"They estimate that it's somewhere between $10K and $20K per patient per year to run a phase III clinical trial"
CROs pay enormous sums of money to doctors to get them to enroll patients. The reason they do this is because the patent clock is ticking, so no matter what it costs it's worth it. But if you were actually testing a drug that's not under patent, then there is no reason to pay doctors to finish the study as fast as possible. Of that 10k per patient, 8k of that could easily be the fee that the doctor gets for signing up each patient.
Also, the majority of drug approval studies only have a couple hundred patients. You'd be hard pressed to find many phase III trials with over 500 patients. IIRC the Jupiter study was a phase IV study that was done for marketing reasons to promote what was already a blockbuster drug, so it's not really relevant
$8K of the $10K is not money used to grease the wheels to get studies done. Think about it: you're treating a patient for a whole year with a new drug. You're dosing the drug, taking blood samples, monitoring the patient closely, running tests to determine endpoints, collecting and processing data. You think that would only cost $2K/yr/pt?
Pharma companies may incentivize physicians to participate in clinical trials, but that $10K-$20K is the cost of running the actual trial. Doctors, physicians, technicians, data analysts don't come cheap.
And no, the majority of drug approval studies don't have only a couple hundred patients. If you're doing research for an orphan drug or an extremely rare cancer, that might be true, but those hardly make up a majority of the drug trials that happen.
A great example, Contrave an obesity drug went in front of the FDA. The FDA wanted more data (on top of the phase III studies that were already done). How many patients for the additional trial? 10,000.
CROs pay enormous sums of money to doctors to get them to enroll patients. The reason they do this is because the patent clock is ticking, so no matter what it costs it's worth it. But if you were actually testing a drug that's not under patent, then there is no reason to pay doctors to finish the study as fast as possible. Of that 10k per patient, 8k of that could easily be the fee that the doctor gets for signing up each patient.
Also, the majority of drug approval studies only have a couple hundred patients. You'd be hard pressed to find many phase III trials with over 500 patients. IIRC the Jupiter study was a phase IV study that was done for marketing reasons to promote what was already a blockbuster drug, so it's not really relevant