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Post by als57 on May 21, 2015 20:19:16 GMT -5
This is in regard to scripts bringing up the rear. I listened to Hakan state that new scripts were about 8 wks. behind projected numbers. I am not certain whether Hakan meant Sanofi or Mannkind's expectations and when asked if it could be Sanofi reps not pushing big A, to which Hakan responded that they are well incentivized.
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Post by Deleted on May 21, 2015 20:21:31 GMT -5
His facial expression spoke volumes when addressing this. It was as if he was saying "the spirometry issue was as obvious as the light of day and Sanofi were idiots for missing it". That said, you have to hand it to Al for having a Microlife Spirometer on hand and speaking to purchasing large volumes of them to address the situation. BTW, if any of you want one, go to drugstore.com and for $39.99 its all yours. The only issue now is how to get the spirometer to the doctor - Sanofi cannot give it to them as it would be construed as an inducement to write Rx for Afrezza. Figuring out a solution won't take much time, getting it through Sanofi's legal department will. I enjoyed the tour of the factory and the opportunity to speak with some of the engineers who worked on the dreamboat. Seemed like a competent, enthusiastic group. NRx count needs to start climbing and soon. While the partnership deal with Sanofi can be terminated I believe by either party in the future, I don't think Mannkind can survive that kind of restart and at this point in the game, not sure Al would come up with another couple of hundred million to make the transition to a new partner. Does anyone who attended think the guy from Florida left any type of lasting impression on senior management or the board of directors other than Matt asking about the guys Nike golf shirt embroidered with an Afrezza logo? Why is everyone assuming giving away a low cost FEV1 spirometer is an inducement - it is less than $100.00, can be used to identify many medical issues and as a device that measures only FEV1, the test is not reimburseable (Al is brilliant, but I believe his comments re: providers being able to pay for the device after submitting one reimbursement claim is incorrect). I am not suggesting that MNKD or SNY are incorrect deeming a giveaway as violative, but I am not sure it is a black and white issue. But heck, I'm just one knucklehead in the room. There are all sorts of anti-kickback laws as well as the sunshine laws. Given how image conscious big pharma is, they tend to tread lightly on this stuff. Here is a link to reimbursement: www.jonesmedical.com/pdf/Jones_Spirometry_Reimbursement_Guide_2015.pdf
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Post by od on May 21, 2015 20:29:38 GMT -5
Why is everyone assuming giving away a low cost FEV1 spirometer is an inducement - it is less than $100.00, can be used to identify many medical issues and as a device that measures only FEV1, the test is not reimburseable (Al is brilliant, but I believe his comments re: providers being able to pay for the device after submitting one reimbursement claim is incorrect). I am not suggesting that MNKD or SNY are incorrect deeming a giveaway as violative, but I am not sure it is a black and white issue. But heck, I'm just one knucklehead in the room. There are all sorts of anti-kickback laws as well as the sunshine laws. Given how image conscious big pharma is, they tend to tread lightly on this stuff. Here is a link to reimbursement: www.jonesmedical.com/pdf/Jones_Spirometry_Reimbursement_Guide_2015.pdfThanks Scotta. Understood re: industry staying clear of the edge on anti-kickback and sunshine regs. Just making the point that it is an easy 'excuse' not to distribute low cost FEV1 only devices. Re: reimbursement advice from Jones, I believe they all require full spirometry - not FEV1 only.
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Post by ezrasfund on May 21, 2015 20:35:41 GMT -5
I really think that the tone conveyed confidence that we will get to the promised land. But we are certainly still in the desert. The double whammy of prior authorization and spirometry is holding back scrips, but the product is so good, if anything even better than anticipated, that it will eventually be widely adopted.
Not just the management team, but all of the engineers I spoke with have been working for MNKD for many years. They are all very committed and still very enthusiastic.
I was talking with one of the guys who developed the dreamboat, and his previous work had been developing a new type of syringe. He mentioned that the dreamboat is much simpler and much less expensive to produce than a syringe.
