Exubera: The road to hell is paved with good intentions

I’ve been waiting to write up the Exubera story for the next edition of Building Biotechnology, and the story just keeps getting better.

Exubera is was Pfizer’s innovative answer to the diabetes drug market. The market is so saturated with competitive products, that the only way to capture significant market share is to innovate. Either produce a better drug — difficult, unless you can think of something better than resolving an insulin deficiency by administering insulin! — or improve on current delivery methods. Answering the second challenge, Pfizer developed an inhalable version of insulin. This drug promised to eliminate the need for injections or implantable dosage systems.

Early responses were positive (Washington Post and NPR), but in what is being painted as a marketing catastrophe, it soon became evident that the delivery system was far more cumbersome than the asthma inhalers most people are accustomed to, much more cumbersome, and a lot harder to use than injections.

With a mere $12mm in annual sales, Pfizer decided to pull Exubera, taking a $2.8b hit for assets, inventory, etc. This recall also impacts partner Nectar therapeutics, as it calls their technology and future revenues into question. They rapidly issued a press release, chastising Pfizer for weak marketing efforts.

For some post-mortem notes on Pfizer’s failure and some lessons to be learned, see the Wall Street Journal, Pharma Marketing and In The Pipeline.

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  1. Laureen
      October 30, 2007

    Pfizer’s sales force was less than effective because they did not provide any information on Exubera to doctors, until doctors requested information on Exubera. I know this because it took my Endocrinologist several weeks and multiple phone calls for Pfizer to receive training and documentation on the product. Exubera is still not listed in the Physicians Desk Reference, which is the bible for Physicians. I can tell you this type of marketing and sales is not effective, as will Pfizer, but they will not admit any fault of their own. Additionally, Pfizer expected to generate over a billion dollars with a new, progressive drug, after only one year? Have they ever heard of a new product life cycle? Apparently not.

    While there is some negative press surrounding Exubera, it is from people who know little to nothing about the product. Dosing does require thinking, so someone who doesn’t think should not use Exubera or any other medication. Many Doctors are not progressive and don’t want to change what medications they are prescribing. A different approach must be taken with non-progressive doctors. Unfortunately, some doctors would rather show a patient the negatives versus the positives of a new, progressive product. For me, and millions of insulin dependent diabetics, Exubera is the best solution we have.

    I know Pfizer will say I have other options, but do I really? I can’t have an islet cell transplant due to anti-rejection drugs; I can’t take a pill because I am insulin-dependent. My only option is to go back on 4 injections a day: to have bruised, sore arms and legs again and to have to get up and run to the bathroom to give an injection before breakfast, lunch, and dinner or to get gawked at if I give an injection at the table in a restaurant. Exubera is my CURE. I don’t have the luxury of not taking insulin. I need it to survive. This may be the closest thing to a cure that many Type I diabetics will ever see.

    Pfizer says on their web site, “That’s why we at Pfizer are committed to being a global leader in health care and to helping change millions of lives for the better through providing access to safe, effective and affordable medicines and related health care services to the people who need them” (Pfizer.com). Instead of Pfizer improving my life they are taking away the ONLY non-invasive treatment option for me and the 3 million Type I diabetics in the US.

    I would love to sit down with the person who made the decision to take it off the market and give him or her 4 injections a day for a week, let alone 20 years, and see if he would change his mind.

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