An assortment of temptations

My visitor breezed in on high heals; quite rare in rural Northern New Mexico. She was blonde, thin and busty. Cute as a button. She brought a mocha-chocolate cake from the Chocolate Maven in Santa Fe, complete with chocolate covered strawberries on top.

Well, it had been a while since I had a visit from Lucifer.

Yep. My poor Exubera rep, feeling guilty about Pfizer’s leaving the few, but happy, inhaled insulin users in the lurch, bought cakes for all her providers that had scripted out the doomed product.

For what it’s worth, Pfizer is going with a scorched earth policy the like of which hasn’t been seen since the Huns swept over Europe.

They’ve officially dropped the product, only filling scripts for 90 more days. They’ve shut down the factory. They’ve laid off the workers. According to Amy’s blog which she calls Diabetesmine and I call the New York Times of Diabetes, Pfizer is taking a 2.8 billion-with-a-B dollar loss; the largest in pharma history as far as anyone can recall. My spies tell me the company “only” made 12 million on the product last year.

Of course, to be fair, it would take the company 233 years to break even at that rate.

Back to scorched earth, Pfizer has even gone so far as to prohibit their reps from giving the samples in the trunks of their cars to patients already using the product. Instead of ending up in the lungs of diabetics, these very expensive packets of insulin will end up in a land fill somewhere.

I called around to my various contact in the medical world. No one could recall a FDA approved med, that is under no apparent pall of suspicion, being made to fall on its sword due to lack of sales.

More strangely, Pfizer reportedly had just contracted with a third party to develop a new, more compact inhaler for the medication that was to look less like penis enlarger.

I had only one patient on Exubera. It dropped him from an A1C of 7.5 to a “perfect” 6.5 with virtually no hypos. He loves it, and is feeling very abused and abandoned. He wonders why Pfizer would react so violently. Why not just marginalize the product and let sales slowly grow, he wonders.

I wonder too. The billions have already been spent. Pfizer is in desperate need. They’ve got no block-buster drug in their portfolio once Lipitor goes generic in a few years. One would think that every 12 million dollars would help when your back is up against the wall.

…..boy what I could do with 12 million…. Can you hear the seagulls and the waves lapping against the beach?

Of course I have no earthly idea how much it actually cost them in terms of payroll, electricity, shipping, etc. to make the packets that brought in the 12 million; but I’m betting that, development costs aside, they were actually making a cash-flow profit on the drug.

I never for a minute expected Exubera to be the block buster that Pfizer deluded themselves into believing it would be. One wonders at the lack of connection to reality in America’s board rooms.

By the time 95% of D-folk need fast-acting insulin, they are already taking basal insulin. When I presented the massive six-story inhaler in one hand vs. another insulin pen in the other….well, you know what happened.

Now, had Pfizer developed an inhaled basal insulin first; then they would have had unstoppable run-away sales. Until they’ve had their first shot, most new insulin candidates are terrified of “the needle.”

All of that said, I thought Exubera was a nice little niche product. I like having every possible arrow in my quiver and I’m sorry to see it go away. It’ll be interesting to see if the other inhaled insulin players will try to jump into the void left by Pfizer’s departure; or if they will quietly close the books, take the development as a charge against their profits for the quarter and move on to the next act in the diabetes drama.