The Scottish Medicines Consortium has followed the lead of its equivalent south of the border and decided not to back the use of Pfizer’s inhaled insulin product Exubera on Scotland’s National Health Service.

Pfizer launched Exubera across the UK last month, even though the National Institute of health and Clinical Excellence, which decides on the cost-effectiveness of new treatments in England and Wales, said it should only be used in diabetes patients with needle phobia or persistent infections from repeated injections.

The SMC said it could not back use of Exubera because Pfizer had not supplied sufficient economic data to enable it to decide on the cost-effectiveness of the product when used as an alternative to injectable insulin.

Last month, Germany’s Institute for Quality and Efficiency in Health Care (IQWIG), which looks at the clinical role of new treatments but does not make judgements on cost-effectiveness, dealt another blow to Exubera’s prospects in Europe after it concluded that there is no evidence to show that it has any advantages over short-acting human insulin or insulin analogues administered subcutaneously.

With the UK and Germany seemingly reluctant to endorse the new product, market research indicating that inhaled insulin will drive the growth of the European insulin market from $2.8 billion last year to $4.6 billion in 2012 may need to be re-considered.

The IQWIG said there was also no evidence that Exubera would improve the quality of life or treatment satisfaction of diabetes patients in Germany, and in fact could have a disadvantage compared to subcutaneous injections of insulin in the rate of severe hypoglycaemia. Exubera was launched in Germany earlier this year.