[dnautics]

How do you define "minor"? These insulins have dramatically different serum half lives (for example there are fast acting ones for postprandial administration, others that are optimized for pumps, etc) and so there is a clear pharmacological difference. Moreover, discovering these variants is nontrivial, as each insulin must be checked against igf-1 receptor cross reactivity, lest it become teratogenic. Making matters worse, the exact binding of insulin and igf-1 to their receptors is not known making this endeavor especially difficult to predict.

What is not clear is whether these modifications are an over optimization over "the original". For each patient the cost/benefit calculation will be different and based on many variables.

[ecobiker]

http://theconversation.com/explainer-evergreening-and-how-bi...

I'm not an expert and I can't comment on specifics. But I'm of the opinion that a small enhancement is not the same as an invention of a drug and it doesn't come anywhere close to extending the life of the patent - unless that tiny change actually makes a big different in effectiveness.

Any good patent system should find a good balance between the two seemingly conflicting goals of incentivizing companies to innovate and keeping the price down for patients.

[dnautics]

These insulin changes are like the difference between a spanner and a torque wrench, or a spanner and a ratcheting wrench. The torque wrench is definitely more effective for certain use cases, as is the ratcheting wrench, both are nontrivial, but 99% of the time the spanner would do just fine / maybe be a bit more of a hassle.

[DrScump]

(for Americans: "spanner" -> "hammer")

[ferrari8608]

I believe you meant wrench.