Announcement

Collapse
No announcement yet.

The drug Exubera looks like an expensive flop for Pfizer

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • The drug Exubera looks like an expensive flop for Pfizer

    NEW YORK: Exubera, the first and so far only commercially available inhaled-insulin diabetes treatment, is on the verge of turning into an expensive flop for its maker, Pfizer.

    At one point, the company regarded the drug as a potential blockbuster. But despite six months of marketing to doctors, Exubera receives only about one of every 500 prescriptions for insulin written in the United States.

    A new diabetes pill, Januvia, which is made by Merck and was approved after Exubera, is already prescribed about 40,000 times a week in the United States, 25 times as often as the Pfizer drug.

    And so Wall Street analysts are cutting their sales estimates for Exubera, which has been dogged by questions about its safety, cost and convenience.

    Pfizer says it has not given up on Exubera and last week started a new marketing campaign to persuade doctors to prescribe the medicine.

    In January, the company projected that despite its slow start, Exubera would eventually achieve worldwide sales of $2 billion. But doctors and analysts are skeptical.

    "I don't think the drug can be saved," said David Risinger, an analyst at Merrill Lynch, who last week cut his estimates for Exubera sales. Risinger now expects that Exubera will have $310 million in sales worldwide in 2012, down from his previous estimate of $800 million. Other analysts have also cut their forecasts.

    Exubera's problems add to the uncertainties facing Pfizer, whose shares have lost almost half their value since 2000. While the company remains very profitable, its health is increasingly tied to Lipitor, a best-selling cholesterol-lowering medicine that faces competition from cheaper drugs and in several years, patent expiration.

    In interviews Monday, Pfizer executives acknowledged Exubera's problems but said they believed that a new sales push would spur the drug's sales. The company will work to convince doctors that insulin, in both inhaled and injectable forms, is underprescribed. And this summer, Pfizer plans to begin directly advertising the inhaler to patients.

    "Sales have been slower than expected," said Olivier Brandicourt, general manager for Pfizer's metabolic and cardiovascular division, which includes Exubera. "It takes time to educate the physician."

    Rochelle Chaiken, Pfizer's vice president for global medical affairs, said that almost 60 percent of diabetes patients had overly high blood sugar levels despite being on standard oral diabetes medications. Many of those patients should be taking Exubera, she said.

    But Pfizer's marketing may not be enough to overcome the medical, economic, practical and legal concerns that have hurt Exubera.

    In theory, the drug's biggest advantage over standard injectable insulin is that it is more convenient and does not require needle pricks.

    In reality, though, the Exubera inhaler is bulky and can be hard to use, doctors say. The device is nearly as large as a tennis ball can when it is open, and must be repeatedly pumped before the insulin can be inhaled. Making matters worse, Exubera comes in different doses from standard insulin, and converting doses can be complicated, the doctors say.

    And insurers have been reluctant to pay for Exubera, which costs about $5 a day, compared with $2 to $3 a day for injectable insulin.

    In addition, the needles now used for conventional insulin injections are smaller and less painful than they once were. "Out of 2,000 times or more I've tried to start patients on insulin, I've only been turned down twice," said Dr. John Buse, professor of medicine at the University of North Carolina.

    Doctors and patients have many more options for managing diabetes than they did a decade ago, Buse said. In the last two years, three new diabetes medicines have reached the market - Januvia, Byetta and Symlin - as well as Levemir, a longer-acting version of injectable insulin. As with Januvia, sales of Byetta, which is made by Eli Lilly and Amylin Pharmaceuticals, have grown quickly.

    Another concern for doctors about Exubera is that long-term use of inhaled insulin can damage the lungs. Pfizer's clinical trials show the drug causes lung function to drop in some patients. The decrease appears to be minor and to reverse if patients stop using the drug. Even so, patients must take a lung-function test before beginning Exubera, something that has discouraged doctors from prescribing it, said Dr. Joel Zonszein, a diabetes specialist at Montefiore Medical Center. Zonszein said he had tried to put about half a dozen patients on Exubera since the drug was introduced last summer. All have stopped using it, he said. "The inhaled market may just not be there," he said. "The needles we have nowadays are very friendly. They're easy to take."

