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Post by mannmade on Jan 12, 2019 15:37:18 GMT -5
Oddly enough I think Afrezza and a cgm connected to a smart phone make it easier to manage your diabetes. Though I am not diabetic I have a smart phone which I am on constantly as many are. Having an alarm setting for both high and low will help. Also due to the competitive nature of many people especially T1’s I know I think they will gladly spend the time managing their diabetes when it is so easy as to see thooer BG on their mobile smart phone and then just take a hit of afrezza. It becomes addictive... Witness: Sam, Eric, Gustavo, Laura, etc just mho...
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Post by akemp3000 on Jan 12, 2019 15:46:51 GMT -5
Everyone who has followed this company for many years knows that Mike Castagna has turned this company around in less than two years. Maybe not all decisions have been perfect but Mannkind is in much better shape today than at any time in the past. Personal criticisms of Mike, credible or not, are simply irrelevant. As always, anonymous sources have no credibility.
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Post by mytakeonit on Jan 12, 2019 15:49:50 GMT -5
Sorry Galileo ... but I couldn't get pass the first couple of sentences ... so I don't really know what you said.
BTW, why are you here in a proboard room for MNKD?
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Post by agedhippie on Jan 12, 2019 16:57:27 GMT -5
Oddly enough I think Afrezza and a cgm connected to a smart phone make it easier to manage your diabetes. Though I am not diabetic I have a smart phone which I am on constantly as many are. Having an alarm setting for both high and low will help. Also due to the competitive nature of many people especially T1’s I know I think they will gladly spend the time managing their diabetes when it is so easy as to see thooer BG on their mobile smart phone and then just take a hit of afrezza. It becomes addictive... Witness: Sam, Eric, Gustavo, Laura, etc just mho... I agree with some of what you say. I have both a Dexcom and a Libre but I almost always use the Dexcom because it talks to my phone so every time I look at my phone my levels are in notifications in the top right hand corner. I really like that as it makes things easy for me. I don't need to decide I want to test and swipe the sensor as with the Libre, instead the numbers are right there in front of me. Where we disagree is the spending time managing T1. Almost all the T1s I know want to spend as little time as possible managing their diabetes which is why automated delivery is such a big thing. Dr Bode, Sam's endo I think and very pro Afrezza, says that, " We’re going to look back, the discovery of insulin happened in 1920 but the next biggest step was automated insulin delivery, which happened in 2017". Not the introduction of Afrezza, but automated delivery because it allows people to spend minimal time dealing with diabetes by automating the process. I do not mean any of this as a criticism of people who maintain tight control as everyone deals with diabetes in their own way. There have always been people who are prepared to put in the effort to maintain very tight control, and while they are not many they are vocal. That is perfectly logical - if you have found a way to get good control wouldn't you want to share it with everyone? So you see the early adopters with a high profile. This happens with Afrezza, this happens with the LCHF diet, this happens with the Loop artificial pancreas/Nightscout crowd.
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Post by mnholdem on Jan 12, 2019 17:15:51 GMT -5
“CGM access has progressed with Dexcom and Medicare, but there are still only an estimated 15% of people with type 1 diabetes on CGM in the US... to say nothing of people with type 2 diabetes.” Source: diatribe.org/cgm-and-time-range-what-do-diabetes-experts-think-about-goalsThat leaves Afrezza with a remaining target of 85% of people with T1 and likely 99%+ of people with T2. So I don’t understand why this argument over CGM v Afrezza keeps on occupying this discussion. The vast majority of people with T1 are using neither Afrezza nor a monitor. After all, there’s plenty of room for both companies to take more market share.
