Post by mindovermatter on Oct 10, 2015 12:50:01 GMT -5
Like many, I have been a reader of the board and not one to post. This will be my only post here but I wanted to relay a conversation I had with someone familiar with biotech sector as she is an MD, PhD and MBA who now is doing research at the University setting. She has worked with another biotech during a drug launch and has experience while a deal with a major pharma was being negotiated. She wasn't a key figure but has first hand experience with how the process goes.
She is aware of Mannkind and with Afrezza. This is her opinion on what she thinks is happening. Most is what many of you already know.
- Mannkind and Sanofi knew full well that the roll out of Afrezza was going to take time and would be a slow roll out. She doesn't follow the company close enough to know that its been slower than expected per Mannkind's admission.
- Mannkind most likely chose Sanofi because Sanofi not only assured them they would be there for the long haul but that they had the resources to weather the storm. Evidence of that is clearly the $175 Million loan facility -i told her about the loan facility- knowing that Afrezza wouldn't move quickly at first and wouldn't for at least a few years. That in itself should be proof that Sanofi isn't going to abandon the drug anytime soon assuming the drug showed good results and that initial patient retention was strong.
- She doesn't know if Afrezza will be successful but she does know that it's a revolutionary drug and a paradigm shift from current treatment. Because of this, doctors and insurance companies will rightfully be slow to adopt so don't expect to see any huge gains in prescriptions until end of 2016 at the earliest by her account. She told that new drugs typically take a few years for insurance and especially doctors to get comfortable with. Doctors are bombarded with new treatments and that change is hard for them especially if they have patients doing well on current treatments.
-Afrezza is challenging already existing billion dollar franchises. As she stated, this is a 12 round fight and Afrezza is not going to knock out other insulins in the 1st 2nd or even 8th round. Odds are not in Afrezza's favor right now. She stated that it doesn't mean Afrezza is doomed but you need an 800 lb guerilla (Sanofi) to be in the ring with you. Again, why Mannkind partnered with Sanofi. Interesting, she also opined that she thought Sanofi was always the partner in the shadows as other pharmas with existing fast acting insulin would have no interest in Afrezza as it would cannibalize their existing cash cows.
-Afrezza would be hampered by its label. Again, something many of you already know. Doctors who have to take a lot of time to write a prescription is a recipe for disaster and Afrezza isn't the easiest script to write due to the lung function requirement. It's not just the FEV1 test but that she believes many doctors will have a hard time without knowing the long term consequences of inhaling insulin. I asked her her belief and she believes it is safe and that the FDA, as is the case, is erring on the side of safety due to past safety concerns/scandals it has endured. She said in the end it hurts patients because what is never written is that there were many more that were helped by a drug than the few who were hurt by it. No drug is going to be 100% safe and without any side effects.
-Metformin. Cheap and many doctors, like muscle memory, go to it for first line of therapy in type 2. Hard to compete with a cheap pill.
-She believes that Afrezza will ultimately have more success outside the United States because of how medicine is dispensed in socialized health. But that will impact how successful Afrezza is revenue wise. If Sanofi believes Afrezza can become a monopoly in the fast acting parandial insulin market by displacing needle based insulin, better to be a monopoly with lower margins than having nothing at all. She believes that Health ministries could make Afrezza the insulin of choice assuming they see the benefits of Afrezza with increased compliance that lowers over all cost of care for diabetics. If the data supports what we are initially seeing, Sanofi has the ability politically to get health ministries to make the move to Afrezza as the first line of care. In regards to the US, she isn't so sure Afrezza will become a leader due to how drugs are marketed and sold here. She said it will ultimately come down to whether or not Doctors become comfortable prescribing an insulin that is absorbed in the lungs after decades of being comfortable with needle based delivery.
My apologies for being long winded. Her take away is that Afrezza is going to take time to get an audience. Outside of a buyout, don't expect much from the stock. It's a marathon and not a sprint.
As for me, I own shares and have family members who are diabetics thus explaining my interest in the stock. And like many of you, I am underwater.
She is aware of Mannkind and with Afrezza. This is her opinion on what she thinks is happening. Most is what many of you already know.
- Mannkind and Sanofi knew full well that the roll out of Afrezza was going to take time and would be a slow roll out. She doesn't follow the company close enough to know that its been slower than expected per Mannkind's admission.
- Mannkind most likely chose Sanofi because Sanofi not only assured them they would be there for the long haul but that they had the resources to weather the storm. Evidence of that is clearly the $175 Million loan facility -i told her about the loan facility- knowing that Afrezza wouldn't move quickly at first and wouldn't for at least a few years. That in itself should be proof that Sanofi isn't going to abandon the drug anytime soon assuming the drug showed good results and that initial patient retention was strong.
- She doesn't know if Afrezza will be successful but she does know that it's a revolutionary drug and a paradigm shift from current treatment. Because of this, doctors and insurance companies will rightfully be slow to adopt so don't expect to see any huge gains in prescriptions until end of 2016 at the earliest by her account. She told that new drugs typically take a few years for insurance and especially doctors to get comfortable with. Doctors are bombarded with new treatments and that change is hard for them especially if they have patients doing well on current treatments.
-Afrezza is challenging already existing billion dollar franchises. As she stated, this is a 12 round fight and Afrezza is not going to knock out other insulins in the 1st 2nd or even 8th round. Odds are not in Afrezza's favor right now. She stated that it doesn't mean Afrezza is doomed but you need an 800 lb guerilla (Sanofi) to be in the ring with you. Again, why Mannkind partnered with Sanofi. Interesting, she also opined that she thought Sanofi was always the partner in the shadows as other pharmas with existing fast acting insulin would have no interest in Afrezza as it would cannibalize their existing cash cows.
-Afrezza would be hampered by its label. Again, something many of you already know. Doctors who have to take a lot of time to write a prescription is a recipe for disaster and Afrezza isn't the easiest script to write due to the lung function requirement. It's not just the FEV1 test but that she believes many doctors will have a hard time without knowing the long term consequences of inhaling insulin. I asked her her belief and she believes it is safe and that the FDA, as is the case, is erring on the side of safety due to past safety concerns/scandals it has endured. She said in the end it hurts patients because what is never written is that there were many more that were helped by a drug than the few who were hurt by it. No drug is going to be 100% safe and without any side effects.
-Metformin. Cheap and many doctors, like muscle memory, go to it for first line of therapy in type 2. Hard to compete with a cheap pill.
-She believes that Afrezza will ultimately have more success outside the United States because of how medicine is dispensed in socialized health. But that will impact how successful Afrezza is revenue wise. If Sanofi believes Afrezza can become a monopoly in the fast acting parandial insulin market by displacing needle based insulin, better to be a monopoly with lower margins than having nothing at all. She believes that Health ministries could make Afrezza the insulin of choice assuming they see the benefits of Afrezza with increased compliance that lowers over all cost of care for diabetics. If the data supports what we are initially seeing, Sanofi has the ability politically to get health ministries to make the move to Afrezza as the first line of care. In regards to the US, she isn't so sure Afrezza will become a leader due to how drugs are marketed and sold here. She said it will ultimately come down to whether or not Doctors become comfortable prescribing an insulin that is absorbed in the lungs after decades of being comfortable with needle based delivery.
My apologies for being long winded. Her take away is that Afrezza is going to take time to get an audience. Outside of a buyout, don't expect much from the stock. It's a marathon and not a sprint.
As for me, I own shares and have family members who are diabetics thus explaining my interest in the stock. And like many of you, I am underwater.
