Post by joeypotsandpans on Jun 21, 2018 12:56:01 GMT -5
Spencer's counter article to the Stat Study Results
His attempt to be both an author and physician at the same time is very entertaining. I must have missed where SO earned his medical degree with a research pathway in Endocrinology, he obviously didn't receive a degree in Mathematics as 3X4u is the same as 1X12u and 9X4u is the same as 3X12u...this might help him www.montereyinstitute.org/courses/DevelopmentalMath/COURSE_TEXT2_RESOURCE/U09_L3_T1_text_container.html . I don't even know where to begin in response (and thought about not even bothering just because with so little merit to his arguments regarding the study it's almost not worth it). However, it also makes it easy to show why in fact the study will not only lead to Afrezza's ultimate success but accentuate it.
Here is the first "intelligent" statement and these are not in any particular chronological order from the article rather as I randomly choose to address:
SO: Being "in range" 61-62% of the time is great, but how much better is it than being in range 55% of the time with less dosing, less monitoring, and less cost?
Perhaps SO rather than lead with a question of UNCERTAINTY you tell your readers what is statistically significant about the difference in those percentages when it comes to the damage being done to those with the lower TIR compared to those that with those with the higher TIR? Again, and correct me if I am wrong but other than being a writer "for traders" how do you make that statement without knowing the differences? Perhaps the one with the proper and appropriate background will address this at the ADA to those who will understand the statistical significance of the differences.
SO: One hope of this study was that it would provide a compelling argument for using time in range as a new standard of assessing diabetes treatment. It seems like DexCom's (NASDAQ:DXCM) continuous glucose monitors used in the study may have better selling points from these results than MannKind.
If you understand the importance of TIR (which is questionable based on your statement questioning how much better it is to be in range 7% more of the time) and why the CGM would use that as better selling points than it is the very same compelling reason of the better selling points of Afrezza compared to Aspart based on the study.
Here is your disclaimer, SO: From a scientific standpoint, the data may be significant enough to warrant further studies that are more detailed, longer, and with more patients. That is all well and good if MannKind had the cash reserves to embark on such a journey. Some like to say the science will prevail, but in this case, the science seems to not show the chasm of difference that some investors hoped to see.
The science is prevailing, the PWD who have dialed in their titration are consistently showing their improved TIR and in turn their corresponding spectacularly lower A1c's.
As published from US National Library of Medicine National Institutes of Health just last month:
www.ncbi.nlm.nih.gov/pubmed/29718785/
Prior to the availability of degludec and regular human insulin inhalation powder in the type 1 diabetic patient glycemic control with subcutaneous insulin injections was difficult to obtain due to nocturnal, pre-prandial and often severe hypoglycemia as well as post-prandial hyperglycemia and hypoglycemia due to 'stacking' of insulin. A 62-year-old female with type 1 diabetes for 56 years who could not be controlled with continuous subcutaneous insulin aspart infusion obtained glycemic control without significant hypoglycemia or increased post-prandial glycemic excursions utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed. The availability of degludec and technosphere insulin improved the management of brittle type 1 diabetes.
Regarding the proper dosing and titration leads me to your following statement:
SO: Let's assess what this means using the lowest dose of Afrezza at 4 units. The directions essentially tell a consumer to use three doses for each meal. That is 9 cartridges a day. The four unit script has 90 cartridges. That means it will take three scripts a month to treat as directed. That would be great if the masses were willing to buy Afrezza in such volume, but reality and history show us that getting folks to stay on Afrezza is difficult at best
You are living in the past with this statement, as you have written in your previous litany of articles you admit that the revenue numbers increased significantly and in your words are "peaking/stabilizing due to the change in SKU's and packaging". So the consumer is not using three doses of 4u at a time, the only time I would take three 4 unit cartridges at a time would be if I ran out of the single 12 unit cartridges. Those that require higher doses based on where they are in the progression of the disease and their respective needs are more likely getting the 180 ct. boxes in their scripts. The consumers that are getting the 90 unit boxes either only require one 4u cartridge at a time or are being mis-prescribed by their physicians, obviously why the STAT study with the follow up correcting doses is significant.
All I have time for right now but it is just the tip of the iceberg regarding his latest. SMH.
