Seven months after Pfizer (New York) pulled “Exubera” from the market, the star-crossed product’s saga continues. Pfizer apparently plans to close its Terre Haute, Indiana, manufacturing facility, which had gotten a cash infusion to prepare it to produce—you guessed it—Exubera. The company insists that the plant closure is unrelated to Exubera’s failure, but I find that hard to believe.

Is this plant closure the final nail in the coffin of inhaled insulin?

I doubt it. Replacing injections with inhalers is too good an idea for the pharmaceutical industry to pass up. Inhalers are a much less intimidating, and much more convenient, way to take drugs—especially for chronic conditions.

Nektar (San Carlos, CA) stopped looking for partners for its inhaled insulin because clinical-trial patients showed an increased incidence of lung cancer. But I don’t think that Exubera’s technical and medical problems are insurmountable. Nektar had already developed an inhaler that was smaller and less cumbersome than the original Exubera inhaler.

Surely it’s possible to achieve a safe formulation of insulin for respiratory delivery. MannKind’s (Valencia, CA) “Technosphere” inhaled insulin has not been associated with any adverse events. Their technology seems to show that convenient and safe inhaled insulin is feasible.

But even MannKind stopped its search for a partner for Technosphere Insulin. The company judged that its product wouldn’t be accepted, given the market’s fear and skepticism resulting from Exubera’s highly publicized troubles.

I think it’s simply a matter of time before inhaled insulin is widely available and accepted. It’s within our grasp, and the advantages for patients and the pharmaceutical industry are significant. It might take more trial and error. It might take time for our nerves to be settled and our doubts to be assuaged. But I think this idea’s time is coming soon.