Don't most insurers these days require you to take the generic if one is available? So it shouldn't really matter whether the doctor prescribes the brand name or the generic. Or does that generic-if-possible rule not work here because the brand name one is ever so slightly different?
Yes, the new drug is different, so there is no generic for it.
Another class of "patent extender" is to take two existing good drugs, package them together, and then trial and sell it as a new drug. The combined product is not the same as the two off-patent generic parent drugs.
I'd love to see an example of this. I'm not saying I don't believe you but I'd really like to see an example and then look to see what Kaiser (a medical insurer and provider here in CA for the non-CA and a few other state folks) does since I don't think they would go for that.
Thats exactly the point, if the drug is covered under patent there is no generic. So if the doctor prescribes the newer yet not better drug, there will be no generic alternative.
