Friday, October 19, 2007

Exubera: A Titanic Failure! What the survivors are saying.

The Wall Street Journal today characterized the failure of Exubera as "one of the drug industry's costliest failures ever." Mike Krensavage, an analyst at Raymond James & Associates, was quoted in the same article as saying "This is one of the most stunning failures in the history of the pharmaceutical industry." (See "Insulin Flop Costs Pfizer $2.8 Billion"; subscription required.)

We haven't heard such comments since the sinking of the Titanic! So, the following image borrowed from PharmaGossip (see "Pfizer - Exubera: without a trace") is spot on as the Brits would say.

Image source: PharmaGossip
[If you'd like to see more blog images depicting the failure of Exubera, see my post over at Pharma Blogosphere ("'Round the Sphere: Best Exubera Failure Headline/Graphic. And the Winner is...").]
There are plenty of other similarities between Exubera's failure and the failure of the "unsinkable" Titanic. I am specifically talking about Pfizer's hubris and marketing's poisoned Kool Aid. Like the builders of the Titanic, the Exubera marketers felt they had an "unsinkable" product that would quickly reach blockbuster status and make the company a bundle.

According the WSJ, at a meeting with analysts in 2006, Karen Katen, president for human health and one of current Pfizer CEO Kindler's rivals for the top job, told investors that their "average forecast for Exubera sales in 2010 -- $1.15 billion -- was too low; Pfizer put it closer to $2 billion." Compare that to a Credit Suisse estimate of $8.7 billion in world-wide sales for all insulin in 2006.

Maybe the Pfizer board knew something was up last year when it ditched Ms. Katen and chose Kindler as CEO? Perhaps some of them even profited from the inflated Exubera sales estimates before side-lining Katen?

A Litany of Problems

WSJ: "Although the drug was approved in January, it wasn't introduced fully until September because of manufacturing problems. Once on the market, diabetes specialists said it was hard to use. Patients need to insert packets of powder into the device measured in three or nine milligrams -- not the units doctors are used to. The company had problems getting insurance companies to cover the treatment at a favorable rate, and a British medical committee said Britain's health authorities shouldn't pay for it at all because it didn't offer advantages over less-expensive therapies. Exubera costs about $5 a day while injectible insulin costs about $2 to $3 a day."

Pfizer marketers must have drunk their Kool Aid: "Still," says WSJ, "Pfizer promoted the drug until the bitter end."

What Are the Survivors Saying?
Pfizer employees have so far survived "one of the most stunning failures in the history of the pharmaceutical industry." Here are some choice comments from posters over at the Pfizer Company board on CafePharma:

Wrong Drug, Wrong Time , Wrong Delivery System!
"This is the worst thing I have seen in 15 years - OUR NEW OFFICIAL POSITION IS SURRENDER - Jeff Kindler - you are the Jimmy Carter of corporate America - no better way to convey confidence than to give up - This drug had no chance from day 1 - the launch was an absolute joke - a standard by which all other companies should not launch drugs - partial targeting, limited supplies, selective call cycles. Then we tell the inept APN division that they are losing the drug months before they actually do - so what do they do?? Big shocker --- they put it away for months - never talk about it, blow off contractual obligations to major targets who went to speaker training and were expecting to do talks -- and then.... my favorite - we hot potatoe the drug to the division that is carrying our flagship 10billion dollar product on the eve of managed care annihilation - and fly thousands of reps to Arrowwood to be fed and lodged for days so they could watch a video conference that could have been done in a webcast at the cost of millions of dollars - we then get 6 months to raise this drug from the dead. And just when we getting some momentum -- pull the plug - I am embarrassed beyond words - never thought I would live to see the day that the House That Steere Built would run from a challenge that was only a challenge because of the mistakes that we made. Lilly or Tekada would have made this a billion dollar drug - we don't remember how to do that anymore"

A RESPONSE: "You are dead wrong here..neither Lilly or Takeda or anyone else could have made this piece of shit a $100m drug...wrong drug, wrong time , wrong delivery system..S/A knew it, do did the developer but hunted for idiots and found one! That drug was doomed but we were grasping for a winner, any winner to replace the lost drugs!" (Access Thread Here)

Pfizer Hubris
"You gotta be kidding, surely Pfizer knows this product is has absolutley (sic) no chance of success. Do they think that if they wish hard enough that it will turn into a blockbuster?"