    Hoping to spur sales, Pfizer has transferred responsibility for promoting Exubera from its pain management division to its cardiovascular division. The cardiovascular sales force, which helped turn Lipitor into the world's top-selling medicine, is highly regarded. But the change may not make a difference, said George Grofik, a drug industry analyst at Citigroup.

    In February, Grofik's team surveyed 35 doctors, polling primary care physicians and diabetes specialists, to get their opinions on Exubera. Nearly 9 of 10 doctors had "medium" or "high" awareness of the drug, the survey found. But more than half said they were concerned about Exubera's safety. They were also concerned about its price and the bulkiness of the Exubera inhaler.

    Because doctors already seem to have made up their minds on Exubera, Grofik said, Pfizer will face an uphill battle as it tries to change their views. And by having its representatives promote Exubera when they make sales calls, he added, Pfizer risks taking attention from Lipitor and other more profitable medications. "There's an opportunity cost in detailing Exubera that could be used on higher-margin products," Grofik said.

    Over the next five years, other drug companies, including Lilly, may receive approval for their versions of inhaled insulin, said James Reddoch, a biotechnology analyst at Friedman, Billings, Ramsey. The next-generation inhalers are smaller and more convenient than the Exubera inhaler and may attract more prescriptions, Reddoch said. The lack of interest in Exubera has made Wall Street wonder whether the inhaled-insulin market is as large as drug companies once thought, he said. "It sounds nice on the surface, the fact that you can now breathe in your insulin," Reddoch said. "But there are problems from a practical standpoint."

    Another problem

    A new U.S. television advertisement for Pfizer's painkiller Celebrex that has attracted attention for both its length and innovative marketing approach is now the target of criticism for its message, the New York Times reported.

    Public Citizen, a consumer group, asked the Food and Drug Administration on Monday to ban the Celebrex television commercial, charging that it gives consumers a false impression that the prescription drug has no more safety risk than some other painkillers.

    Celebrex is in the same class of drugs as the Merck pill Vioxx, which was withdrawn in 2004 because of its link to cardiovascular problems.


  • #2
    might have a chance for those who really do not like to use needles for insulin uptake. it must be improved then it can be used...

    Comment


    • #3
      Perhaps the use of Exubera will prove to be only a temporary solution as there is a possibility that all current treatments will be overtaken by other remedies:

      Originally posted by Al-khiyal View Post

      Comment


      • #4
        I'm not sure Exubera would be the #1 choice among Muslim diabetics- I don't think they could use it during Ramadan since the way to take it is through the mouth. ...hmmm or could they?
        It seems as if one fails to conceive
        The meaning my name strives to achieve

        To a biological form you cannot relate-
        Because a reproductive cell is a gamete not gamate!

        It means to unite, -to become consolidated
        So without me in a.com, is there hope we'd be amalgamated?

        Comment


        • #5
          well, it's an inhalant ... dunno. What's ur fatwa on breathing medicine ya sheikha .

          Comment


          • #6
            still, not during Ramadan ya Bent injections are ok but I know that absolutely nothing is can to go down one's throat when fasting. but here's where it's a bit obscure: can no food/drink/item go down the throat (comprising both esophagus and trachea) or more specifically, can nothing go down just the esophagus, the food tube, where as something going through the trachea, air tube, is on the other hand permissable?


            It seems as if one fails to conceive
            The meaning my name strives to achieve

            To a biological form you cannot relate-
            Because a reproductive cell is a gamete not gamate!

            It means to unite, -to become consolidated
            So without me in a.com, is there hope we'd be amalgamated?

            Comment


            • #7
              well it HAS to be permissible or else we'd be breaking our fast by just BREATHING!! I don't think we can hold our breaths that long

              Comment


              • #8
                we can neither NOT swallow our spit! so breathing and swallowing are ommited in the criteria


                i guess it also depends upon the fluidity of the insuline inhaler... is it more or less fluid than let's say, Proventil (Albuterol) inhaler?
                It seems as if one fails to conceive
                The meaning my name strives to achieve

                To a biological form you cannot relate-
                Because a reproductive cell is a gamete not gamate!

                It means to unite, -to become consolidated
                So without me in a.com, is there hope we'd be amalgamated?

