|
Post by savzak on Jul 8, 2014 13:06:55 GMT -5
Well said Spiro! Er, I mean baba? Mnkdlong, you make several interesting points, but I'm going to have to disagree with point no. 6: "6. Afrezza has a chance to be successful- I think it will be, but the journey ahead will not be easy. We all know Afrezza cannot be compared to Exubera, but physicians minds are going to go to Exubera right away. Sales and marketing will have an uphill battle changing this perception." A "chance" to be successful - not phrased like someone long at this point in time (close to $4 billion market cap). A "great chance" maybe, but a chance? Not to say your words aren't technically correct, but again, guys with "long" in their handles don't usually write like that! And at $4 billion in market cap, no, get me out of this stock if all we have is a regular old, run of the mill "chance." Listen to the public presentations at the AdCom, as surely you have, then, perhaps listen again. Doctors will prescribe this treatment, cuz their patients will say "prescribe it or give me a really good reason why not." The docs are going to lose face if they compare it to Exubera for long, especially if the ADA remains a fan of "Afrezza." If nothing better comes along and if some new, profound and material side effect is not discovered, the "uphill battle" will be over relatively quickly. "Afrezza" will become the new standard of treatment for millions, until something better comes along or it is genuinely discredited. Not saying either can't happen, but a "chance." As to your other points, I have to defer to you and those fellow posters that know stuff about pharmas.
|
|
|
Post by spiro on Jul 8, 2014 13:19:28 GMT -5
Babaoriley is almost as good as Spiro at sniffing out a short, but Greeks usually have much bigger noses.
|
|
|
Post by mnkdlong on Jul 8, 2014 13:28:56 GMT -5
I am long on mnkd, have been since my 1.68 entry point (perfect timing that was nothing but luck), plus I want this drug to be successful for the patients I see daily with diabetes. That being said, I'm also a realist. I think a 6-8 billion dollar buyout is possible, but if this is going to be a partnership we will have some very real hurdles to overcome to reach that market cap.
The pharma world is very complex and again just because something is a good/great treatment doesn't mean it will be successful. The insulin market is a commodity market with massive pricing wars. The faster time action profile and ease of use will mean nothing if they can't compete in the current pricing wars. We also have to remember that we live in a current market that isn't using the needles of old, but rather 32 gauge needles that you hardly feel (if hurts far far worse to test your blood sugars). Is this slight reduction in pain worth the unknowns of putting a growth hormone through the lungs? This drug may seem like a no brainer to us, but I promise you physicians are not viewing it that way.
I believe in this drug and it's place in the market (obviously by my position), but its success is highly dependent on the ability of its partner or buyer to successfully market it and price it.
|
|
|
Post by esstan2001 on Jul 8, 2014 13:55:31 GMT -5
a few points people should consider based on what was written here-
Insulin may be commoditized as you say, but this proprietary delivery method and time of action is certainly not; and this alone can warrant a premium to the pricing, that being left up to the really good marketing guys to figure out...
Nearly unfathomable how the 'faster action and ease of use will mean nothing if'... Isn't the faster acting responsible for the lower highs and higher lows, associated with less strain on the body's cells, the pancreas etc? The health benefits over injected fast acting insulin will surely spread by word of mouth to other diabetics and drive demand...
Bottom line, regardless of how good or bad marketing is (and I vote for good) at some point barring any undiscovered longer term side effect, when patients using Afrezza are leading more normal, healthy, energetic lives, other diabetics will notice and be asking their doctors for the switch.
|
|
|
Post by savzak on Jul 8, 2014 13:57:31 GMT -5
I am long on mnkd, have been since my 1.68 entry point (perfect timing that was nothing but luck), plus I want this drug to be successful for the patients I see daily with diabetes. That being said, I'm also a realist. I think a 6-8 billion dollar buyout is possible, but if this is going to be a partnership we will have some very real hurdles to overcome to reach that market cap. The pharma world is very complex and again just because something is a good/great treatment doesn't mean it will be successful. The insulin market is a commodity market with massive pricing wars. The faster time action profile and ease of use will mean nothing if they can't compete in the current pricing wars. We also have to remember that we live in a current market that isn't using the needles of old, but rather 32 gauge needles that you hardly feel (if hurts far far worse to test your blood sugars). Is this slight reduction in pain worth the unknowns of putting a growth hormone through the lungs? This drug may seem like a no brainer to us, but I promise you physicians are not viewing it that way. I believe in this drug and it's place in the market (obviously by my position), but its success is highly dependent on the ability of its partner or buyer to successfully market it and price it. "This drug may seem like a no brainer to us..."
Frankly, it doesn't sound to me like Afrezza is a "no brainer" to you. It sounds like you have concerns over whether physicians will be difficult to market ("but I promise you physicians are not viewing it that way"), whether it's marginal convenience over injections is adequate ("market that isn't using the needles of old, but rather 32 gauge needles that you hardly feel"), whether there are unknown dangers associated with Afrezza ("worth the unknowns of putting a growth hormone through the lungs"), not to mention the standard concerns over pricing which applies to any new drug.
