I guess I understand a bit better now about the clinical trials - the for-profit hospitals wont get involved, for various reasons, but one of them is probably the for-profits are not "Teaching" hospitals - those associated with Universities, and other non-profit organizations (such as religious groups).
As far as I know, for a clinical trial to be valid, the Pharmas would not know the design, the process, until the very end - so there is no leakage of info nor interference of the process.
It makes sense the patients participate in a trial would be recruited thru hospitals.
Of course FDA holds the final decisions on the results ted. We only need to see how any biotech stock goes thru to roof on a promising Phrase 3 trial as that means soon they can application to FDA and eventually, hopefully to get positive feedback from the panel and lead to eventual approval. The opposite would be a dramatic fall of the stock price, like being cut in half...