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Post by joeypotsandpans on May 21, 2015 20:36:49 GMT -5
Let me interject a little second hand conversation I had recently with someone I trust that knows one of the SNY reps. (If you remember I basically "predicted" the launch date which was from same source). The rep was excited when selected to be on the Afrezza launch, was then a bit down when ran into the issues that have been brought up regarding the timelines for getting a script through, and most recently was genuinely excited and enthusiastic regarding the product and feedback from the MD's they have been working with. They explained the education is a process, the samples take a while to work through before actual scripts, but definitely stated that SNY was behind the product and most recently their U.S. VP of sales went along on a few of their visits/appointments and is definitely encouraged by the feedback from those that have been prescribing. I only bring this up because of the interpretation being taken from the meeting by those on the board and it is very much contrary to the feedback from one of the "soldiers" on the ground. Take it fwiw,
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Post by ezrasfund on May 21, 2015 20:52:34 GMT -5
Joey, my impression today was really just the same from the soldiers and the generals at MNKD. The product is incredible, and it is just taking a while to get off the mark and get things rolling.
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Post by BD on May 21, 2015 20:55:51 GMT -5
Question for those attending today , maybe someone could create a poll ? I'm curious if or how much anyone who attended may have had their confidence shaken . From what I'm reading from you all there seems to be much disconnect between Mannkind & Sanofi ( or maybe Mannkind just can't disclose anything ) . Sorry if this is a stupid question, but no one seems that impressed , I'm more so curious if it's bc Sanofi may not be holding up their end of the partnership agreement . I've no plans to sell . The question I'm asking myself is do I still want to buy more if Sanofi isn't doing their job ./ And more so can Mannkind survive without Sanofi ? Lynn Lynn, I would suggest that a poll may not represent a very useful metric here, but individual replies to the meeting's effect on confidence level with explanations could be valuable. Speaking for myself, my confidence was slightly increased simply by virtue of getting to know the company and its personnel better (I didn't know them much at all previously, not from direct experience anyway. It's the first time I've seen any of them live.) Everything about MannKind and Afrezza seems to take longer "than it should" to happen, so why should progress at this stage of the game really be any different? Sometimes the only surprise is how I can continue to be surprised in the same way over and over again. This is the adult version of "A Series of Unfortunate Events" (um, did that one end happily? I'm not sure I want to know, lol) Ultimately, the excellence of the product has got to pull share valuation north. The only real question is, "Can I hold on long enough to benefit from that?" While the wait is neither easy nor fun, I do think I can.
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Post by eddiemoy on May 21, 2015 20:56:29 GMT -5
this all reminds me of tesla, their cars have the highest satisfaction rating of any auto manufacturer. we have a similar satisfaction here with the afrezza product.
tesla was under short attack as well. but elon was able to orchestrate plan to boost confidence in the company by removing all the doubt that the electric car is the future. it was a 5 part plan to address the 5 things that the shorts were using to attack the stock...
difference here is that management isn't in control of the actual marketing and selling of the product, but neither was tesla. the tesla sedans were so good it sold through referrals alone. to this day even after it has gone up in price over 12X, since the release of model s, they haven't did a single bit of advertisement! i see a strong parallel here with afrezza. product will pick up when doctors see how well it works! these issues will be worked through. tesla is production constrained, i see that happening to afrezza as well... like al mann said, their factory can only address 2m of the nearly 400m diabetics!
i think management can start citing from the post clinical studies that al mann has alluded to in the q1 conf call. but for now the best testament is all the great results everyone is getting and spreading it through social media. i truly believe in the product due to all the positive life changing feedback i'm seeing. give them a few months to sort this all out. they really need lines 2-3 up and running for the mass marketing to start.
what i didn't get to confirm from the tour is how long it takes to bring lines 4-5-6 up if things pick up!