                Comment


                • #9
                  um - either way - it messes up your lungs so you're better off not taking it anyways

                  there problem solved

                  Comment


                  • #10
                    yes, let's just make things less complicated on ourselves and stay with the injections.

                    my royal fatwa: "Allahu yuridu bikum al yusra wa la yuridu bikum al 3sr"



                    ~Dame
                    It seems as if one fails to conceive
                    The meaning my name strives to achieve

                    To a biological form you cannot relate-
                    Because a reproductive cell is a gamete not gamate!

                    It means to unite, -to become consolidated
                    So without me in a.com, is there hope we'd be amalgamated?

                    Comment


                    • #11
                      Originally posted by amalgamate View Post
                      still, not during Ramadan ya Bent injections are ok but I know that absolutely nothing is can to go down one's throat when fasting. but here's where it's a bit obscure: can no food/drink/item go down the throat (comprising both esophagus and trachea) or more specifically, can nothing go down just the esophagus, the food tube, where as something going through the trachea, air tube, is on the other hand permissable?


                      hi girls,
                      first of all...this is a health forum and not a religious forum.
                      As for the injections...it is still not allowed during fasting, any medication you take (provided at any route: inhalation, injection, eating, drinking..) and which will be absorbed by your blood streams will make your fast not valid anymore.
                      So, injections are NOT OK during fasting, neither are ihalation medications (such as Azhma inhalers...etc)
                      As a general rule in our religion though...if a patient is very sick and/or on regular medication, they are allowed not to fast during Ramadhan and they have a couple of options to re-do their Ramadhan (by fasting again...or paying money...etc).
                      hope this clarifies some issues...but be careful of injections...it is not allowed at all, unless you have to.
                      take care
                      Miss NinaGucci says: The Grass is Always Greener on The Other Side Of the Fence

                      Comment


                      • #12
                        For diabetic- type 1 patients in case of hyperglycemia:
                        Do four things every day to lower high blood glucose:


                        ACTION STEPS...
                        IF YOU USE INSULIN OR NOT
                        * Follow your meal plan.

                        Don’t skip meals, especially if you’ve already taken your insulin, because your blood glucose may go too low.


                        * Be physically active.

                        Physical activity is good for your diabetes. Walking, swimming, dancing, riding a bicycle, playing baseball, and bowling are all good ways to be active. You can even get exercise when you clean house or work in your garden. Physical activity is especially good for people with diabetes because

                        physical activity helps keep weight down

                        physical activity helps insulin work better to lower blood glucose

                        physical activity is good for your heart and lungs

                        physical activity gives you more energy

                        Before you begin exercising, talk with your doctor. Your doctor may check your heart and your feet to be sure you have no special problems. If you have high blood pressure or eye problems, some exercises like weightlifting may not be safe. Your health care team can help you find safe exercises.

                        Try to be active almost every day for a total of about 30 minutes. If you haven’t been very active lately, begin slowly. Start with 5 to 10 minutes, and then add more time. Or exercise for 10 minutes, three times a day.


                        *Take your diabetes medicine every day.

                        Take Your Diabetes Medicine Every Day
                        Three kinds of diabetes medicine can help you reach your blood glucose targets: pills, insulin, and other injectable medicines.

                        If you take diabetes pills
                        If your body makes insulin, but the insulin doesn’t lower your blood glucose, you may need diabetes pills. Some pills are taken once a day, and others are taken more often. Ask your health care team when you should take your pills.

                        Be sure to tell your doctor if your pills make you feel sick or if you have any other problems. Remember, diabetes pills don’t lower blood glucose by themselves. You’ll still want to follow a meal plan and be active to help lower your blood glucose.

                        Sometimes, people who take diabetes pills may need insulin for a while. If you get sick or have surgery, the diabetes pills may no longer work to lower your blood glucose.

                        You may be able to stop taking diabetes pills if you lose weight. (type 2 diabetis usually, lways check with your doctor before you stop taking your diabetes pills.) Losing 10 or 15 pounds can sometimes help you reach your target blood glucose level.

                        * Check your blood glucose regularly.


                        There are five ways to take insulin.

                        Taking shots, also called injections. You’ll use a needle attached to a syringe—a hollow tube with a plunger—that you fill with a dose of insulin. Some people use an insulin pen, a pen-like device with a needle and a cartridge of insulin.

                        Using an insulin pump. A pump is a small device, worn on a belt or in a pocket, that holds insulin. The pump connects to a small plastic tube and a very small needle. The needle is inserted under the skin and stays in for several days.

