Yes, it's too big a dilemma to be ignored by VoiceOver users. While sighted iOS users can easily rely on app reviews to determine if an application works the way they want, VoiceOver users should solely rely on websites such as AppleVis -- the most comprehensive repository of app reviews from the viewpoint of the visually impaired, a couple of email lists and the very occasional mention of VoiceOver support on the App Store before making a purchase. Admittedly, with a huge number of apps at our disposal, simply too many so-called unreviewed apps exist on the market. This means BoiceOver users should either give in and purchase the app whose description entices them to face a more or less unusable app or just ignore the urge and go on. I'm not sure if asking Apple for a refund always works. Even if it works, I'm not sure which item from the combo box of the Report a problem page should be selected to achieve that.
At any rate, I'd like to know how you -- the geeky app lovers and adventurers -- deal with this dilemma. Personally speaking, I now have about twelve unreviewed apps on my waiting list, but since I now have a couple of problematic paid apps on my iDevice, I'm not sure what to do. Wish the App store could allow people to try apps for, say, a day before purchasing!