I'm with Baba. If I thought only a $6B to $8B market cap is possible with a partnership but only after we "overcome" some "real hurdles", I would exit most of my position. If a best case scenario is a 50% to 100% gain from here and that best case scenario is only possible after a long hard slog, then I would consider myself way over weighted in this stock. I might keep some for the emotional attachment that I've developed over the many years I've held it, but it would be a fraction of my current position.
|
|
|
Post by jpg on Jul 8, 2014 14:08:48 GMT -5
I think Exubera barely registered with most MDs and will easily be forgotten. I don't think the Exubera fiasco will more then superficially hurt Afrezza. It could actually be used as a marketing sales point if ever brought up. It would be easy, very easy, for a sales force to turn Exubera into a selling point for Afrezza.
JPG
|
|
|
Post by mnkdlong on Jul 8, 2014 14:13:08 GMT -5
I appreciate the investment strategies, as that is not my area of expertise (Amylin was my first stock buy, this is my second). I am hoping for a buyout to make a clean exit as I stand by statement that this isn't a slam dunk. I am also in a position where I only own 2700 shares, so I am not a major player banking on this to hit big.
I have held on to the shares hoping for the big upside of a buyout (may not be the best strategy). I have also hung on because this stock after 3 years has become important to me- I believe in what they are doing against all odds.
Now, as a realist who works in this market daily, I cannot state enough that this is not a slam dunk to be successful on the market. Yes- a faster time action profile will lead to fewer hyper and hypo glycemic events for a patient. But absolutely NO that will not trump cost and any safety factors- perceived or real. NPH insulin is so much worse then Lantus, the hypo rates are drastically higher- that said NPH a DECADE after Lantus has been on the market still gets a respectable SOM, because it's cheaper!
Glyberide causes so much hypo- it's honestly dangerous. It still holds a 30% market share of ALL ORAL AGENTS. The doctors know better options exist, but glyberide is cheap.
I have asked every endocrinologist I have met over the past three years about Afrezza, this has included endos from the Cleveland clinic to Mayo: they all are intrigued but have concerns- some of which stem from exuberas quick exit from the marketplace (many are convinced lung cancer was showing up in the data and Pfizer got out quick).
Please don't misunderstand me- I want this product to be successful and I think it can. Perhaps my positions aren't well executed considering my concerns- but again I'm trying to be a realist from what I see everyday in the diabetes market. It's easy to fall in love with this company and Mann, but let's acknowledge the challenges that remain.
|
|
|
Post by jpg on Jul 8, 2014 16:29:37 GMT -5
The only reason we prescribe glyburide is that it is cheap AND patients don't want to go on sc insulin. This would apply to many if not most of the oral agents. Get an inhaled insulin on the market that acts quickly without much of a tail and you will have a hit with PCP. To bad no one thought of developing such a product...
Oh wait!
JPG
|
|
|
Post by chmith27 on Jul 8, 2014 18:45:48 GMT -5
I think Exubera barely registered with most MDs and will easily be forgotten. I don't think the Exubera fiasco will more then superficially hurt Afrezza. It could actually be used as a marketing sales point if ever brought up. It would be easy, very easy, for a sales force to turn Exubera into a selling point for Afrezza. JPG in 2008 or so when that went down with exubera, i had been a resident in the er for at least a year. i hadn't heard of exubera or inhaled insulin (as far as i can remember) until 2010 when i got deeper into mnkd. er docs wouldn't be the first to hear about it but they shouldn't be the last either. so i have to agree with jpg on on this. exubera was likely more on wall street's minds as opposed doctors'.
|
|
|
Post by chmith27 on Jul 8, 2014 19:00:18 GMT -5
i don't think mnkdlong is short based on his comments. maybe based on his username, which does scream short lol. when i was a spy for the nsa i had a license plate that said "IMNOTASPY". i thought it would help me blend in....
|
|
|
Post by babaoriley on Jul 8, 2014 19:18:06 GMT -5
I think Exubera barely registered with most MDs and will easily be forgotten. I don't think the Exubera fiasco will more then superficially hurt Afrezza. It could actually be used as a marketing sales point if ever brought up. It would be easy, very easy, for a sales force to turn Exubera into a selling point for Afrezza. JPG in 2008 or so when that went down with exubera, i had been a resident in the er for at least a year. i hadn't heard of exubera or inhaled insulin (as far as i can remember) until 2010 when i got deeper into mnkd. er docs wouldn't be the first to hear about it but they shouldn't be the last either. so i have to agree with jpg on on this. exubera was likely more on wall street's minds as opposed doctors'. First of all, Chad, in 2008, you were likely too busy partying too hear about Exubera (what were you then, Doogie Howser or something?), and second, Bakersfield? Have they heard of Jonas Salk there yet? I think word of what happened at the O.K. Corral is just now filtering into Bako. Now, if you tell me you did your residency at Mass General, well, I'll take it back! LOL!
