[ekr____]

Original author here: Yeah a lot of the evergreening techniques (chiral switch, etc.) don't prevent anyone from getting the original, though of course doctors may try to switch you. The inhaler thing is double bad because of the CFC ban.

I didn't dig into the details of the fluticasone HFA switch, but my impression is that while it's obvious to replace the propellant, apparently you do need to do some engineering (e.g., on the nozzle) to make it work right. I don't know enough about what they actually had to do to know if the patent should have been granted or not.