If at first you don't succeed - go straight to the patient's home. After a lackluster attempt to sell doctor's on prescribing Phizer's inhalable insulin, Exubera, the company has decided to begin running television and print campaigns to advertise directly to patients.

The ads will start appearing the second half of 2007. However the main contention from Congress and medical groups is that mass marketing to patients encourages excessive use of costly therapies. Exubera gained a reputation for being an over priced and not-so-discreet way to administer insulin. Doctors say the inhaler is unwieldy. Depending on a patient's health care plan, they can pay about $600 a year more for Exubera than injectable forms of insulin. Clinical trials have found the product can reduce lung function for some patients. Pfizer says the condition is reversible and is conducting a five-year study among users to monitor it.

Why the push, Pfizer? You seem hell-bent on making this one stick. The president of Pfizer's worldwide pharmaceutical operations says the television ads will target newly diagnosed diabetics who may not want to inject themselves daily. Patients who develop diabetes later in life may put off using insulin because of needle phobia. Fair tradeoff: I see your fear of needles and raise you $600 a year, a license to toke (in public), and maybe a little bruising on your alveoli. Puff, puff...give it a shot.

Get a load of this GREAT news quote: "We had Korn, then Harry Potter, now Laurie Jordan." Er, who the heck is Laurie Jordan?! She is, or should I say was, a teaching aide in Michigan, apparently. And the quote comes courtesy of the parent of a kid who attends Roosevelt Elementary School in Michigan. The bosses of the school, the Zeeland school district, have a reputation for toughness. First they banned Korn t-shirts. Then they banned Harry Potter readings in the classroom. And now? An employee, Laurie Jordan, was fired because she refused to learn to give insulin shots.

Jordan's excuse: a fear of needles. School administrators decided all school employees should acquire the know-how to give emergency care to diabetic students, which of course includes learning how to administer insulin shots. Jordan said no, thanks. On Monday, a big crowd turned up to a public meeting in support of Jordan. The general consensus seems to be that firing her was a tad on the excessive side. Present at the meeting were school board members, school employees and community members. "A show of support like that is overwhelming," said Jordan after the meeting.

Needle phobia is fairly common. This woman is not a nurse, she has no medical training, and she does not want to undergo this kind of training. Parents want their kids to be protected. Giving an insulin shot is a pretty straightforward procedure. On the other hand, should employers be allowed to force employees to take on this responsibility? It's tricky.

To read more, check out this article in the Grand Rapids Press.

Exubera, Exubera. What will become of you? That is the big question. Pfizer's eagerly awaited inhalable insulin device is nearing the market. For anyone following this saga, there is a must-read market analysis piece on Business Week's website. With the great title to boot: "From Pfizer, Irrational Exubera?"

The article looks at the big question everyone is asking about Exubera: will it be the blockbuster drug it's been hyped as? While Pfizer says it expects billions of dollars in sales (and the company is pouring millions into promoting the product), critics say it is an overhyped, overpriced product that could put some diabetics in danger of lung damage. Not to mention the device is the size of a county fair prize-winning squash! Who wants to suck on that in public?! Let alone tote it around. On the other hand, let's not forget it's big selling point: no needles. Yet critics maintain so-called needle phobia is not as widespread as Pfizer would have you believe.

If you check out this article, also take a look at the readers' comments at the end. There seems to be a fairly even split in opinion on this thing.

The controversy continues in the UK over the introduction of the inhalable insulin product Exubera from Pfizer Inc. Well, really the source of the controversy is not the drug itself, but the fact that those who oversee treatments dished out by the nation's public health system (the National Institute for Health and Clinical Excellence) think Exubera is a big old waste of precious cash. The public health service people (although not all of them, by any means) say why waste money on a new-fangled insulin delivery method when the old-fashioned insulin shots are perfectly effective if they are used correctly. And anyway, they say, why should our taxpayers help line the pockets of Pfizer, which plans to charge a pretty penny for Exubera? Finally, they argue that there is no evidence to back up Pfizer's claim that Exubera will be more effective than using shots simply because it will be easier to use and pain-free.

The latest development is that the National Institute for Health and Clinical Excellence has backed off a little and has said the system will pay for Exubera to be given to diabetes patients who have a proven phobia of needles. While I hate to see the pharmaceuticals industry make mega-bucks, I don't see why you should have to have a proven phobia to get this drug. I actually suspect Pfizer may be correct in its claims that access to inhalable insulin will increase treatment compliance amongst diabetics. Bottom line: tons of people out there hate using needles. No, they may not have a diagnosed phobia about it, but aren't they entitled to the least painful treatments out there?