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Post by eddiemoy on May 21, 2015 20:59:22 GMT -5
i was impressed with the automation, again it reminds me of tesla where they use robots to do a lot of the assembly of the model s. what shocked me is how small a foot print it takes to do the assembly. this just means that when they need to expand beyond 2m patients should be relatively easy.
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Post by purge on May 21, 2015 21:14:33 GMT -5
Sanofi will never reply or act on any emails. Has anyone here emailed them? Has anyone ever received a response? Don't waste your time with emailing Sanofi.
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Post by corpplanner on May 21, 2015 21:15:14 GMT -5
Wow. That's disappointing in so many ways. Exactly. Not what I expect from a CEO. Many constructive ways to handle this concern without washing hands of it. I wasn't there, so can't interrupt context and intent properly. But if serious, while I really appreciate that they are personally accessible, shoulda kept that one at the water cooler. Otherwise, management should represent our shareholder concerns. They really need some corp comm help. I repeat ….. Oy. And so I wonder why I got beaten up yesterday on this board when I suggested that MNKD mgt needed some professional PR assistance with their messaging.
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Post by babaoriley on May 21, 2015 21:16:24 GMT -5
So of the posters here, who traveled the furthest to attend the meeting?
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Post by kball on May 21, 2015 21:20:15 GMT -5
Joey, my impression today was really just the same from the soldiers and the generals at MNKD. The product is incredible, and it is just taking a while to get off the mark and get things rolling. It would seem to match the impression and conclusions of quite a few shareholders from this board as well...including me
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Post by Deleted on May 21, 2015 21:24:47 GMT -5
I try to look very long term.. Seems a lot are getting lost in the weeds.
The product is exceptional. How many besides Al Mann thought we would have seen the success the early adopters would experience? Anyone?
Every NRx is a lifetime user. Over 20 yrs, a user like Sam will spend $100,000 on Afrezza. 2000 users is $200 million. 20,000 users is $2 billion. 100,000 users (less than a few % of the RAA market is $10 billion. 1,000,000 users is $200 billion.
Spirometer and PA are early issues with process. Paradigms change processes. The kinks will get worked out and Afrezza will slowly add lifetime users.
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Post by lynn on May 21, 2015 21:59:17 GMT -5
Question for those attending today , maybe someone could create a poll ? I'm curious if or how much anyone who attended may have had their confidence shaken . From what I'm reading from you all there seems to be much disconnect between Mannkind & Sanofi ( or maybe Mannkind just can't disclose anything ) . Sorry if this is a stupid question, but no one seems that impressed , I'm more so curious if it's bc Sanofi may not be holding up their end of the partnership agreement . I've no plans to sell . The question I'm asking myself is do I still want to buy more if Sanofi isn't doing their job ./ And more so can Mannkind survive without Sanofi ? Lynn Lynn, I would suggest that a poll may not represent a very useful metric here, but individual replies to the meeting's effect on confidence level with explanations could be valuable. Speaking for myself, my confidence was slightly increased simply by virtue of getting to know the company and its personnel better (I didn't know them much at all previously, not from direct experience anyway. It's the first time I've seen any of them live.) Everything about MannKind and Afrezza seems to take longer "than it should" to happen, so why should progress at this stage of the game really be any different? Sometimes the only surprise is how I can continue to be surprised in the same way over and over again. This is the adult version of "A Series of Unfortunate Events" (um, did that one end happily? I'm not sure I want to know, lol) Ultimately, the excellence of the product has got to pull share valuation north. The only real question is, "Can I hold on long enough to benefit from that?" While the wait is neither easy nor fun, I do think I can. BD , Thanks for using your Moderator super powers to reply to my deleted post I wasn't sure if my question was appropriate & the hour window I have to decide usually compels me to delete . I've done this many times But , I'm glad you brought it back from the grave yard & am bummed I didn't get to meet you & Liane today ! One day I hope to get the chance You guys rock ! Lynn
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