The promise: Billed as a potential blockbuster replacement to painful injections, former Pfizer CEO Henry McKinnell called Exubera "a major medical breakthrough," predicting that the drug would annual sales of $1.5 billion in 2010. Pfizer was so confident in its blockbuster potential, that days before approval, the company paid $1.4 billion to Sanofi-Aventis for its share of the drug. After less than two years, the inhaled insulin product captured just 1 percent of the insulin market--despite heavy advertising.
What went wrong: Part of the drug's failing was its extremely large drug delivery device, which was the size of a can of tennis balls and inconvenient for patients to carry. Pfizer had counted on patients' aversion to needles to boost Exubera sales, but diabetes needles have become so tiny that most users have no problem with self-injection. There were also concerns about possible dosing errors due to the difference between doses of the inhalable formula versus traditional insulin. Finally, insurers and NICE were underwhelmed by Exubera's cost effectiveness, noting that it was no more effective than existing treatments despite the higher price.
After spending hundreds of millions to develop the drug, Pfizer announced in October 2007 that it would stop manufacturing the drug. "Despite our best efforts, Exubera has failed to gain the acceptance of patients and physicians," said Pfizer CEO Jeffrey Kindler. The company was forced to take a $2.8 billion charge when it wrote off the drug, including $661 million of Exubera inventory. When Pfizer made its decision, three other inhalable insulin drugs were under development; only Mannkind is still in the race, persuing development of Afrezza.