Tiny Tweak, New Monopoly: Evergreening Shouldn’t Mean a Bigger Bill

I’m not saying the billion-dollar backroom worships a stopwatch, but the patent expires and—boom—“innovation” shows up as an extended-release, a new coating, or a combo pill. Same original drug, new paperwork, new dose, with that fresh little seal slapped on like it’s a brand-new invention. Not every reformulation is a real breakthrough; sometimes it’s just the legal version of swapping a street sign and calling it “progress.”

When competition waits, Medicare keeps paying while the price clock does a victory lap under a new nameplate. A small change shouldn’t mean a bigger bill—yet the system treats “tiny tweak” like it’s the next chapter in monopoly fanfic, just with higher invoices.