>BIOD – It's not quite fair to say that it was only stat sig by excluding India, as that was the Type I trial only (and type II is obviously the "market").<
Agreed.
>OTOH, I suspect the real issue is that it was stat sig *inferior* to Humulin, despite being stat sig non-inferior (yes, I think I said that right).<
Which of the two trials are you referring to now?
>How common is that [for a trial to be statsig non-inferior as well as statsig inferior]?<
This seemingly paradoxical outcome is entirely possible from a mathematical standpoint. However, few non-inferiority trials contain a prespecified two-sided test for superiority/inferiority of the experimental agent vs the control; without such a prespecified test, one cannot legitimately declare the experimental agent inferior to the control even if it comes out that way according to a post hoc analysis.
>It's probably not a good idea to have an also ran in this market.<
Agreed. The various insulin analogs (what Novo-Nordisk calls “modern insulins”) are steadily gaining market share at the expense of ordinary insulin. A tweaked formulation of ordinary insulin, even if it works, is not exactly a winning business idea, IMO. Also see #msg-31043957 for related commentary.
“The efficient-market hypothesis may be the foremost piece of B.S. ever promulgated in any area of human knowledge!”