Scott Hensley at the WSJ.com Health Blog had a banner day today with the sad withdrawal by Pfizer of their inhaled insulin product, Exubera. When I was a pharmacy professor in the mid-1990s, we shared Pharma's optimism that an inhaled insulin product would be a godsend for diabetes patients who had to inject themselves with this essential hormone. The Terra Sig blog also has a historical soft spot for insulin since it was first crystallized by our nom-sake, Prof John Jacob Abel (PNAS 1926; 12:132-6 - PDF here).
Well, Abel must be quite disappointed somewhere out there in the Great Beyond: Exubera was a bust, selling only $12 million last year after being touted as a multi-billion dollar drug. Hensley pointed out one drawback was that the bulky inhaler was compared by some to a bong.
Indeed, in Health Blog's quoting an old interview with the president of the American Diabetes Association, John Buse, the product was characterized as follows:
"I'm going to make it sound pretty bad: 'A., You may have to take it for a long time and we only have three-year safety data. B. You're going to carry this crazy thing that's the size of a can of Coke. You're going to be mixing packets before meals. People are going to think you're doing drugs. Why would you do that?' "
But that wasn't all.
Health Blog then followed the response of Pfizer's corporate partner, Nektar, who reported finding out about the discontinuation via press release at the same time as the public. Lovely. Nektar's shares fell 15% today as a result.
Interestingly, the financial trail of this marketing trainwreck was foreseen by one of Pharmboy's favorite blogs, the UK's Pharmagossip in these posts from Jan 2006 and Oct 2005. (Pharmagossip's Insider also seized upon the bong angle in today's post) The only winner in this whole episode was Sanofi-Aventis who Pfizer paid $1.3 billion for rights to the product.
The good news for diabetic patients who hate giving themselves injections are other inhalable insulin products under development. For them, I hope that lessons were learned from this experience.
WTF? If I was a Type I diabetic, I like to think I would opt for the bong versus the pump and needle.
This stinks of marketing.
My son is type I diabetic. We looked into this--it sounds nice, until you scratch the surface. It really is a bulky and inconvenient device. Yes, inconvenient even when compared to injections. The dosages are less consistent than injections, the apparatus is bigger, the procedure is more complicated and takes more time than injections...
It is a very good option (was, I guess) for people who are clinically phobic of needles. My son hated the idea of injecting himself (next weekend marks his one year anniversary of diagnosis; he is 18 years old), but frankly, jabbing himself 4-5 times a day for a week or so got him over that real fast. Now, he is considering a pump, but I don't think he would opt for an inhalable even if it were approved.
I honestly do not think it is marketing. I spoke to the drug reps who were pushing this option, and it sounded great. My son's doctor did not like it, and my son, having the experience with shooting up, was not convinced by the spiel. Even very good marketing will not make up for a not-very-good product.
I thank God every day that I don't have diabetes. It seems everyone suffers so much.
Anon, thank you so much for relating the experiences of you and your son. Like I said, we scientists were very excited about the general idea of giving peptide drugs via the lungs instead of injection - it's obviously still as viable idea but will require refinements, as are being done by other companies.
But the real proof for a new pharmaceutical dosage form lies with the patients who must use it, day in and day out. I really appreciate you sharing your story with us.