Wednesday, April 09, 2008

Doctors (and Patients) were Smarter than Exubera Marketers

I can't help reading this story about Exubera reported in the WSJ Health Blog and thinking: "Thank God that physicians (and patients) don't fall for ALL the BS pharmaceutical marketers throw at them."
Pfizer said this morning that it’s adding a warning about lung cancer to the labeling for its inhaled insulin Exubera. The number of cases is low — six out of 4,740 patients treated with the drug, compared with one case out of 4,292 comparable patients who did not receive the drug. (see "Lung Cancer Warning May Be Last Gasp for Inhaled Insulin").
Of course, Pfizer says that "all patients who developed lung cancer had a prior history of cigarette smoking, and that there were too few cases to determine whether the development of lung cancer is related to the use of Exubera" (see Pfizer's statement).

But assuming the 4,292 "comparable" patients in the control group also have the same number of smokers, I'd be pretty scared right now if I were using Exubera and smoking. Probably scared enough to quit the study and stop using Exubera -- but not quite scared enough to quit smoking!

Exubera failed miserably not because physicians or patients thought it could cause lung cancer, but because it did not live up to the hype of marketers -- who only were able to get a few DTC commercials going on TV and stories written in the press about Exubera before it was pulled from the market by Pfizer. You can read more about the failure here: "Exubera: A Titanic Failure! What the survivors are saying."

But imagine a world where Exubera was still on the market and this bit of news comes out. Would Pfizer caution diabetic smokers to quit smoking -- using Chantix, of course -- before bonging away on Exubera? I think it could have happened! Which is why I say thank God that it was such a lame device that both doctors and patients were not impressed!

More conjecture: What did Pfizer know about this "side effect" of Exubera BEFORE it decided to pull it form the market? Any hint whatsoever that increased chance of lung cancer could be a side effect might have been the determining factor for pulling Exubera off the market. If true, I suppose Pfizer would have said so and gained some credibility. Who knows?


  1. Anonymous10:54 PM

    "Lame device"? Are you kidding me? Tell that to the 5-year-old who is taking 5 shots a day to control her blood sugar so she can live a long and healthy life. I have used the Exubera inhaler for years now on clinical trials. I have yet to meet any Type I diabetic who has had any complaints about this device. I fail to understand why the fact that 6 patients come down with lung cancer after using Exubera is a concern. HELLO!!! THEY WERE ALL SMOKERS!!! If you are a Type I Diabetic AND you are a smoker, lung cancer is the least of your worries anyway! Smoke away, Type I diabetics, your heart will never outlast your cancerous lungs. I just want to say a big "thank you" to the tobacco industry whose stupid lung-cancer-causing prouducts have now caused me and millions of Type I diabetics to lose the opportunity of inhaled insulin. I hope you all die a horrible and painful death at the hand of a lung carcinogen!

  2. Anonymous4:34 PM

    My wife, who had not smoked for at least 10 years prior to taking Exuberea, developed a severe cough that lingers today and is getting worse in the days since the test. She was told by the doctors that her cough was not relevant to Exubera as nobody else had adverse side effects and they dismissed her symptoms and complaints as a nuisance factor without exploring further.

    A subsequent cat scan revealed a nodule in her lungs and she is going tomorrow for a second scan because her cough is becoming unmanageable and unbearable.

    My point is: how many others were dismissed as nuisance factors to keep the ratio of cancer cases so low?

  3. Anonymous10:57 PM

    So she was a smoker at one time as well? So far the ratio is still 100% smokers who had this issue after using Exubera. I have yet to hear of anyone who never smoked having lung issues with Exubera. My point is: If you ever smoked and also used Exubera, why in the world would you choose to blame Exubera when the data for cigarettes causing cancer is so overwhelming? Seems like a real stretch to me. Wakeup, America! Cigarettes kill you and I don't want to pay for it.

  4. Anonymous4:26 PM

    John Mack, your an ASS. When making posts about a product, report the numbers correctly. I worked on the Exubera product with Pfizer in Terre Haute Indiana and the test numbers YOU STATE are wrong. There were two test groups, one were made of smokers and ones that had not smoked. The were a few cases of cancer findings in the smokers group and only one in the non smokers group!.
    With all the "cancer" problems today with all people, I'd take those low numbers any day!!!!!!
    The reason Pfizer pulled the drug is because the upper management mis-managed selling the product on the market and the Exubera section of Pfizer did not pay off the medical doctors to push this process. Other drugs and companies are pushed by doctors, but for some reason Pfizer refused to offer up the $$$ to doctors on this product. WHAT A WASTE OF A GREAT IDEA!!!!

    But next time, get your facts straight you arrogant ass!!!!!

  5. Anonymous4:59 PM

    and another thing, you arrogant ASS, you state: "Exubera failed miserably not because physicians or patients thought it could cause lung cancer, but because it did not live up to the hype of marketers " It was the mis-marketing of the Pfizer Upper Management that killed the product. Pfizer studies show that doctors did not want to spend the extra 5-10 minutes with a patient to show them how the product/device worked. (This proves in my mind a valid point because Doctors are on a time table to see patients because of our wonderful MVP healthcare insurance plans wanting doctors to see x number of patients every hour.) So in turn, most doctors never even wanted to bother with the product, much less tell their people about it. I am familiar with the product, it takes less than 3 minutes to use it.
    What I can't understand is a doctor would rather show a patient how to use a needle, rather then have them inhale on a device?? I changed family doctors in T.H. Indiana, because he said that he wound NEVER recomend the drug? I asked him why and he really didn't know anything about it in the first place. Our family doctors at work!!!!
    As far a calling the product a bong, (did you ever see the device??) what do you call the inhalers that people with asthma use???
    You are an idiot to post stuff that you don't look into. Try talking with a person that knew the product.

