I know many don’t agree but I always thought the trade off for approval was always going to be getting manufacturing up to speed for a commercial model that works for everyone. Artisan was never going to be that model and this emphasis seemed to be as clear as day to me when Linda was begging for a manufacturing partner back in 2018. I was a critic of this open plead for help but that was a real need then as they needed a breakthrough knowing that rGBM was likely going to be in the mix and maybe more. Once the proteomics data showed the true potential and data from Specials likely backed that up, the need for reduced cost to bring this treatment to a wider group of patients in the near future likely became a glaring need for NHS and for NWBO to go from limited funding and numbers of patients treated for a very limited reimbursement rate to widespread use. I can’t blame MHRA or NHS completely for needing to stay in range because this is initially an add on treatment as tested. You yourself said NHS is broke so keeping a lid on reimbursement rate while trying to adopt wide spread use over time likely required some finagling. The IFRs are probably the best way to get this done initially. Best wishes.
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