Writing good Wiki entries for Afrezza and inhaled insulin would probably be the single biggest contribution advocates could make.
Quick update:
I am working with another editor who pushed back on some edits. So far, only one edit to the inhaled insulin wiki remains (that afrezza is now approved).
Wikipedia editing has become more difficult, many many rules.... Next edit I would like to make is that Afrezza IS cost effective in some cases. Current text says "The additional cost is so much more that it is unlikely to be cost-effective." (2007 article)
Here is one article that is "in press" --- Does anyone have access?
www.sciencedirect.com/science/article/pii/S0168365915300389Journal of Controlled Release
Available online 26 July 2015
In Press, Accepted Manuscript — Note to users
Cover image
Future prospect of insulin inhalation for diabetic patients: The case of Afrezza versus Exubera
Moawia M. Al-Tabakha
Abstract
The current review was designed to compare between the insulin inhalation systems Exubera and Afrezza and to investigate the reasons why Exubera was unsuccessful, when Afrezza maker is expecting their product to be felicitous. In January 2006, Pfizer secured FDA and EC approval for the first of its kind, regular insulin through Exubera inhaler device for the management of type 1 and 2 diabetes mellitus (DM) in adults. The product was no longer available to the market after less than two years from its approval triggering a setback for competitive new inhalable insulins that were already in various clinical development phases. In contrary, Mannkind Corporation started developing its ultra-rapid-acting insulin Afrezza in a bold bid, probably by managing the issues in which Exubera were not successful. Afrezza has been marketed since February, 2015 by Sanofi after getting FDA approval in June 2014. The results from this systematic review indicate the effectiveness of insulin inhalation products, particularly for patients initiating insulin therapy. Pharmaceutical companies should capitalize on the information available from insulin inhalation to produce competitive products that are able to match the bioavailability of subcutaneous (SC) insulin injection and to deal with the single insulin unit increments and basal insulin requirements in some diabetic patients or extending the horizon to inhalable drug products with completely different drug entities for other indications.
Here is another:
The Benefits, Limitations, and Cost-Effectiveness of Advanced Technologies in the Management of Patients With Diabetes Mellitus
Robert A. Vigersky, MD1
1Walter Reed National Military Medical Center, Bethesda, MD, USA
Robert A. Vigersky, MD, Endocrinology and Diabetes Service, Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA. Email: Robert.a.vigersky.mil@mail.mil
Abstract
Hypoglycemia mitigation is critical for appropriately managing patients with diabetes. Advanced technologies are becoming more prevalent in diabetes management, but their benefits have been primarily judged on the basis of hemoglobin A1c. A critical appraisal of the effectiveness and limitations of advanced technologies in reducing both A1c and hypoglycemia rates has not been previously performed. The cost of hypoglycemia was estimated using literature rates of hypoglycemia events resulting in hospitalizations. A literature search was conducted on the effect on A1c and hypoglycemia of advanced technologies. The cost-effectiveness of continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitors (RT-CGM) was reviewed. Severe hypoglycemia in insulin-using patients with diabetes costs $4.9-$12.7 billion. CSII reduces A1c in some but not all studies. CSII improves hypoglycemia in patients with high baseline rates. Bolus calculators improve A1c and improve the fear of hypoglycemia but not hypoglycemia rates. RT-CGM alone and when combined with CSII improve A1c with a neutral effect on hypoglycemia rates. Low-glucose threshold suspend systems reduce hypoglycemia with a neutral effect on A1c, and low-glucose predictive suspend systems reduce hypoglycemia with a small increase in plasma glucose levels. In short-term studies, artificial pancreas systems reduce both hypoglycemia rates and plasma glucose levels. CSII and RT-CGM are cost-effective technologies, but their wide adoption is limited by cost, psychosocial, and educational factors. Most currently available technologies improve A1c with a neutral or improved rate of hypoglycemia. Advanced technologies appear to be cost-effective in diabetes management, especially when including the underlying cost of hypoglycemia.
Another: anyone have access?
Published online before print January 2, 2015, doi: 10.1177/1932296814565661
J Diabetes Sci Technol March 2015 vol. 9 no. 2 320-330
The Benefits, Limitations, and Cost-Effectiveness of Advanced Technologies in the Management of Patients With Diabetes Mellitus
Robert A. Vigersky, MD1
1Walter Reed National Military Medical Center, Bethesda, MD, USA
Robert A. Vigersky, MD, Endocrinology and Diabetes Service, Department of Medicine, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA. Email: Robert.a.vigersky.mil@mail.mil
Abstract
Hypoglycemia mitigation is critical for appropriately managing patients with diabetes. Advanced technologies are becoming more prevalent in diabetes management, but their benefits have been primarily judged on the basis of hemoglobin A1c. A critical appraisal of the effectiveness and limitations of advanced technologies in reducing both A1c and hypoglycemia rates has not been previously performed. The cost of hypoglycemia was estimated using literature rates of hypoglycemia events resulting in hospitalizations. A literature search was conducted on the effect on A1c and hypoglycemia of advanced technologies. The cost-effectiveness of continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitors (RT-CGM) was reviewed. Severe hypoglycemia in insulin-using patients with diabetes costs $4.9-$12.7 billion. CSII reduces A1c in some but not all studies. CSII improves hypoglycemia in patients with high baseline rates. Bolus calculators improve A1c and improve the fear of hypoglycemia but not hypoglycemia rates. RT-CGM alone and when combined with CSII improve A1c with a neutral effect on hypoglycemia rates. Low-glucose threshold suspend systems reduce hypoglycemia with a neutral effect on A1c, and low-glucose predictive suspend systems reduce hypoglycemia with a small increase in plasma glucose levels. In short-term studies, artificial pancreas systems reduce both hypoglycemia rates and plasma glucose levels. CSII and RT-CGM are cost-effective technologies, but their wide adoption is limited by cost, psychosocial, and educational factors. Most currently available technologies improve A1c with a neutral or improved rate of hypoglycemia. Advanced technologies appear to be cost-effective in diabetes management, especially when including the underlying cost of hypoglycemia.