Changing an atom is a big deal, thats a whole other drug. Evergreens, where they extend patents through small modifications, has nothing to do with the active i

Changing an atom is a big deal, thats a whole other drug. Evergreens, where they extend patents through small modifications, has nothing to do with the active ingredient since changing that requires another few hundred million dollars in clinical trials. And generics companies are already incentivized by law to sue and overturn patents. I would suggest spending time to learn about what these problems like evergreening actually are, and how drug development actually works from a scientific perspective, before trying to come up with societal structures to do it better. I would also recommend then reading up on the current societal structures so you can get a sense of what off label use actually means, what that entails, how generics companies work, what their incentives are, and so on. But start with the science behind how drugs and drug development works, the statistics of why clinical trials are needed, etc, since you really can't do anything without that basis.