  6. Well, due to the fact the anon commenter who called you an arse worked on the product, it just sets the tone for patients and consumers to continue to be skeptical of the industry. With ppl like that person working on Exubera, we have nothing to look forward to except for more arrogant, defensive pharma shills promoting their products. But, not that I am accusing pharma reps or researchers of lacking ethics or being w/out scandal and always having perfect data *cough*.

  7. Dear anon,

    Looks like Stephany recognizes who's the genuine ass!

  8. Anonymous5:09 PM

    John Mack. Unless I don't read into Stephany's post correctly, which I may not, I don't believe she is calling me a rep or defending pharma skills. I indeed was just a plain worker there and we were exposed to considerable data and information that the general public was not.
    Now I have no problem with you calling me an ass. No PROBLEM at all. But I would like to ask you, where you got YOUR INFO from? And did you really ever see a picture or know what the so-called bong looked like. Did you know that Pfizer already had plans for a phase two dispenser that was no bigger than a woman's compact? I bet the farm that you had no freakin clue about it, nor did you yourself ever see or handle the original "bong".
    That being said, I bet you that you just picked up what someone else printed about the test group and cancer. (you might wanna check with Michael Douglass who just went public about his throat cancer. You probably think he used the Pfizer product too).
    I am just very upset that what I THOUGHT was a great product, especially for a alternative for childhood diabetic needles and pain, was canceled. My feeling is it's much more dangerous for young children inhaling second hand cigarette smoke than worrying about 1-2% chance on coming down with cancer from using the Exubera drug and not having to poke themselves with needles.
    Post your email address and I'll be able to contact you with more information. Otherwise, please don't make more medical posts on things that you are not correctly informed about or having hear-say. I will be happy to put you in contact with people that worked on the Exubera product and Doctors that would not offer information about the product even though they didn't know anything about it.
    Enough said.............

  9. Anonymous5:13 PM

    One last point that I forgot to make. Those of us out there that read this post. Do you think people believe more of what they read or are told by the press looking to make a story, or information that is handed down and reported to you by your employer? And that what they see going on in their workplace?
    Me, I believe more of what I actually see and come across at the jobplace, rather than what I see in the press.

  10. I can see that you have very strong feelings about this. You might have started off in a less confrontational manner. I of course have seen many photos of the device which many people called a bong before I did. What I saw were a lot of negative comments from some very influential diabetes patients who had personal experience with the product. Just because I never held one in my hands does nit mean I am not qualified to report to my readers what other people have said and try to put it in context of pharmaceutical marketing, which in this case just could not counteract negative perceptions by the users.

  11. Anonymous5:38 PM

    I am not so convinced about the so called "influential patients" . Who were they? They were several people that I worked with that were using the product. They all could not say enough about the product. Two things were that they NEVER had a product control their suger blood level as well and the ease of use of the product. For one thing, the insulin did not have to be refridgerated.
    On a post that did not for some reason make it here, I stated that I DONT BELIEVE every thing in the press that I read. Some people do.
    We also saw bad press about the product. When that press was tracked down, it was from a fellow medical company trying to trash the product because they were behind in that type of research. And you can't tell me that type of bad press does not happen in any industry.
    Do YOU IN FACT know anyone that was on the EXUBERA product, or a Doctor that was familiar with the workings of the drug and the device ?

  12. I'm watching the phillies right now and can't research this. Later.

  13. See Amy tenderich

  14. Anonymous1:32 PM

    John, something very wrong must be going on with this Blog. I have three times tried to Post a comment asking you to highlight or give a direct pointer to where Amy Tenderich mentions "anything" about the Pfizer Product, Exubera. Other than where she states that they could have saved money if they would have reached out to her group about comments. Or something to that effect. But my post (request) has never shown up. I entered the given password and my post was accepted, and it stated that it would be posted, pending approval for comment? So I have been looking for a couple days now with no results. ??? Whats up with this area????

  15. Anonymous,

    For Pete's sake! Just search Google for "exubera bong" and you will see Amy's post is #1. Duh!

    But since you are lazy and want me to do the work for you, here it is: Exubera “Bong” OK for Older Folks? -

    It's even in the title of her post, which she wrote in 2006.

    Is that good enough for you?

  16. Anonymous2:06 PM

    John, I can see your a very busy person from your posts. One that can't take enough time to fully research an item before posting a story like at the beginning of this blog. Then your too busy again to answer a post on your story because your watching a baseball game. Then your post again about Amy Tenderich. I spent considerable time looking her up and could not find anything. Now you state about her post she wrote back in 2006. Before I even try to find or read her post, I will am wondering what she could have put in this post back in 2006, even before the Exubera Product was announced or placed on the market?
    But rather than be considered "lazy" again, I won't post to this blog again. I can see what kind of research you've done on this product.

    By the way, if you are being paid to write blogs and stories on topics, where can I find employment like yours? Cause I don't see the work involved in placing blogs and information out on the internet, without doing some valid reseach on both sides of a story.

    I am done with this and this blog. I wish I would have never found it.

  17. Anonymous,

    Thanks for your comments. One more comment and you would win the distinction of submitting the most comments to a single blog post! I wish all my readers were as engaged -- but not as enraged -- as you are! Have a nice day. And don't let my blog door bump you on the ass on the way out!


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