According to several recent reports, Pfizer, Inc. (NYSE:PFE) appears to have produced such a huge quantity of Exubera inhaled insulin at its Terre Haute, Indiana production facility that it should have roughly 3 years worth of drug inventory by the end of 2007.

Earlier this month, Brandweek reported that Friedman, Billings, Ramsey healthcare analyst Dr. James Reddoch wrote to the firm’s institutional brokerage clients that Pfizer had built up roughly $800 million in Exubera inventory, and should have 3 years worth of inventory built up the end of 2007:

“With lackluster demand so far, Pfizer has built up nearly $800 million in Exubera inventory this year and, based on guidance, will have over $1.5 billion in inventory by the end of this year (i.e., nearly three years’ worth of demand, based on our estimates). Pfizer will re-launch the product in April; this is probably the last chance to get traction with physicians and stimulate demand.”

Even with Pfizer’s lackluster sales of the insulin, the Vigo County Council in Indiana where the diabetes drug is produced approved a $4.515 million tax increment finance, or ‘TIF’ bond based on Pfizer’s taxes.

According to the Terre Haute Tribune-Star:

Taxes paid by Pfizer will fund the TIF bond payments, with the county’s income tax serving as a backup to secure the 15-year bond through 2021.

In other words,  if Pfizer defaults on the bond payments, the county will use it’s own income tax as security to pay the bond’s obligation.

Another reporter quotes many doctors and inurance companies who are loathe to prescribe Exubera, the inhaled insulin developed by Pfizer, Inc. and Nektar Therapeutics.

The article highlights what this blog has written about for over a year: that many doctors are concerned about the known and unknown pulmonary risks for diabetics who would use the new insulin.

Last November, Exubera-Risks.com reported the results of a study at the Tufts University Medical Center the lead investigator concluded that the the unknown safety effects that Exubera had on diabetic lung function remained a concern.

Another physician, a pulmonologist who was on the FDA’s Endocrinology and Advisory Committee that studied and approved Exubera, expressed grave concern that the inhaled insulin was approved based on “a finding that was based on studies of relatively few patients with [Chronic Obstructive Pulmonary Disorder] followed for up to 1 year.”

In February 2007, an important study was published in the American Diabetes Association’s professional journal, Diabetes Care. The study concluded that after roughly 7 years, the number of diabetics on Exubera whose lung function would decrease enough to make them inelgible for using it would double — a 50% increase in the number of ineligible diabetics based on safety factors and a history of progressively deterioration of lung function by Type 2 diabeteics.

Another reporter looked into Exubera sales recently, and found that Pfizer’s sales of Exubera inhaled insulin are pretty bad.

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In her report, Kathryn Barrett of Virginia station WVEC concluded that:

Whether it’s a lack of marketing, or less of a need that anticipated, this weapon against diabetes is gathering dust.

Barrett mentioned Exubera’s expensive cost and problematic insurance coverage under drug formulary plans.

Not to be overlooked, either, was an assessment that Kim Moloney, a nurse and diabetes educator at the Strelitz Diabetes Institutes at the Eastern Virginia Medical School, drew for Barrett.

Perhaps the biggest reason for Exubera’s less than stellar sales, according to Moloney, may just be that “many diabetics are just used to injections.”

A fascinating new by a diabetic reporter was just published, and it should cause Pfizer, Inc. (NYSE:PFE) plenty of worries. She expressed considerable disappointment handling an Exubera inhaler, concluding that it “was large and awkward.”

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And those might be the kindest words of her commentary.

Having taken insulin injections for 21 years, Meredith Cummings tells her Alabama readers in the Tuscaloosa News that she gave herself a “pep talk” to prepare for a training session and meeting at her physician’s office, “in case my doctor suddenly became a pushy Exubera spokesman.”

Last week she wrote about waiting for the results of her Exubera spirometry test.

Then, she described the shock and surprise (not awe) that she experienced upon seeing her doctor with the pulmonary drug delivery device:

He took out the inhaler, which was much larger than I thought it would be. When I tell people that I’m trying the new inhaled insulin, they assume that it looks like an asthmatic inhaler, small and portable. But if I wanted to fit this in my purse — unless my purse happened to be the size of a small cat — well, good luck.

When I held the inhaler’s blue handle, I felt more like I was holding a light saber from “Star Wars” than an inhaler, and that my doctor and I should have a duel. (emphasis added)

Then came the realization that she had to “figure out how to pay for the inhaler” and the Exubera blister packs, and that it might be expensive. That’s because, Cummings explained, “getting people off insulin shots onto inhaled insulin is big business.”

She closed with a plea to Pfizer and its Exubera drug sales force to send her some Exubera samples before her next column.

The gripes apparently being posted by Pfizer reps on a well-known drug sales team message board just keep rolling in.

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Yesterday’s new post on Cafe Pharma’s board appears to be from a Pfizer rep who doesn’t sound too optomistic about the diabetes drug, especially when s/he hears misgivings from “a physician who is worried about antibodies? Can you blame them for being cautious?”

One caveat: the poster claims to have spoken with more than ten endocrinologists — not the general practitioners (GPs), family practitioners (FPs), and internal medicine docs (IMs) that Pfizer reportedly said it would start targeting this spring.

Many physicians continue to report their skepticism over Exubera, given the known and potential safety risks associated with the insulin.

The apparent Pfizer sales team member wrote that out of all the doctors s/he tried to sell the drug:

6 said they won’t use it, 3 have used at least one and the rest are still up in the air. About half of my potential customers wont use any??? Y I K E S!! Optimistically it is conceivable that I can convince some of the naysayers but that looks to be a battle.

It looks like the glass still remains more than half-empty for Exubera sales, not half-full.

Frequent readers of this blog will recall earlier reports of alleged Exubera inhaler and Q&A problems with the 1mg insulin blister packets being made by Pfizer (apparently at the company’s Terre Haute production facility).