His attempt to be both an author and physician at the same time is very entertaining. I must have missed where SO earned his medical degree with a research pathway in Endocrinology, he obviously didn't receive a degree in Mathematics as 3X4u is the same as 1X12u and 9X4u is the same as 3X12u...this might help him www.montereyinstitute.org/courses/DevelopmentalMath/COURSE_TEXT2_RESOURCE/U09_L3_T1_text_container.html . I don't even know where to begin in response (and thought about not even bothering just because with so little merit to his arguments regarding the study it's almost not worth it). However, it also makes it easy to show why in fact the study will not only lead to Afrezza's ultimate success but accentuate it.
Here is the first "intelligent" statement and these are not in any particular chronological order from the article rather as I randomly choose to address:
SO: Being "in range" 61-62% of the time is great, but how much better is it than being in range 55% of the time with less dosing, less monitoring, and less cost?
Perhaps SO rather than lead with a question of UNCERTAINTY you tell your readers what is statistically significant about the difference in those percentages when it comes to the damage being done to those with the lower TIR compared to those that with those with the higher TIR? Again, and correct me if I am wrong but other than being a writer "for traders" how do you make that statement without knowing the differences? Perhaps the one with the proper and appropriate background will address this at the ADA to those who will understand the statistical significance of the differences.
SO: One hope of this study was that it would provide a compelling argument for using time in range as a new standard of assessing diabetes treatment. It seems like DexCom's (NASDAQ:DXCM) continuous glucose monitors used in the study may have better selling points from these results than MannKind.
If you understand the importance of TIR (which is questionable based on your statement questioning how much better it is to be in range 7% more of the time) and why the CGM would use that as better selling points than it is the very same compelling reason of the better selling points of Afrezza compared to Aspart based on the study.
Here is your disclaimer, SO: From a scientific standpoint, the data may be significant enough to warrant further studies that are more detailed, longer, and with more patients. That is all well and good if MannKind had the cash reserves to embark on such a journey. Some like to say the science will prevail, but in this case, the science seems to not show the chasm of difference that some investors hoped to see.
The science is prevailing, the PWD who have dialed in their titration are consistently showing their improved TIR and in turn their corresponding spectacularly lower A1c's.
As published from US National Library of Medicine National Institutes of Health just last month:
www.ncbi.nlm.nih.gov/pubmed/29718785/
Prior to the availability of degludec and regular human insulin inhalation powder in the type 1 diabetic patient glycemic control with subcutaneous insulin injections was difficult to obtain due to nocturnal, pre-prandial and often severe hypoglycemia as well as post-prandial hyperglycemia and hypoglycemia due to 'stacking' of insulin. A 62-year-old female with type 1 diabetes for 56 years who could not be controlled with continuous subcutaneous insulin aspart infusion obtained glycemic control without significant hypoglycemia or increased post-prandial glycemic excursions utilizing degludec insulin for basal needs and technosphere before meals and between meals if needed. The availability of degludec and technosphere insulin improved the management of brittle type 1 diabetes.
Regarding the proper dosing and titration leads me to your following statement:
SO: Let's assess what this means using the lowest dose of Afrezza at 4 units. The directions essentially tell a consumer to use three doses for each meal. That is 9 cartridges a day. The four unit script has 90 cartridges. That means it will take three scripts a month to treat as directed. That would be great if the masses were willing to buy Afrezza in such volume, but reality and history show us that getting folks to stay on Afrezza is difficult at best
You are living in the past with this statement, as you have written in your previous litany of articles you admit that the revenue numbers increased significantly and in your words are "peaking/stabilizing due to the change in SKU's and packaging". So the consumer is not using three doses of 4u at a time, the only time I would take three 4 unit cartridges at a time would be if I ran out of the single 12 unit cartridges. Those that require higher doses based on where they are in the progression of the disease and their respective needs are more likely getting the 180 ct. boxes in their scripts. The consumers that are getting the 90 unit boxes either only require one 4u cartridge at a time or are being mis-prescribed by their physicians, obviously why the STAT study with the follow up correcting doses is significant.
All I have time for right now but it is just the tip of the iceberg regarding his latest. SMH.
