In recent years, much of the focus of novel treatments for respiratory diseases has been in the development of inhalers containing new, longer-acting compounds in established drug classes, either alone or in combination. However, there remain patients who are unable to use such devices properly, who rely upon nebulized therapy, yet there have been few new drugs marketed in nebulized form in the last 30 years. This undoubtedly has had a negative impact on disease control.
A novel approach to development is to focus first on bringing the nebulized formulation to market, and only to start development of the inhaler once the new drug candidate has successfully demonstrated safety and efficacy. Not only does this mitigate the risks associated with developing an inhaler formulation only for the drug to fail in the clinic, it also studies drug outcomes in the most severe group of patients, in whom a positive effect should be easiest to demonstrate. This can reduce the commercial barriers to the introduction of new nebulized drugs, thereby ensuring such patients have access to the latest innovations in drug development.
Parallel device developments will ensure this market continues to grow at a faster rate than that of the overall inhaler market. Innovations such as small volume, breath activated mesh nebulizers are likely to see the gap narrow between the treatment times for inhaler and nebulizer use, whilst the added benefits of an electronic-based technology will lead to adoption of patient monitoring approaches in inherently more at-risk patient populations.