Exubera's Problem: It's Still Just Insulin

"We still need to figure out how to market this drug," admitted a senior executive at Pfizer Inc. at a recent conference. Indeed. Even its maker isn’t denying that the launch of inhaled insulin Exubera has been a flop. The drug, once hailed as the blockbuster that could change millions of patients’ lives by eliminating painful injections, made only an estimated $6 million in the first quarter of 2007 in the US, with European sales likely lower still.

It’s a far cry from analysts’ predictions last year of "rapid uptake due to pent-up demand"; most have sharply revised forecasts of $1.4 billion sales by 2009. Yet Exubera’s shaky...