But Francis is also cautious: "To test such a product on a mass level and get it to the point where it can be shown to convincingly work as well as a needle-delivered vaccine is a costly investment, and not one that for-profit drug companies have shown a lot of interest in." What is clear is the cost benefit. For example, the WHO says that current injectable inactive flu vaccines cost between $3 and $7 per dose.
No dry-powder inhalable flu vaccine is on the market, but if this $3-to-$7 price were to hold for inhalable powders, a cheaper inhaler could shave 5 to 10 percent from the cost of each dose, just from the delivery system alone. And a far larger additional savings would come from the reduced need for trained staff who would otherwise have to administer individual syringe injections.
While Cambridge Consultants says it can't name the pharmaceutical companies it is working with, there is clearly widespread industry work on dry-powder versions of many drugs and vaccines. For example, Pfizer is making inhalable insulin, and Alkermes and Lilly are working together to develop both inhaled insulin and an inhaled osteoporosis drug. At least five companies are developing inhalable flu vaccines, prompted by billions of dollars in government investment in preventing an avian-flu pandemic. Glaxo Smith Kline already has an inhalable flu treatment--Relenza--on the market. "This area is absolutely booming," Barney says.
Marie-Paule Kieny, director of the WHO's Initiative for Vaccine Research, says the WHO is hoping that a number of new technologies, including powders, nasal sprays, and patches, will be available over the next decade. "A simple and cheap device to permit the delivery of influenza vaccines by inhalation could potentially contribute significantly to mass immunization, particularly in the event of a pandemic," she says.
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