Trials overseas, India, Georgia, etc., are done there because they are cheaper. The physicians are cheaper, the hospitals are cheaper, the salaries of the administrative staff who collects the data is cheaper, and so on. The patient population is also more apt to not have had prior treatment with drugs or any treatment for that matter which can effect a fair evaluation of the drugs being administered. Cheaper and more access to drug naive patients is why many trials not just PPHM are done overseas.
That said one of the issues that going overseas creates is that the population's genetics do not mirror those of the USA.
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