Afrezza, an ultra-rapid-acting inhaled insulin. Will it be a success?

Afrezza is an ultra-rapid-acting insulin: it is faster than Humalog and Novorapid. Afrezza is not injected but inhaled – you don’t need the needles. A cartridge with 4 units of Afrezza is equivalent to 3.1 units of Humalog. What else do we know about Afrezza?

Barriers to Afrezza’s success

Break-Up With Sanofi

Afrezza was previously marketed by Sanofi, a big pharmaceutical company known for its best-selling insulin Lantus. Sanofi decided to stop marketing Afrezza. The insulin is now marketed by Mannkind Corporation, the original manufacturer.

Inhaled insulins are unpopular

Afrezza is not the first inhaled insulin. The previous one, Exubera, was a market failure. After 11 years of development and 1 year of sales, Exubera was taken off the U.S. market – it was because of the lack of consumer demand. Medical professionals seem to prefer the traditional, injectable insulin.

Lack of reimbursement

Insurance companies already cover a portfolio of rapid-acting insulins – and Afrezza has a lower priority to get into this list.

You need a lung test before starting on Afrezza

To get an Afrezza prescription, you need to take a pulmonary function test – so your doctors need to understand where to send you, or to install their own machine. Sanofi executives cited this as another obstacle to Afrezza’s success. To overcome this barrier, Mannkind decided to sell third-party $400 handheld lung testers for doctor’s offices.

Safety concerns

The cough is the most popular reason why people quit Afrezza. When using Afrezza, you lose lung capacity faster than without in.
A 2016 study with 4,271 patients has demonstrated a slightly greater decline in lung function when using Afrezza during the first three months (approximately 30 to 40 mL difference in FEV1). After three months, the change in lung capacity was similar in both groups for up to 24 months.

Future of Afrezza

Afrezza is faster than rapid-acting insulins. Data from the studies show that onset of action for Afrezza is 16-21 minutes (compared to 45-52 minutes for Humalog and other rapid-acting insulins), and duration of action is shorter by 2-3 hours.

Mannkind is determined to make Afrezza a market success. Pfizer abandoned Exubera after one year of disappointing sales. Mannkind wants to persist, and an idea for the future is to create a Bluetooth-connected inhaler to track variables such as insulin dosing, lung capacity, types of cartridges.

Will Mannkind be successful? Time will tell.

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