Sanofi this week launched “Surprise, it’s insulin,” the first direct-to-consumer campaign for its inhaled insulin product, Afrezza, as the drugmaker seeks to boost sales after the disappointing launch of the new therapy.

The ads, now appearing on, feature three people casually using the inhaled insulin in public spaces, like a table at a restaurant or before eating a sandwich on a hike in the woods. A print ad in the Aug. 3 issue of Time magazine mimics the online video spots.

Afrezza is a mealtime insulin and it’s also the only inhaled insulin on the market. MannKind’s bet in developing and marketing Afrezza is that some diabetes patients would prefer to use an inhaled insulin rather than using needles and pens every day.  

Other digital components of the campaign, which was developed by Havas Health, are also being rolled out. A Sanofi spokeswoman declined to provide additional information about the campaign, including spend.

Sanofi is the marketing partner for Afrezza, which was developed by biopharma firm MannKind. Sanofi said Thursday that the insulin generated about $2.2 million in sales in the second quarter, bringing total sales since the launch in February to $3.3 million. Analysts had predicted that the therapy would be a blockbuster but have since cut sales forecasts for Afrezza.

“MannKind investors need to consider the possibility that the company may never even come close to profitability even with an FDA-approved drug for diabetes,” Maxim Jacobs, analyst at Edison Investment Research, said in a note on Thursday.   

The companies have grappled with specific challenges to marketing an inhaled insulin product: It’s the only one available in the US since Pfizer pulled its marketing support in 2007 for Exubera over weak sales; the FDA label requires that patients taking Afrezza undergo regular lung tests; and insurance reimbursement for MannKind’s therapy is limited and usually requires higher co-pays for patients than other types of insulin. (Exubera in 2008 had its label updated with a warning about a lung-cancer risk, which prompted Nektar Therapeutics to stop its inhaled insulin program.)

Still, MannKind’s CFO Matthew Pfeffer has said that the number of prescriptions will increase once the DTC campaign launched.

During a presentation at the Jefferies Global Healthcare Conference in New York City in June, Pfeffer said that the Afrezza marketing effort includes sending 54,000 sample packs to physicians, establishing a doctor-education seminar series and incorporating the treatment into Sanofi’s Coach, a free diabetes-management program. 


The product’s patient-assistance program provides one free copay on the first prescription, with additional refills costing no more than $30. 

This story has been updated.