Other than convenience, no inhaled insulin product has an efficacy qdvantage over injuected insulin and that is why insurers won't reimburse for it. Fai9lure to reimburse has nothing whatsoever to do whether the device is bong-like or fashionable. NVO and LLY clearly saw the handwriting on the wall and scrapped their own promising inhaled insulin stage 3 products within weeks of Pfizer taking Exubera off the market in October 2007.
Due to reimbursement problems here and abroad, there would be such a small effective market for Afrreeza even if approved that no big pharma would be even remotely interested in a partnmership. And MNKD simply doesn't have the ssales structure to go it on its own; they MUST have a partnership.
Unless the insurers completely reverse themselves which they are most-unlikely to do, MNKD is a doomed company.