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Post by agedhippie on Aug 7, 2017 21:51:06 GMT -5
Aged, the majority of patients that lose complete beta cell function is not because of genetics. Some HCP continue to perpetuate this fallacy by lumping all Type 1s together. Genetics is certainly indicated in children who lose beta cells, but they are a relatively small segment of the diabetes population as a whole. I am not sure that anyone loses all their beta cells. That was one of the interesting and accidental discoveries when they started the islet cell transplants. They found these people they were evaluating had up to around 15% of their beta cells left. The idea now is that you continue to produce them but your autoimmune system keeps killing them. They have been able to stop this cycle in mice, but never in humans (another reason to hate mice). The genetic side of Type 2 is well established. They have over 100 of the genes responsible mapped last I saw. One of the problems with Type 2, and why I think they may cure Type 1 first, is the sheer number of genetic permutations in Type 2. That genetic decline can appear steeper in combination with other aspects like diet and weight, but it is always there. Removing those external aspects can help you live within your insulin capacity - one reason gastric bypass is so successful. That capacity is still declining though and in time you likely will become diabetic again.
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Post by dreamboatcruise on Aug 7, 2017 22:20:38 GMT -5
Aged, the majority of patients that lose complete beta cell function is not because of genetics. Some HCP continue to perpetuate this fallacy by lumping all Type 1s together. Genetics is certainly indicated in children who lose beta cells, but they are a relatively small segment of the diabetes population as a whole. I am not sure that anyone loses all their beta cells. That was one of the interesting and accidental discoveries when they started the islet cell transplants. They found these people they were evaluating had up to around 15% of their beta cells left. The idea now is that you continue to produce them but your autoimmune system keeps killing them. They have been able to stop this cycle in mice, but never in humans (another reason to hate mice). The genetic side of Type 2 is well established. They have over 100 of the genes responsible mapped last I saw. One of the problems with Type 2, and why I think they may cure Type 1 first, is the sheer number of genetic permutations in Type 2. That genetic decline can appear steeper in combination with other aspects like diet and weight, but it is always there. Removing those external aspects can help you live within your insulin capacity - one reason gastric bypass is so successful. That capacity is still declining though and in time you likely will become diabetic again. Wonder if that is true of Hashimoto's Thyroditis. The way it was explained to me I'd "have a lump of scar tissue where my thyroid once was after my immune system finished its assault."
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Post by sportsrancho on Aug 8, 2017 12:50:45 GMT -5
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Post by sportsrancho on Aug 8, 2017 12:55:03 GMT -5
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Post by careful2invest on Aug 8, 2017 20:31:03 GMT -5
This graph alone, should be able to convince anyone with a rational thinking brain to possibly give AFREZZA a try...Wouldn't you think?
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Post by sportsrancho on Aug 8, 2017 20:40:45 GMT -5
This graph alone, should be able to convince anyone with a rational thinking brain to possibly give AFREZZA a try...Wouldn't you think? So true. Even though we know it. And the reps know it. It's like getting a shot in the arm. ( no pun intended:-) All the work Vdex has done. Even if they can't talk to the doctors about all of it. It's got to be confidence building. Knowing for a fact you are selling one of the best drugs on earth!
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Post by sayhey24 on Aug 8, 2017 20:46:50 GMT -5
One would hope it should be good enough to convince the FDA to give afrezza the "Near Natural" acting insulin label change. Could it really be much closer to first phase pancreatic insulin release? Probably not because monomer insulin is monomer insulin whether its coming for the natural pancreas or the "Near Natural" pocket pancreas.
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Post by letitride on Aug 8, 2017 20:56:36 GMT -5
This graph alone, should be able to convince anyone with a rational thinking brain to possibly give AFREZZA a try...Wouldn't you think?
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Post by letitride on Aug 8, 2017 21:02:48 GMT -5
It seems insurance is one of the greatest holds on afrezza.
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Post by careful2invest on Aug 8, 2017 23:10:01 GMT -5
It seems insurance is one of the greatest holds on afrezza. But even insurance has improved quite a bit, but obviously, more needs to happen on that front! We really need the new drug formularies to be AFREZZA friendly! That, with a new label etc...etc... We're going to get there! IMHO, of course... GLTA!
