulled the plug on) only cost something on the order of $20m.
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