Comment by starkparker

The drug itself might be paid for, as well as tests under the scope of the study (which might be narrow), but services to administer the drug, and tests or treatment for effects not in the scope of the study, aren't always covered. Or, in the stupidest cases, approval gets bogged down by the drug company, patient, or administering clinic/practitioner trying to get the patient's insurance to cover whatever's not covered by the trial for so long that the patient no longer qualifies (or is dead) by the time insurance relents and agrees to pay.