Actually, that asterisk was mine... after talking to thousands of doctors and payers, I have come to the conclusion that managed care companies hogtie doctors and restrict patient access to many treatments. Getting approval for most branded medicines requires 2FTEs in doctor's offices and adds hours of administrative time to the doctors' days. I'm not saying that these medicines aren't overpriced and in many cases don't need some oversight, but it points to just one more layer of bureaucracy that someone has to pay for.