This document discusses dry powder inhalers (DPIs) and their potential uses beyond treating asthma and COPD. Currently, most DPIs are used to treat these conditions. However, DPIs may enable new applications such as delivering vaccines without needles. Key challenges for new uses include ensuring accurate and repeatable dosing. Exciting potential developments include inhaled insulin, migraine treatments, and tuberculosis vaccines delivered via DPIs. The future of DPIs could involve devices that are simple, low-cost, accurate, efficient, and safe while providing desirable and intuitive delivery of high-payload medications.

2. Beyond Asthma and COPD
Challenges and Opportunities
Dry Powder Inhalers
Management Forum - 19 & 20 June 2012
David Harris, John Burke
Presentation_ManagementForum-DPIs_v1-0.ppt

3. Ben has
severely injured
his hand

4. Catch twenty-two?
The vast majority of dry
powder inhalers are used
to treat asthmatic and
COPD patients...
They’re powered by the
Confidential © Team Consulting 2012
impaired organ!

5. What’s this?

6. Pain relief
How many tonnes of OTC analgesics
185,000 tonnes!
1, 2, 3, 4
are produced globally per year?
If all analgesic tablets were placed
end-to-end, how many times would
they pass around the Earth?
140 times!
How many analgesic tablets are
taken globally every second? >14,800!
1. Richard L Myers; The 100 Most Important Chemical Compounds, ISBN-13: 978-0-313-33758-1, p151
2. http://www.in-pharmatechnologist.com/Ingredients/Univar-steps-into-paracetamol-breach
3. Warner TD, Mitchell JA (2002); Cyclooxygenase-3 (COX-3): filling in the gaps toward a COX continuum?
Proc Natl Acad Sci USA 99 (21): 13371–3
Confidential © Team Consulting 2012 4. http://www.rsc.org/chemistryworld/Issues/2009/February/BusinessRoundup.asp

7. What’s the cost?
468,000,000,000 analgesic tablets are taken every year.
If it takes around 30 minutes for the tablets to kick-in.
Working at 75% productivity during this time
amounts to: 29,302,884,615 hours! Which
equates to 16,987,179 years!
The average cost of time per hour is around $10.5
The total cost per year is a staggering: $293,028,846,154
Confidential © Team Consulting 2012 5. http://www.bbc.co.uk/news/magazine-17512040

8. What are the challenges?
Current analgesics are large doses
 need more potent drugs
Tablet blister packs are simple,
effective and inexpensive
 need simple devices!
Delivering drugs with much
narrower therapeutic indices
 accurate and repeatable delivered dose
Confidential © Team Consulting 2012

9. Imagine...
Vaccination
without needles

10. no
no cold
pain chain
Can DPIs
shorter
no
needle
stick
deliver queues
vaccinations less
fear
stable
successfully? faster
formulation
delivery

11. What are the challenges?
• Delivery of dose needs to be as
accurate as a needle and syringe Excellent Perfectly
• Usability DCU intuitive
 many users will never have seen an
inhaler before!
• Majority of vaccinations given to
infants or children Works for
Very low
• Very low cost children
cost
 on par with a needle and syringe & adults
Confidential © Team Consulting 2012

12. 50 years on
from the
first DPI...
what next?

13. Some exciting developments
• Inhaled insulin – Mannkind Corporation 6
• Nasal migraine relief – Sumatriptan
• Breakthrough cancer pain – inhaled Fentanyl, Akela Pharma
7
• Inhaled tuberculosis vaccine 8
6. http://www.mannkindcorp.com/product-pipeline-diabetes-afrezza.htm
7. http://www.akelapharma.com/products.html
Confidential © Team Consulting 2012 8. http://www.pnas.org/content/105/12/4656.full.pdf

14. The future for DPIs?
simple low cost
low
accurate
wastage
high safe
payload
intuitive desirable
efficient
Confidential © Team Consulting 2012

15. DPIs offer significant
advantages...
Their future is up to us!
Confidential © Team Consulting 2012