I think this partly comes because the american system is so fragmented. I believe that in places with centralized healthcare systems, there are people who are

I think this partly comes because the american system is so fragmented. I believe that in places with centralized healthcare systems, there are people who are responsible to understand the new drugs, both at the level of the healthcare provider and the health ministry - and they guide doctors on what to prescribe. This makes sense because they don't have a conflict of interest(unless bribed).