Who makes that decision - the insurer, or as posted yesterday, a pharmacy chain like CVS that enacted a "GV only" rule in central CA? Any Medicare patient that is forced onto GV is going to pay a lot more money than if they got V, maybe as much as $2k-$3k if you take multiple drugs - brand names are required to provide large discounts while patients are in the donut hole, and those savings get applied to total drug costs that are added up to calculate when you leave the donut hole and enter catastrophic coverage - but generics do not have to provide discounts in the donut hole so you'll be paying full retail price for GV in the gap, which is almost as expensive as V, ~ $400/mo in 2021. If I am not forced to take GV I will "only" pay $120/mo while in the gap, but if forced to take it my costs stay near $400/mo - I cannot possibly afford that, out of the question, and I'm reasonably well off - this will kill V sales if it becomes widespread, the US market will.....erm....evaporate.....JT will be forced to go the authorized generic route to preserve market share, neglecting the infringement issues because nobody has figured out who actually gets sued to prevent swapping GV for V in the R-IT population.