Sanderson has an outperform rating on Nektar Therapeutics ( NKTR), the developer of the inhaler and a partner of Pfizer. He doesn't own shares of Nektar, which also developed the dry-powder insulin formulation, as well as other Exubera technologies. His firm has had a recent investment-banking relationship with the company. Another Cowen analyst follows Pfizer and has an underperform rating on the stock. Other analysts are more cautious. Morgan Stanley's Jami Rubin attended the recent American Diabetes Association annual scientific session in Washington, and told clients afterward that her informal poll indicated that "many physicians felt that two years of lung-safety data was not enough data to feel comfortable" about Exubera. On the basis of her conversations with Pfizer sales representatives, Rubin says Exubera's launch "will be tempered by the large amount of education required" for both diabetes specialists and general practitioners. She frets that Exubera could be affected by "a tough reimbursement environment, which means that patients may not be so excited, presuming they have to pay out of pocket or pay a high co-payment." She predicts that Exubera will record a little more than $1.1 billion in sales in 2010. Rubin has an underweight rating on Nektar and an overweight rating on Pfizer. Her firm has had investment-banking relationships with both companies, and Rubin owns shares of Pfizer.
Analysts and doctors will be watching how patients and insurers respond, because Pfizer is heavily promoting Exubera for its convenience. "We believe that Exubera will improve patients' acceptance of insulin and thereby reduce the risk for serious complications in the future," said Dr. Jack Watters, vice president for medical affairs at Pfizer. Watters made his comments after the company issued surveys earlier this month showing that many patients delay taking insulin because they don't like injections . Some of Pfizer's patient-preference research has been criticized by regulators in the U.K. where the National Health Service is deciding whether to pay for Exubera. Previously, some drug companies, and their stockholders, have been disappointed when enthusiastic market-research findings weren't matched by patient and physician acceptance.