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Post by agedhippie on Jan 12, 2019 18:16:38 GMT -5
“CGM access has progressed with Dexcom and Medicare, but there are still only an estimated 15% of people with type 1 diabetes on CGM in the US... to say nothing of people with type 2 diabetes.” Source: diatribe.org/cgm-and-time-range-what-do-diabetes-experts-think-about-goalsThat leaves Afrezza with a remaining target of 85% of people with T1 and likely 99%+ of people with T2. So I don’t understand why this argument over CGM v Afrezza keeps on occupying this discussion. The vast majority of people with T1 are using neither Afrezza nor a monitor. After all, there’s plenty of room for both companies to take more market share. I think it is because there is an expectation that there is about to be an explosion in CGM use, but as the diatribe numbers show the insurers have a very tight grip on CGMs. I expect the Type 1 numbers to grow as a result of the deals that Medtronics is doing with insurers like Aetna and UHC around their 670G hybrid AP and results based cost sharing. I think there is a huge market for Afrezza, but I think CGMs will remain restricted due to cost.
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Post by mango on Jan 12, 2019 18:27:40 GMT -5
Shoot galileo, tell us who you are, how you know him, and tell us in detail these facts you say you know about Mike before he was with MNKD and while he has been with MNKD To Liane and other MC Cheerleaders, Y’all asked for more evidence supporting my opinion about Mike Castagna. Fair enough. I’ll share as much as I can but I’m limited. The unflattering picture I have of him is a mosaic composed of disparate bits of information I’ve gathered. It’s not something I’ve hatched because I don’t like the guy. I started from a neutral position, neither pro or con. I’ve not met Mike so I am relying on two broad groupings of information: the opinions of people who’ve worked directly with Mike and actions I’ve seen Mike take during his time at MNKD. I hope you appreciate that negative information is rarely well received by those who are dug in on their position, which is one reason we hear so little of it. Political correctness also stifles it. I’ve spoken to 5 executives who’ve worked with Mike, 3 in former companies and 2 now departed from MNKD. None of them want their names used so these anonymous sources are subject to that criticism. So be it. Dismiss what I write below if you want. All five said very similar things: 1) Mike is ruthlessly political, 2) out for his own good, 3) will stab people in the back-has no loyalty, 4) is only interested in his own ideas or ideas that he can take credit for, 5) surrounds himself with yes men, and 6) is a very good talker. One said upon hearing Mike was made CEO of MNKD said he lost all respect for or interest in the company. The guy said Mike was “not impressive,” and he wondered how a company could be so desperate to make Mike the leader. He questioned whether the MNKD BOD was “asleep at the wheel.” This person is a successful, high-profile businessman who’s held high level executive positions in companies that you’d all recognize instantly. He has no apparent axe to grind. The other two non-MNKD people said mostly the same thing and that Mike was ambitious to a fault. These were people I met randomly so I didn’t seek out the contrary opinions. The two departed MNKD execs told me to look at the turnover since Mike came in. They said good, competent people don’t like working with Mike because he is so obviously calculating and self-absorbed. He is not a team player. One told me Mike privately admitted to him his goal to displace Matt Pfeffer within a month or two of Matt bringing Mike in. He said Mike went right to work on the BOD undermining MP. The other said Mike is a phony who’ll pretend to befriend you but will knife you in the back when it suits him and will step over the body. One commented that Mike’s line is “I’ve never failed with a drug.” I could go on, but you get the point. The actions Mike has taken himself are also revealing. Go back and listen to what Mike says in presentations over the past 18 months. He always sounds like he’s got it all figured out, like success is just months away, and that he and the team are wonderful. He’s never admitted mistakes or failure. He doesn’t mention things that don’t go well. For example, he claims the DTC campaign in Q4-2017 worked well, yet he abandoned it. In the most recent conference call he talked about all the progress in 2018, yet given the huge marketing spend, the script numbers are horrible. Remember, nobody made Mike issue guidance of $25-30 million. He did so because he was confident about exceeding it. He actually delivered about half. Mike implies he brought in Kendall. I happen to know that the company talked to Kendall long before Mike was even on the scene. They had worked on Kendall for a couple years. Yet, Mike lets everyone think it was his