In early February Sanofi and MannKind announced the official launch of the ultra rapid-acting inhaled-insulin Afrezza. The insulin is now available at pharmacies nationwide.
Those interested in using Afrezza may have access to a “Patient Savings Card” which, depending on your insurance coverage, will allow the first prescription of Afrezza to cost $0, followed by no more than $30 for each additional refill (each refill supplies two inhalers and a month’s supply of cartridges). Unfortunately at this time details about coverage of Afrezza by individual insurance plans is not available.
Before receiving a prescription for Afrezza, patients will need to have a breathing test (spirometry) to evaluate lung health (Afrezza is not approved for people with chronic lung disease, including asthma and COPD and is not recommended in patients who smoke or who have recently stopped smoking).
For those who used Exubera (Pfizer) in the past, consider the differences between Afrezza and Exubera:
- The Afrezza device is very small and portable;
- The Afrezza device doesn’t require any additional cleaning or maintenance (users simply
dispose of the Afrezza device after 15 days of use and replace with a new one)
- Afrezza’s insulin dosing is much simpler as cartridges are labeled in injectable insulin
units, so no conversion factor is needed when health care providers prescribe it.
– This fact alone is a good place to address the available doses. For those with low insulin needs or who have become accustomed to using more precise doses of insulin (such as delivered by an insulin pump). The current doses for Afrezza are limited to 4 unit and 8 unit doses. Thus, for those using small amounts for meals it may not be optimal.
- Afrezza’s insulin appears to act faster (based on anecdotal data) – it peaks in about 15 minutes
and is designed to be out of the system in 3 hours.
- Afrezza is not available outside the US market at present.
We hope to see that it’s “ease of use” means it’s more likely that people will take insulin when they need it most! Afrezza could be a great option for people with type 2 diabetes that are not reaching BG goals with their current medications, as well as for those who dislike injections or have needle phobia. It will be beneficial for those struggling to manage mealtime blood sugars, and those who experience lots of high BG values after meals. Although dosing options aren’t optimal for those with precise dosing plans right now, it will be interesting to see how type 1’s figure out ways to use it to their benefit. Since it appears to work faster than injected or pumped insulin it may be helpful to use it when eating particularly high carb meals or possibly to speed up correction of a very high blood sugar.
As with any new medication, it is important to discuss it with your health care team and assess if it is something that could fit your needs for balancing diabetes in your life.