An intellectual property obstacle nearly terminated the bivalirudin project. This constraint forced the team to devise a novel "bivalent" molecule, which not only bypassed the patent issue but also resulted in a more potent drug. This illustrates how external limitations can unexpectedly trigger superior innovation.

Ipsen's billion-dollar drug Somatoline is maintaining strong sales despite facing generic competition since 2021. The drug is extremely difficult to manufacture, which has prevented generic players from ramping up production. This "manufacturing moat" serves as a powerful, often overlooked, defense against revenue erosion after a patent cliff.

Breakthrough drugs aren't always driven by novel biological targets. Major successes like Humira or GLP-1s often succeeded through a superior modality (a humanized antibody) or a contrarian bet on a market (obesity). This shows that business and technical execution can be more critical than being the first to discover a biological mechanism.

To overcome regulatory hurdles for "N-of-1" medicines, researchers are using an "umbrella clinical trial" strategy. This approach keeps core components like the delivery system constant while only varying the patient-specific guide RNA, potentially allowing the FDA to approve the platform itself, not just a single drug.

After a successful trial showed GIK could halve cardiac arrest and mortality, researchers were surprised it wasn't adopted. Pharmaceutical companies refused to manufacture the simple glucose, insulin, and potassium mixture because it didn't fit their business model of patenting a new drug and marketing it heavily. This forced the researchers to form their own company.

Adderall's success proves a core chemical patent isn't essential for market dominance. A strong brand that becomes synonymous with a condition, combined with secondary patents on novel delivery mechanisms (like Adderall XR's capsule), can create a durable, highly profitable business moat.

The FDA incentivizes animal drug development by granting years of market exclusivity to companies that prove a generic human drug works for a novel use in animals. This avoids the "aspirin problem" in human medicine, where no one will fund trials for off-patent drugs because they can't be profitably marketed.

Many peptides are unlikely to ever receive FDA approval because their simple, easily replicated structures make them commodities. Pharma companies won't fund billion-dollar trials for drugs they can't patent, leaving them in a permanent gray market.

While patents are important, a pharmaceutical giant's most durable competitive advantage is its ability to navigate complex global regulatory systems. This 'regulatory know-how' is a massive barrier to entry that startups cannot easily replicate, forcing them into acquisition by incumbents.