idea. Consider the move of HQ. Know what his proffered explanation was? Because MNKD needs to be located there to recruit talent. Well, guess where Mike lives? One executive told me this was all about making Mike’s commute shorter. A good expenditure of company funds? I don’t think so. Now, think about script renewals. Know why you don’t hear that talked about? Because they’re really bad. It’s been a problem from the start. That’s why revenue isn’t building the way one would expect. There’s no evidence that renewals are better following the DTC campaign. I’ve heard from people in a position to know that over 70% of the people who start Afrezza drop it. That’s a problem, yet it goes unmentioned. I was told that Mike has pushed for more executive compensation and less rank and file compensation, contrary to the what Al Mann believed. He’s out to feather his own nest while others suffer. Has anyone else been looking at executive compensation? Has company performance been so good that we need to reward these people the way we do? Do we really believe they deserve bonuses? Don’t you think this company is top heavy? Liane you had a laundry list of “accomplishments” of Mike’s. I can counter each one, but let me deal with only one: the elimination of debt. You cite this as a credit to his leadership, but consider the cost: extreme and continuing dilution. The debt would have been preferable in the context of growing sales. If sales are ramping up one can handle the debt and avoid all the dilution. We shareholders would have kept more of the company. It is only because of the failure of sales that the debt became a problem, and we shareholders have seen our positions eroded. So, do you still think MC “accomplished” something by getting rid of it? He had to because his sales strategy bombed. I’ve talked to two independent investment bankers who’ve examined the recent financings the company has done under Mike: their comments are that the deals are terrible and reek of desperation. They both felt the deals looked like the work of “amateurs.” They say this just turns off other possible partners. MNKD looks like a loser. I’ve talked to lower level of people at MNKD too who are still with the company. Obviously, they’re not going to say anything public, but hey the news is the same. It’s not good people. Honestly, I had a damn hard time finding someone closely associated with Mike who can say anything positive. Isn’t this odd?! I’m sure you’ve all heard enough by now, and diehard cheerleaders won’t be persuaded anyway, so I’ll leave you with this thought: It has been said by others that you want a CEO with integrity, energy and intelligence. But, without the first, the last two will kill you. Don’t say I didn’t tell you. Quite the novel you got there, g
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Post by mannmade on Jan 12, 2019 18:44:42 GMT -5
Aged, I respect your response. I recently tested for Hba1c which cane in at 6.0. I am in fairly good shape and not overweight (too much). However, diabetes runs in my family as I have a brother who has been a T1 since age 8 and both my parents became T2’s later in life.
So knowing the above, I asked my pcp for a cgm script and afrezza. She told me instead to change my diet and exercise more. Need to stay away from dairy and carbs. Big problem for me as I love cheese and pasta etc... however I did as she wished, which I still have the discipline for, and am now at 5.8.
There will come a time when I do not care to restrict my diet so much and will push harder for the cgm and afrezza which I am actually tempted to do with a 5.8 because I like knowing my vitals. It’s why I wear an iWatch and take my blood pressure regularly.
But that may just be me...
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Post by nylefty on Jan 12, 2019 18:54:07 GMT -5
Everyone who has followed this company for many years knows that Mike Castagna has turned this company around in less than two years. Maybe not all decisions have been perfect but Mannkind is in much better shape today than at any time in the past. Personal criticisms of Mike, credible or not, are simply irrelevant. As always, anonymous sources have no credibility. I agree that Mike has turned the company around and therefore don't really care if he's a nice guy or not. My only (major) problem with his performance is his failure to see that the current TV commercial should be scrapped and replaced with one that (at least) suggests why Afrezza is a better choice than other mealtime diabetes drugs. The award that he brags about was for "creativity." We need an ad that would win awards for effectiveness.
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Post by sportsrancho on Jan 12, 2019 19:38:30 GMT -5
I agree we need a different commercial, but just as an aside about the CGM’s. Cramer said that the Dexcom CEO was the star of JP Morgan. For whatever that’s worth:-) but it doesn’t bode well for the awareness aspect of the CGM’s.