A RESPONSE: "If you worked for Pfizer you'd know that Pfizer believes that by shear force of will they can do anything.

With enough will power you can make Exubera profitable.

With enough will power you can make employees happy.

With enough will power you can make black hole sites profitable.

With enough will power you can make a drug pipe line using only sycophants, politcians (sic) and diplomats as your researchers.
(Access Thread Here)

Life After Death?
"On a different note, doesn't anyone realize that Exubera is a whole lot more than a drug? Its a new technology that will open the floodgates on development of other Pfizer medications that are currently only administered by injection. I believe the success of the process is worth more to the company than the product ever was going to be. I truly believe that the success of Exubera has already been attained in some eyes. Approved commercial use of a system that can take a liquid and safely convert it to be administered in an inhalable form. I once read somewhere that Terre Haute was being labeled by Pfizer as its Inhale production facility for the world. I think Exubera is just a piece in the proverbial puzzle for Terre Haute. The facility already has the square footage available to contain multiple product lines."
(Access Thread Here)

P.S. Have you taken our "Kevlar Kindler" poll yet?

Will Kindler Survive the Exubera Bomb?


  1. Pretty obvious WHY it flopped, but the question is, what will competitors learn in terms of engaging with the patient community FIRST?


  2. Anonymous3:48 PM

    It's a little unfair to blame Pfizer marketers for having "drunk their Kool Aid: 'Still,' says WSJ, 'Pfizer promoted the drug until the bitter end.' What would you expect them to do, not promote it. Essentially, Pfizer marketers put in an atraordinary effort that gave the product every possible chance. Sometimes, even the best markers end up with New Coke.

  3. It's interesting that the Wall Street Journal just published an article that suggests Kindler was too quick to kill Exubera! or rather he bucked an industry trend. See "Pfizer the headless Chicken."

  4. Anonymous8:21 PM

    Pfizer’s sales force was less than effective because they did not provide any information on Exubera to doctors, until doctors requested information on Exubera. I know this because it took my Endocrinologist several weeks and multiple phone calls for Pfizer to receive training and documentation on the product. Exubera is still not listed in the Physicians Desk Reference, which is the bible for Physicians. I can tell you this type of marketing and sales is not effective, as will Pfizer, but they will not admit any fault of their own. Additionally, Pfizer expected to generate over a billion dollars with a new, progressive drug, after only one year? Have they ever heard of a new product life cycle? Apparently not.

    While there is some negative press surrounding Exubera, it is from people who know little to nothing about the product. Dosing does require thinking, so someone who doesn’t think should not use Exubera or any other medication. Many Doctors are not progressive and don’t want to change what medications they are prescribing. A different approach must be taken with non-progressive doctors. Unfortunately, some doctors would rather show a patient the negatives versus the positives of a new, progressive product. For me, and millions of insulin dependent diabetics, Exubera is the best solution we have.

    I know Pfizer will say I have other options, but do I really? I can't have an islet cell transplant due to anti-rejection drugs; I can't take a pill because I am insulin-dependent. My only option is to go back on 4 injections a day: to have bruised, sore arms and legs again and to have to get up and run to the bathroom to give an injection before breakfast, lunch, and dinner or to get gawked at if I give an injection at the table in a restaurant. Exubera is my CURE. I don't have the luxury of not taking insulin. I need it to survive. This may be the closest thing to a cure that many Type I diabetics will ever see.

    Pfizer says on their web site, "That's why we at Pfizer are committed to being a global leader in health care and to helping change millions of lives for the better through providing access to safe, effective and affordable medicines and related health care services to the people who need them" ( Instead of Pfizer improving my life they are taking away the ONLY non-invasive treatment option for me and the 3 million Type I diabetics in the US.

    I would love to sit down with the person who made the decision to take it off the market and give him or her 4 injections a day for a week, let alone 20 years, and see if he would change his mind.

    email your Exubera stories to me"


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