The unimpressive start has prompted some to ask if Afrezza could be destined for the same fate as Pfizer's Exubera, which was pulled a year after launch at a cost of $2.8bn (€2.5bn) after failing to win over patients and physicians.
The Street, for example, noted that after 21 weeks on the market, Afrezza has been prescribed less often than Exubera over a comparable period before it was withdrawn.
While Sanofi spokesman Philip McNamara would not comment on the comparison, he told us Afrezza had generated revenue of around $1m between February and April.
Watch this space…
But this is all set to change, according to Matthew Pfeffer, the CFO of MannKind which developed the product and will receive 35% of the profits.
“We believe in the product and, based on the results people are seeing, remain convinced in its ultimate success,” he told in-Pharmatechnologist.com. “If the sales are lower than they should be, it cannot be blamed on the product, but only on our sales methods, which just means we need to change them.”
Sanofi has recently changed its approach and is about to commence a broader marketing effort which will include direct-to-consumer (DTC) advertising, Pfeffer explained.
“It is clear that Afrezza is not widely known, but given the patient appeal, we believe DTC advertising will have an important effect on awareness and consequently on demand,” he said. “So we are obviously hoping for a major inflection in sales in coming weeks.”
What Pfeffer made clear, however, is that Sanofi and MannKind will not allow Afrezza to go the same way as Exubera.
“The market is very different than it was when Exubera was introduced and there are a lot more barriers in place - particularly from insurers - to brand new drugs. At the time of the Exubera launch, new drugs were typically put in a tier 3 reimbursement category without restriction. Nowadays, most new drugs on the market require prior authorization, which slows down the process markedly.”
And while he conceded the firms had seen some resistance from physicians towards Afrezza, he said this was “not more than any new drug” and that such a “paradigm shift will always cause doctors to move slowly at first and proceed with caution.”
Afrezza, he stressed, is superior to Pfizer’s product which suffered from an unwieldy delivery device and questionable effects on the lungs, and added that the key to its success is education.
“Exubera definitely muddied the waters quite a bit, but this is a fundamentally different product. Once people become better aware of that, I think things will change, but we are already seeing signs of this.”