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Post by agedhippie on Jan 12, 2019 20:34:38 GMT -5
Aged, I respect your response. I recently tested for Hba1c which cane in at 6.0. I am in fairly good shape and not overweight (too much). However, diabetes runs in my family as I have a brother who has been a T1 since age 8 and both my parents became T2’s later in life. So knowing the above, I asked my pcp for a cgm script and afrezza. She told me instead to change my diet and exercise more. Need to stay away from dairy and carbs. Big problem for me as I love cheese and pasta etc... however I did as she wished, which I still have the discipline for, and am now at 5.8. There will come a time when I do not care to restrict my diet so much and will push harder for the cgm and afrezza which I am actually tempted to do with a 5.8 because I like knowing my vitals. It’s why I wear an iWatch and take my blood pressure regularly. But that may just be me... There is a possible route in getting a loan CGM. Insurers are a lot happier to cover those and you get one for a couple of weeks. It's meant to show you what you can and cannot eat, and what the impact of your medication is. If you are interested it might be worth seeing if your insurer will cover that. Typically they let you do that twice a year from memory. If you want to eat pasta cook it, let it cool, and reheat it. That makes the starch resistant and your body treats it largely like fibre. This will reduce the rise in your blood sugar by around 50%. The starch gets transformed by the heating and cooling so it becomes resistant to digestion and harder to convert into glucose. For me bread is my Achilles heel.
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Post by brotherm1 on Jan 12, 2019 20:35:10 GMT -5
Two years as a CEO for the first time, working on a shoe string budget, he’s learning, and the company is growing slowly but steadily. Issues with insurance, titration education, lack of affordable CGM’s in the past (which are now becoming more affordable every day), lack of funds to market Afrezza, lack of funds to bargain with strength for partnerships....are not Mike’s fault. He came into a company that was in a death spiral. He’s turning it around. I really don’t care if there are people that don’t like him. The best leaders piss off a lot of people.
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Post by golfeveryday on Jan 12, 2019 20:42:55 GMT -5
Shoot galileo, tell us who you are, how you know him, and tell us in detail these facts you say you know about Mike before he was with MNKD and while he has been with MNKD To Liane and other MC Cheerleaders, Y’all asked for more evidence supporting my opinion about Mike Castagna. Fair enough. I’ll share as much as I can but I’m limited. The unflattering picture I have of him is a mosaic composed of disparate bits of information I’ve gathered. It’s not something I’ve hatched because I don’t like the guy. I started from a neutral position, neither pro or con. I’ve not met Mike so I am relying on two broad groupings of information: the opinions of people who’ve worked directly with Mike and actions I’ve seen Mike take during his time at MNKD. I hope you appreciate that negative information is rarely well received by those who are dug in on their position, which is one reason we hear so little of it. Political correctness also stifles it. I’ve spoken to 5 executives who’ve worked with Mike, 3 in former companies and 2 now departed from MNKD. None of them want their names used so these anonymous sources are subject to that criticism. So be it. Dismiss what I write below if you want. All five said very similar things: 1) Mike is ruthlessly political, 2) out for his own good, 3) will stab people in the back-has no loyalty, 4) is only interested in his own ideas or ideas that he can take credit for, 5) surrounds himself with yes men, and 6) is a very good talker. One said upon hearing Mike was made CEO of MNKD said he lost all respect for or interest in the company. The guy said Mike was “not impressive,” and he wondered how a company could be so desperate to make Mike the leader. He questioned whether the MNKD BOD was “asleep at the wheel.” This person is a successful, high-profile businessman who’s held high level executive positions in companies that you’d all recognize instantly. He has no apparent axe to grind. The other two non-MNKD people said mostly the same thing and that Mike was ambitious to a fault. These were people I met randomly so I didn’t seek out the contrary opinions. The two departed MNKD execs told me to look at the turnover since Mike came in. They said good, competent people don’t like working with Mike because he is so obviously calculating and self-absorbed. He is not a team player. One told me Mike privately admitted to him his goal to displace Matt Pfeffer within a month or two of Matt bringing Mike in. He said Mike went right to work on the BOD undermining MP. The other said Mike is a phony who’ll pretend to befriend you but will knife you in the back when it suits him