Pfizer, Inc. (NYSE:PFE) will report First Quarter earnings for 2007 to investors tomorrow. Lackluster Exubera sales of the drugmaker’s inhaled insulin are likely to be mentioned.
One report summarized the problems this blog continues to report on since the diabetes drug received FDA approval last year:

Acceptance of the company’s inhaled insulin Exubera was not promising despite hype on the product as some doctors still worried about long-term lung safety and lacked reimbursement as insurers considered the drug a convenience.

Deutsche Bank analyst Barbara Ryan rates Pfizer stock as a “Buy,” while Prudential Equity analyst Tim Anderson called it a “Neutral” securities purchase.
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A.G. Edwards health care analyst Joseph Tooley reported that Pfizer suffered “a significantly slower start than we had previously expected” of Exubera inhaled insulin sales.

Motley Fool finance web site contributor Brian Lawler lists Mannkind Corporation (NKTR:MNKD) founder Alfred Mann as someone whose medical device companies have been done very well by “keep[ing] you living well beyond when you might expire without” such technologies.

Lawler appears optomistic that, despite Exubera’s launch problems, Mannkind’s Technosphere inhaled insulin “[has] some potential advantages — like easier dosing — that could make it a much bigger hit than Exubera.”

This blog has noted, however, that perhaps the biggest thing that could convince diabetics to choose Mannkind’s inhaled insulin (if it gets FDA approval) over Pfizer’s is the small size of the drug delivery device compared to Exubera’s bong-like appearance.
That could mean a key question behind selling inhaled insulin — besides safety, efficacy, and affordability — is whether device size matters.

Danish diabetes drugmaker Novo Nordisk A/S (NYSE:NVO) is reducing the number of its inhaled insulin patent infringement lawsuit claims against Pfizer, Inc. (NYSE:PFE) from five to two.

Novo’s General Counsel Jim Shehan told the Danish financial news agency RB Borsen that the company believes it still has “a very strong case” against Pfizer.

The two pharmaceutical giants are battling over their respective pulmonary drug delivery technologies to deliver inhaled insulin to diabetics.  Pfizer’s Exuber received FDA approval in January 2006. Novo’s AERx inhaled insulin is currently in clinical trials, but submission for FDA approval is not expected for several years.
On December 14, 2006 a federal judge denied Novo Nordisk’s request for a preliminary injunction to halt sales of Pfizer’s Exubera inhaled insulin.

The patent infringement lawsuit was filed in the beginning of August 2006, shortly after Pfizer’s July announcement that it was delaying the Exubera product launch until September 2006.  The launch was delayed again when Pfizer announced on October 20, 2006 that it was putting off the launch until January 2007.
Pfizer’s legal answer to Novo’s claims alleged, in part, that its competitor wanted to delay sales of its insulin to diabetics because it was the first and only pharmaceutical company to receive FDA approval for inhaled insulin to treat Type 1 and Type 2 diabetics.

Alex Berenson, the New York Times business reporter who covers the pharmaceutical industry, has a new article on how Pfizer’s Exubera inhaled insulin sales are “lagging.”

The analysis discovered that many Wall Street analysts have downgraded their earnings estimates for Pfizer’s diabetes sales.

This blog hazards a guess that some of those analysts have read the research and posts here, discovering that quite a few doctors, insurers, and diabetics do not support Exubera use.

Berenson cites a February 2007 study by Citigroup’s drug industry analyst team which found that after surveying some 35 doctors, “more than half said they were concerned about Exubera’s safety. They were also concerned about its price and the bulkiness of the Exubera inhaler.”

Last July, this blog reported that Harvard Pilgrim’s Health Care’s pharmacy director was shocked that insurers would cover Exubera’s increased cost.

“I don’t get who the target market is — people with unlimited drug coverage who like gadgets?,” said Dr. Neil Minkoff, the insurer’s pharmacy director.

The two largest health insurance companies in the country, Wellpoint (which manages many Blue Cross / Blue Shield plans) and Minnesota-based UnitedHealthcare, list “Exubera in the third tier of their drug formularies. Co-pays at that level run $40 to $50 per prescription at United-Healthcare.”

Berenson also notes that sales of Type-2 diabetes drugs like Byetta and Januvia have grown rapidly compared to Pfizer’s Exubera sales