It comes down to patient compliance. There are perhaps worse outcomes than impaired lung function if the patient is non-compliant. If a patient asserts that he'd be more likely to take his snorts of Exubera than to stick himself with Byetta or whatever, I, as a doctor might be correspondingly less reluctant to prescribe it. Pfizer gets to launch while Lilly/Amylin are having manufacturing constraints. So I think the launch may actually go better than expected.
The other issue is insurance coverage. One analyst thinks Exubera might have a harder time winning coverage because it's only a new form of an existing treatment. I don't really follow his logic. Again, it comes back to compliance. If insurers feel patients will be more compliant on Euxbera, they'll cover it. The cost of non-compliance outweighs the additional cost of the delivery system.
Hard to say. My modest bet says it will win slow acceptance after a fast start. But there will certainly be doctors and patients who share your misgivings, and the patients will then endure the daily sticking pain to save their lung function, I guess. This probably hasn't helped much, and is certainly not new thinking, but hey, you did ask. Sorry I did not produce a more definitive answer. Given your mindset, I'd say just stay away, don't short, don't long.
Cheers, Tuck |
