xrayspex, I think it is very possible that they were doing Shire (the maker of midodrine) a favor. Smaller, innovative biotechs usually have a tougher time with the FDA which I think is corrupted (like most govermnent entities) and needs reform. To reject a drug that has been in use in Japan for over 20 years doesn't make much sense to me, but the FDA is clear when they say they do not take foreign trials or experiecnes into account. It's usually the patients who suffer, I am not for treating everything with drugs (though Northera is close to a natural compound occuring in the body) but the patient should have the choice, esp. with conditions not well understood and where there are unmet needs such as OI.