Exubera Success May Hinge on Usability

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At the recent annual scientific meeting of the American Diabetes Association, the Pfizer (PFE) booth was jam-packed with doctors, nurses, academics and analysts angling for a firsthand look at the Exubera insulin inhaler.

"Change the diabetes experience," said one video display as a platoon of Pfizer representatives showed onlookers how to use the inhaler. To be sure, the New York-based drug giant hopes to vastly alter the way diabetics get their insulin by giving them the first option to injections to come on the market.

However, questions remain about just how easy the device is to use and whether a large number of insulin users will in fact make the switch.

"We still believe the device is a bit large, but [we] found it easy to use," Catherine Arnold of Credit Suisse wrote in research report after the June ADA meeting. She went on to say, though, that the "size and maintenance requirements of the device largely offset the convenience offered by inhaled administration."

The inhaler itself was developed by Nektar Therapeutics (NKTR). Both that company and Pfizer are counting on Exubera to attract new patients and perhaps convert existing diabetics to what they say is an easier way to control blood-sugar levels, even if the drug costs more than injectable insulin.

Arnold for one is concerned that it will take Pfizer 12 to 18 months to educate patients and doctors about safety and device-management issues. She's neutral on Pfizer, and she doesn't cover Nektar. She doesn't own shares of the companies, but her firm says it does or seeks to do business with firms mentioned in its research reports.

"Most clinicians we spoke with indicated there is substantial patient interest in Exubera," Barbara Ryan of Deutsche Bank Securities said in a post-convention review. "They felt the device was certainly less than ideal, but it was generally viewed as easy to use."