[Lazare]

That is correct. From here[1]:

"[The authors] describe the history of insulin as an example of “evergreening,” in which pharmaceutical companies make a series of improvements to important medications that extend their patents for many decades. This keeps older versions off the generic market, the authors say, because generic manufacturers have less incentive to make a version of insulin that doctors perceived as obsolete. Newer versions are somewhat better for patients who can afford them, say the authors, but those who can’t suffer painful, costly complications."

This isn't really a story about patents, it's about marketing and a chicken-and-egg problem. You could buy dirt cheap generic insulin if anyone made it, but they don't, because nobody wants to buy it, probably because nobody makes it.

[1]: http://www.hopkinsmedicine.org/news/media/releases/why_peopl...

[frandroid]

I don't really believe that there isn't a lot of low- and middle-income people with diabetes that wouldn't buy drastically cheaper insulin if it was still rather effective, especially pre-Obamacare. It's clear that there's collusion to keep cheap product out of the market.

[dnautics]

This is exactly spot on. I would also add that "nobody wants to buy it" refers to the "doctors", not the "patient" - which is a very restricted and more easily targetted channel for marketing versus the patients.