gs , ▁as ▁a ▁ 2 0 1 1 ▁study ▁found ▁that ▁between ▁ 2 0 0 4 ▁and ▁ 2 0 1 0 ▁or phan ▁drug ▁tri als ▁were ▁more ▁likely ▁to ▁be ▁smaller ▁and ▁less ▁random ized ▁than ▁their ▁non - orph an ▁counter parts , ▁but ▁still ▁had ▁a ▁higher ▁F DA ▁appro val ▁rate , ▁with ▁ 1 5 ▁or phan ▁cancer ▁dru gs ▁being ▁approved , ▁while ▁only ▁ 1 2 ▁non - orph an ▁dru gs ▁were ▁approved . ▁This ▁allows ▁manufact ures ▁to ▁get ▁cost ▁to ▁the ▁point ▁that ▁it ▁is ▁econom ically ▁feas ible ▁to ▁produce ▁these ▁treat ments . ▁The ▁subs id ies ▁can ▁total ▁up ▁to ▁ 3 0 ▁million ▁dollars ▁per ▁fis cal ▁year ▁in ▁the ▁United ▁States ▁alone ▁. ▁ ▁By ▁ 2 0 1 5 , ▁industry ▁anal yst s ▁and ▁academic ▁research ers ▁agreed , ▁that ▁the ▁sky - high ▁price ▁of ▁or phan ▁dru gs , ▁such ▁as ▁e cul iz um ab , ▁was ▁not ▁related ▁to ▁research , ▁development ▁and ▁manufact uring ▁costs . ▁Their ▁price ▁is ▁arbitrary ▁and ▁they ▁have ▁become ▁more ▁prof itable ▁than ▁traditional ▁medic ines . ▁ ▁Public ▁fund ing ▁ ▁E valu ation ▁criteria ▁By ▁ 2 0 0 7 ▁the ▁use ▁of ▁economic ▁evaluation ▁methods ▁regarding ▁public - fund ing ▁of ▁or phan ▁dru gs , ▁using ▁estimates ▁of ▁the ▁increment al ▁cost - effect iveness , ▁for ▁example , ▁became ▁more ▁established ▁intern ation ally . ▁The ▁Q AL