The findings of this cohort study underscore how manufacturers have obtained and listed tertiary patents not only on top-selling drug-device combinations, like inhalers,11,12,13,14,15 glucagon-like peptide-1,16,17 and insulin,25,26 but on a wide spectrum of medications used for birth control, migraines, allergic rhinitis, chronic pain, schizophrenia, prostate cancer, psoriasis, and many other conditions. The gene discussed is INS; the disease is allergic rhinitis.