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Exubera Slow to Catch On

Posted: Thursday, December 07, 2006

Jury is still out on Exubera.

Diabetics are holding their breath, and that may not be good news for the Pfizer, the world's biggest drugmaker. It's been nearly a year since the FDA approved Exubera, the first inhalable form of insulin for diabetics. Some analysts hail the device as a potential blockbuster, but Exubera doesn't appear to have caught on. Pfizer still has not released sales figures for Exubera - a sign to experts that things aren't going that well. The product first entered the market in May and is now available in the U.S., Britain, Ireland and Germany.

Considering the $12 billion-plus market for diabetes treatments and the presence of more than 20 million diabetics in America, how could this launch from Pfizer and its partner Nektar Therapeutics be so sluggish?

Since Exubera is a device that diabetics and their physicians must be trained to use, the company is conducting a controlled launch, focusing first on endocrinologists rather than general practitioners. Pfizer had planned to release Exubera to general practitioners this month, but decided to bump it back to January.

In a written statement to CNNMoney.com, Pfizer spokeswoman Vanessa Aristide said the company "has focused its education outreach to key diabetes specialists, and we are pleased with the response to Exubera." Aristide also said that powdered insulin is being manufactured for the first time "on a large scale."

The uptake hasn't exactly been robust yet, and I'm not sure it's for lack of awareness, but if people are concerned about the side effect profile, or they're happy with existing treatments, they're probably not going to try something new."

In an Oct. 26 report titled "Inhalable insulin: reality doesn't live up to the hype," Datamonitor analyst Daniel Poso projected an Exubera sales peak of about $200 million by 2015, far short of billion-dollar blockbuster status.

"Presented to great fanfare to physicians and shareholders all over the world as a sure-fire blockbuster in the making, in Datamonitor's opinion, Pfizer/Nektar's Exubera is unlikely to revolutionize therapy as some might expect," said Poso in the report, noting that Exubera would be a boon to diabetics with hemophilia, but others might find the needle too effective to give up.

With endos not too excited by Exubera, it’s fate will rest with the primary care docs. Even if Exubera does catch on with family doctors and diabetics, Pfizer faces future competition in the form of three developmental products for inhalable insulin from five companies. Poso of Datamonitor projects that, by 2010, Novo Nordisk will enter the market with AERx-iDMS, while Eli Lilly & Co. is expected to launch its AIR system and Mannkind is expected to launch its Technosphere.

Source: Diabetes In Control