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Post by alethea on Aug 9, 2017 9:49:35 GMT -5
It seems insurance is one of the greatest holds on afrezza. Yes, exactly. And why do you suppose that is? Because the price is at least TWICE as much as it should be. The braintrusts at MNKD don't seem to realize that if they cut the price in half, Sales would likely go up three, four, even five-fold or more. Why not enlist the insurance companies' cooperation by significantly UNDERPRICING Novalog and Humalog? I think nearly every, single Type 1 should be using Afrezza. It IS superior to the injected insulins. As for Type 2's there is no way in Hell there will be appreciable sales at current prices. I am a quite insulin-resistant Type 2 and I would need two-and-a-half OR three boxes per month. That would cost me $12,000 to $15,000 per year. Why on God's green earth does anyone think insurance companies are going to pay $10K or more per year just for insulin for their diabetic customers? ANSWER: they will not.
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Post by thall on Aug 9, 2017 10:11:04 GMT -5
It seems insurance is one of the greatest holds on afrezza. Yes, exactly. And why do you suppose that is? Because the price is at least TWICE as much as it should be. The braintrusts at MNKD don't seem to realize that if they cut the price in half, Sales would likely go up three, four, even five-fold or more. Why not enlist the insurance companies' cooperation by significantly UNDERPRICING Novalog and Humalog? I think nearly every, single Type 1 should be using Afrezza. It IS superior to the injected insulins. As for Type 2's there is no way in Hell there will be appreciable sales at current prices. I am a quite insulin-resistant Type 2 and I would need two-and-a-half OR three boxes per month. That would cost me $12,000 to $15,000 per year. Why on God's green earth does anyone think insurance companies are going to pay $10K or more per year just for insulin for their diabetic customers? ANSWER: they will not. My impression from what some others have posted is that MNKD can't underprice Lilly or Novo since those companies negotiate package deals with pharmacy benefit managers and have huge leverage in consequence.
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Post by peppy on Aug 9, 2017 10:16:55 GMT -5
It seems insurance is one of the greatest holds on afrezza. Yes, exactly. And why do you suppose that is? Because the price is at least TWICE as much as it should be. The braintrusts at MNKD don't seem to realize that if they cut the price in half, Sales would likely go up three, four, even five-fold or more. Why not enlist the insurance companies' cooperation by significantly UNDERPRICING Novalog and Humalog? I think nearly every, single Type 1 should be using Afrezza. It IS superior to the injected insulins. As for Type 2's there is no way in Hell there will be appreciable sales at current prices. I am a quite insulin-resistant Type 2 and I would need two-and-a-half OR three boxes per month. That would cost me $12,000 to $15,000 per year. Why on God's green earth does anyone think insurance companies are going to pay $10K or more per year just for insulin for their diabetic customers? ANSWER: they will not. I have been surprised at how much insulin type two's need. Afrezza cost for them... large. Alethea, would your insurance provider approve afrezza if you were disabled?
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Post by brentie on Aug 9, 2017 10:26:18 GMT -5
Yes, exactly. And why do you suppose that is? Because the price is at least TWICE as much as it should be. The braintrusts at MNKD don't seem to realize that if they cut the price in half, Sales would likely go up three, four, even five-fold or more. Why not enlist the insurance companies' cooperation by significantly UNDERPRICING Novalog and Humalog? I think nearly every, single Type 1 should be using Afrezza. It IS superior to the injected insulins. As for Type 2's there is no way in Hell there will be appreciable sales at current prices. I am a quite insulin-resistant Type 2 and I would need two-and-a-half OR three boxes per month. That would cost me $12,000 to $15,000 per year. Why on God's green earth does anyone think insurance companies are going to pay $10K or more per year just for insulin for their diabetic customers? ANSWER: they will not. My impression from what some others have posted is that MNKD can't underprice Lilly or Novo since those companies negotiate package deals with pharmacy benefit managers and have huge leverage in consequence. What ever became of this? Hakan: We think we know how to do that. One of those is frankly we think we need to readdress the pricing strategy that Sanofi implemented. Most of you know about that. Those who go way back with we remember I used to talk about this as always being priced at parity. Ultimately Sanofi decided to price it at a significant premium. Clearly we can readdress that. I think that we'll have a great deal of impact on the sales volumes and maybe perhaps more importantly the -- our ability at reimbursement from insurance companies and so forth. seekingalpha.com/article/3809206-mannkinds-mnkd-ceo-matt-pfeffer-presents-34th-annual-jpmorgan-healthcare-conference
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Post by alethea on Aug 9, 2017 10:46:28 GMT -5
Peppy, I don't know if my insurance would cover if I were disabled. But since I am not, I'm not inclined to bother finding out. I will be going on Medicare next summer. I HOPE I can find a Supplemental policy that allows Afrezza, even on Tier 4. If I could get it for even $150 per month, I would be ecstatic! Brentie, as the Joker said to Batman, "where do you get those wonderful cat videos?" Can the cat on the motorcycle video possibly be genuine? ?
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