                        Using an insulin jet injector. This device sends a fine spray of insulin through the skin with high-pressure air instead of a needle.

                        Using an insulin infuser. A small tube is inserted just beneath the skin and remains in place for several days. Insulin is injected into the end of the tube instead of through the skin.

                        Using inhaled insulin. You’ll use a special device to breathe in powdered insulin through the mouth.

                        * have discipline for taking medication.
                        if not , one will get a too high bloodpressure and can faint and go into coma.

                        if taken too much medicine or no meals on time: too low bloodglucose (hypoglycemia) can result in coma too.

                        Comment


                        • #13
                          Originally posted by NinaGucci View Post
                          hi girls,
                          first of all...this is a health forum and not a religious forum.
                          As for the injections...it is still not allowed during fasting, any medication you take (provided at any route: inhalation, injection, eating, drinking..) and which will be absorbed by your blood streams will make your fast not valid anymore.
                          So, injections are NOT OK during fasting, neither are ihalation medications (such as Azhma inhalers...etc)
                          As a general rule in our religion though...if a patient is very sick and/or on regular medication, they are allowed not to fast during Ramadhan and they have a couple of options to re-do their Ramadhan (by fasting again...or paying money...etc).
                          hope this clarifies some issues...but be careful of injections...it is not allowed at all, unless you have to.
                          take care
                          type 1 diabetic persons can't fast at all, the risk of hypoglycemia- too low bloodsugar level- is too big. can result in coma and death.
                          Why make them feel bad by telling their fast is never valid if they can't fast at all? Trying is too risky. and re-do is no option either.

                          Comment


                          • #14
                            thanks for the info, nina and cheba . very useful

                            Comment


                            • #15
                              Originally posted by NinaGucci View Post
                              hi girls,
                              first of all...this is a health forum and not a religious forum.
                              As for the injections...it is still not allowed during fasting, any medication you take (provided at any route: inhalation, injection, eating, drinking..) and which will be absorbed by your blood streams will make your fast not valid anymore.
                              So, injections are NOT OK during fasting, neither are ihalation medications (such as Azhma inhalers...etc)
                              As a general rule in our religion though...if a patient is very sick and/or on regular medication, they are allowed not to fast during Ramadhan and they have a couple of options to re-do their Ramadhan (by fasting again...or paying money...etc).
                              hope this clarifies some issues...but be careful of injections...it is not allowed at all, unless you have to.
                              take care
                              whooaa wait a second ma lady... you better check your sources there.

                              Medical injections for diabetics are allowd in Ramadan. we're not talking about using the injection for heroin or any type of abusive drug. we're talking about insulin.

                              Diabetics need their insulin shots every time they eat whether it be at fajr time or at maghrib time or any time in between. That is permissible to take when a diabetic fasts.

                              Many Type 1 Diabetics who closely monitor their blood sugar, are aware of certain complications associated with fasting but are persistent in fasting during Ramadan. They take their insulin injections as well. Their fast is accepted bi ithnillah. The only reason diabetics are advised not to fast during Ramadan is for fear of any serious side-effects of hypoglycemia/hyperglycemia NOT because the mode of injection of insulin bars them from fasting.

                              no where does it state that insulin injections are haram during Ramadan. What is haram is clear: insisting to eat/drink/inject oneself with types of nutrients just for the heck of it, etc.


                              "Fasting during Ramadan for patients with diabetes carries a risk of an assortment of complications. In general, patients with type 1 diabetes should be strongly advised to not fast. ...Patients who insist on fasting should undergo pre-Ramadan assessment and receive appropriate education and instructions related to physical activity, meal planning, glucose monitoring, and dosage and timing of medications. The management plan must be highly individualized. Close follow-up is essential to reduce the risk for development of complications."

                              Recomendation of Management of Diabetes During Ramadan


                              Salaam
                              It seems as if one fails to conceive
                              The meaning my name strives to achieve

                              To a biological form you cannot relate-
                              Because a reproductive cell is a gamete not gamate!

                              It means to unite, -to become consolidated
                              So without me in a.com, is there hope we'd be amalgamated?

                              Comment

                              Unconfigured Ad Widget

                              Collapse
                              Working...
                              X