U.S. statutory standard does not require that a new therapeutic be superior to available choices, only that it be safe and effective for the intended use.
Since there is no FDA approved alternative to compare to, the placebo was used for the Bloom trials. Libigel was proven effectively on par with placebo and superior in safety to placebo.
What doctor would prescribe a placebo or an off label prescription if Libigel were available? They would just be increasing their liability.
I believe that if safety review is good, they have enough to file for NDA application. Biosante is now just trying to solidify their case by accounting for the placebo effect.