and will step over the body. One commented that Mike’s line is “I’ve never failed with a drug.” I could go on, but you get the point. The actions Mike has taken himself are also revealing. Go back and listen to what Mike says in presentations over the past 18 months. He always sounds like he’s got it all figured out, like success is just months away, and that he and the team are wonderful. He’s never admitted mistakes or failure. He doesn’t mention things that don’t go well. For example, he claims the DTC campaign in Q4-2017 worked well, yet he abandoned it. In the most recent conference call he talked about all the progress in 2018, yet given the huge marketing spend, the script numbers are horrible. Remember, nobody made Mike issue guidance of $25-30 million. He did so because he was confident about exceeding it. He actually delivered about half. Mike implies he brought in Kendall. I happen to know that the company talked to Kendall long before Mike was even on the scene. They had worked on Kendall for a couple years. Yet, Mike lets everyone think it was his idea. Consider the move of HQ. Know what his proffered explanation was? Because MNKD needs to be located there to recruit talent. Well, guess where Mike lives? One executive told me this was all about making Mike’s commute shorter. A good expenditure of company funds? I don’t think so. Now, think about script renewals. Know why you don’t hear that talked about? Because they’re really bad. It’s been a problem from the start. That’s why revenue isn’t building the way one would expect. There’s no evidence that renewals are better following the DTC campaign. I’ve heard from people in a position to know that over 70% of the people who start Afrezza drop it. That’s a problem, yet it goes unmentioned. I was told that Mike has pushed for more executive compensation and less rank and file compensation, contrary to the what Al Mann believed. He’s out to feather his own nest while others suffer. Has anyone else been looking at executive compensation? Has company performance been so good that we need to reward these people the way we do? Do we really believe they deserve bonuses? Don’t you think this company is top heavy? Liane you had a laundry list of “accomplishments” of Mike’s. I can counter each one, but let me deal with only one: the elimination of debt. You cite this as a credit to his leadership, but consider the cost: extreme and continuing dilution. The debt would have been preferable in the context of growing sales. If sales are ramping up one can handle the debt and avoid all the dilution. We shareholders would have kept more of the company. It is only because of the failure of sales that the debt became a problem, and we shareholders have seen our positions eroded. So, do you still think MC “accomplished” something by getting rid of it? He had to because his sales strategy bombed. I’ve talked to two independent investment bankers who’ve examined the recent financings the company has done under Mike: their comments are that the deals are terrible and reek of desperation. They both felt the deals looked like the work of “amateurs.” They say this just turns off other possible partners. MNKD looks like a loser. I’ve talked to lower level of people at MNKD too who are still with the company. Obviously, they’re not going to say anything public, but hey the news is the same. It’s not good people. Honestly, I had a damn hard time finding someone closely associated with Mike who can say anything positive. Isn’t this odd?! I’m sure you’ve all heard enough by now, and diehard cheerleaders won’t be persuaded anyway, so I’ll leave you with this thought: It has been said by others that you want a CEO with integrity, energy and intelligence. But, without the first, the last two will kill you. Don’t say I didn’t tell you. Timely post on the eve of a new marketing campaign and increased spend on tv ads with Rx already rising prior. Not a coincidence in timing is my bet. Good luck to you though.
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Post by gamblerjag on Jan 12, 2019 20:44:45 GMT -5
he lost me at cheerleader.
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Post by Omega on Jan 12, 2019 21:01:46 GMT -5
To Liane and other MC Cheerleaders, Y’all asked for more evidence supporting my opinion about Mike Castagna. Fair enough. It’s not good people. Honestly, I had a damn hard time finding someone closely associated with Mike who can say anything positive. Isn’t this odd?! Don’t say I didn’t tell you. Quite the novel you got there, g A source I personally know and trust has had many conversations with Kendall and since you blatantly lied about that some parts... I need to assume everything else you said is just a bit game of telephone or made up as well. Thanks for not giving one shread of proof and a bunch of 'someone I cannot name said Blah'. I'm just wondering why you are here 'helping' us shareholders with your news. Actually if I was you I'd take out a 2nd on your house and short short short.
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