|
|
|
Post by 4allthemarbles on Jul 8, 2014 21:31:22 GMT -5
Although I started out being very skeptical of mnkdlong posts, I now understand where he is coming from and he puts up some valid points. I don't agree with all of them, but in fairness, this is his area of expertise. It's worth taking a second look at. Plus, let's be honest, the stock price is going down anyway. So the stock price, adding in the very obvious hurdles of doctor acceptance, patient willingness to use the product and the exuberant mess in the back of everyone's mind, maybe we should be more realistic in our expectations of what this company is worth. The cap is already at 4 billion and we don't have a single dollar of sales.
ON CRAZY REVERSE DAY!!!!!
Oh man, anything is possible on crazy reverse day:
Dogs and cats, living together!
George Bush and Barack Obama best friends!
He-Man and Barbie finally making peace!
Adam Fuerstein having a soul!
Devo/ Flock of Seagulls reunion tour selling out the Garden!
The Cubs win the series!
Every other day of the century:
Afrezza changes lives.
If you read this far, those things will not happen. Go short, get burnt.
|
|
|
Post by mnkdlong on Jul 9, 2014 0:02:46 GMT -5
Wow! I don't know how I so quickly became accused of being short! I was thankful I found proboards so that I could escape the idiocy of yahoo boards shorts ranting on about mnkd. The reason that drew me to this board seems to be escaping this thread as I am simply trying to bring perspective from my career. Sorry if I have offended anyone with my opinions.
Now, onto a topic more enjoyable to this community- Buyout. I am hoping for a BP buyout with my current position and these are my candidates based on my market knowledge:
1. Merck: They are in tough times with a pipeline drought. Janeuvia has been their savior: it is the best launch in diabetes marketplace history. That said, the new SGLT-2 marketplace is eating away at the DPP-4 market (DPP-4 had a -20% performance last month nationally!) The decline is realized in the drastic growth of the SGLT2 market (Invokana and Farxiga). Summary: Januvia is the main money maker for Merck, it is losing share quickly, and Merck has a diabetes Salesforce that could represent a novel treatment.
2. J&J: they have the next best launch in the diabetes marketplace- Invokana. They have a newly formed Salesforce that is growing a new class of drug (SGLT2) very successfully. Why have a diabetes Salesforce with only 1 drug?
3. AZ: They are trying to position themselves as a top 3 diabetes company (behind novo and Lilly). They already have a DDP4, SGLT-2, GLP-1, and insulin add on (symlin). The only thing they are missing is an insulin! It's hard to be seen as a diabetes company without an insulin. Additionally they are extremely well staffed. Adding another agent would not require additional hiring.
These are my three predictions. Thoughts? Disagreements?
|
|
|
Post by babaoriley on Jul 9, 2014 0:09:37 GMT -5
Don't know enough to agree or disagree with above post, mnkdlong, but do know enough to say excellent post!
|
|
|
Post by chmith27 on Jul 9, 2014 1:28:04 GMT -5
Wow! I don't know how I so quickly became accused of being short! I was thankful I found proboards so that I could escape the idiocy of yahoo boards shorts ranting on about mnkd. The reason that drew me to this board seems to be escaping this thread as I am simply trying to bring perspective from my career. Sorry if I have offended anyone with my opinions. Now, onto a topic more enjoyable to this community- Buyout. I am hoping for a BP buyout with my current position and these are my candidates based on my market knowledge: 1. Merck: They are in tough times with a pipeline drought. Janeuvia has been their savior: it is the best launch in diabetes marketplace history. That said, the new SGLT-2 marketplace is eating away at the DPP-4 market (DPP-4 had a -20% performance last month nationally!) The decline is realized in the drastic growth of the SGLT2 market (Invokana and Farxiga). Summary: Januvia is the main money maker for Merck, it is losing share quickly, and Merck has a diabetes Salesforce that could represent a novel treatment. 2. J&J: they have the next best launch in the diabetes marketplace- Invokana. They have a newly formed Salesforce that is growing a new class of drug (SGLT2) very successfully. Why have a diabetes Salesforce with only 1 drug? 3. AZ: They are trying to position themselves as a top 3 diabetes company (behind novo and Lilly). They already have a DDP4, SGLT-2, GLP-1, and insulin add on (symlin). The only thing they are missing is an insulin! It's hard to be seen as a diabetes company without an insulin. Additionally they are extremely well staffed. Adding another agent would not require additional hiring. These are my three predictions. Thoughts? Disagreements? for the record i never thought you were short, and i'm pretty skeptical on these things. not that i don't like shorts either, except when deception is used. nice post.
|
|