The promise of needle-free insulin dosing was supposed to give diabetics a new sense of freedom. No more painful injections. No more refrigeration for specialty insulins. No more hassle...
Out comes the Exubera inhaler. This bulky "advance" in insulin delivery fell flat. I had one patient try it and he never got a refill. He chose to go back to the handy dandy needle. Apparently the bulky inhaler was the fatal flaw. He didn't like having to haul the device to use right before eating, especially in public. It made him feel like people were staring at him like he had a plague.
The stigma from a big inhaler was apparently greater than giving yourself an injection.
Beyond bulk is cost. The large box of blister packs is expensive. Many times the copay would be double that of insulin, if it was covered at all. Perhaps this device needs to be redesigned. I am not sure if the design was based on the "No CFC's in inhalers by the end of 2010" or not.
It was so bad that ALL of our Exubera stock has expired. As I send it back for salvage credit my only thought is "Wow, what a disappointment."