Nada, I am currently a BOTOX therapeutic Medical Consultant in Manhattan and worked for Lilly a couple of years ago. I use to sell Byetta and Humalog to both endocrinologist and primary care physicians. The reason why Bydureon and Byetta will never be a big hit is because of patient compliance and formulary restrictions. Patients do not like to inject themselves every time they have a meal and will take oral meds as long as possible. when these medications fail and their pancreas is no longer working properly they need to go directly to insulin. Once these patients have to be on a mealtime insulin any respectable physician will put them on a Basal/Bolus regiment. For those patients whos pancreas are still able to produce some insulin most Doctors aren't going to bother putting them on an incretin mimetic which only lowers A1C levels up to 1.2 percent. Its hard enough for them to convince any patient to take an injection so if they’re successful why would they bother putting them on an inferior medication when they can help their patients achieve better glucose control with insulin. These medications are also a tier 3 product, cost more than $300, and ALWAYS need a prior authorization to be approved. primary Care Physicians do not have the time or office staff that will go through all these hurtles. The only people that somewhat prescribe GLP1's are endo's who have office staff that are willing to do Prior Auths and have educated patients with great insurance coverage. Comparing these products to Afrezza doesn't even make sense. The only reason why patients take orals until complete failure is because they do not want to inject themselves period. Afrezza is discreet, easy to use and should and will probably only have to directly compete with oral medications not an injectable. Most Doctors take the path of least resistance and when you take the fear that patients have of not only having to inject themselves 1-6 times a day and adjusting to their new lifestyles not only will they be more compliant but Physicians will go directly to insulin (Afrezza) every time as long as it works as well as we all hope it will. I also don't understand were you got the idea that pharma sales specialists don't have any training? We get better training on Diabetes. The truth is that primary care physicians have so many disease states which they have to deal with that 80 percent of them have no idea how the hell to treat their patients with diabetes and rely heavily on these “big pharma” sales forces and their endocrinologist speakers to for most of their training. Another thing to remember is that these companies also have Hospital and specialty Reps which are very educated and know just as much as a lot of these doctors. Big Pharma companies are very strategic and always focus and spend a lot of money paying Key Opinion Leaders (KOL’s) to help train and educate other HCP’s. Once the hospitals and the big name Doctors are on board everyone else will follow. And for your statement "When did we start to see mass marketing of prescription drugs directly to consumers? I can't remember, but it doesn't seem that it was as prevelant 10-15 years ago as it was today" When did they ever stop?? Do you have cable, read newspapers or any medical journals? I think I have probably seen at leat 5 drug commercials in the last couple of hours including one for Novolog and Cialis. It's still all about advertising whether it be on TV or through a knowledgeable sales force and that's why we desperately need a Big Pharma partner. And By the way, Access is not an issue. Doctors are always interested in learning about new products specially when it comes to complicated disease states such as Diabetes and medications that save people lives. Clos