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Post by dreamboatcruise on Aug 9, 2017 16:39:18 GMT -5
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Post by thall on Aug 9, 2017 18:00:43 GMT -5
The thing about the approach, as I interpret the phrase, "The manufacturer would be required to provide additional value if members do not achieve...," is that it appears to leave the manufacturer on the hook for costs associated with failures. If I were a manufacturer, I don't know that I would want that without a very clear definition of providing "additional value."
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Post by dreamboatcruise on Aug 9, 2017 18:15:17 GMT -5
The thing about the approach, as I interpret the phrase, "The manufacturer would be required to provide additional value if members do not achieve...," is that it appears to leave the manufacturer on the hook for costs associated with failures. If I were a manufacturer, I don't know that I would want that without a very clear definition of providing "additional value." Gotta take risks. I'd love to see MNKD and One Drop sign up for some sort of trial with CVS for outcome based management. For instance, if Afrezza truly can avoid hypos as we believe it does, why not sign up for scheme whereby we win if it's true and lose if it is not. Would MNKD be willing to? Would CVS offer it? I actually sent them an inquiry using the link provided to ask if they are considering outcome based management for diabetes. I'll post if I get a reply. |
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Post by sayhey24 on Aug 9, 2017 19:23:45 GMT -5
Great post - I followed your lead and sent them an inquiry also. I will be shocked if we get a meaningful reply but you never know. If VDex is correct and as we know 70%+ of T2s are not meeting a 7.0 A1c a goal of 50% meeting 7.0 should be a no-brainer and no risk.
Buffett has an insurance company called AllLife businessinsider.com/hiv-insurer-alllife-launches-diabetes-product-in-britain-with-royal-london-2017-4 This is a potential model One Drop/MNKD could follow for outcome results. However, why not go directly to the Big Dog and see if he wants to play in the U.S. I suspect my one letter will get thrown in the trash but a couple hundred saying afrezza is a paradymn shift in diabetes treatment and if properly capitalized and marketed will transform how diabetes is treated might get someones attention. A hand written letter to
Berkshire Hathaway Inc. 3555 Farnam Street Suite 1440 Omaha, NE 68131 sometimes but not often gets a response.
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Post by radgray68 on Aug 9, 2017 19:48:49 GMT -5
The thing about the approach, as I interpret the phrase, "The manufacturer would be required to provide additional value if members do not achieve...," is that it appears to leave the manufacturer on the hook for costs associated with failures. If I were a manufacturer, I don't know that I would want that without a very clear definition of providing "additional value." Gotta take risks. I'd love to see MNKD and One Drop sign up for some sort of trial with CVS for outcome based management. For instance, if Afrezza truly can avoid hypos as we believe it does, why not sign up for scheme whereby we win if it's true and lose if it is not. Would MNKD be willing to? Would CVS offer it? I actually sent them an inquiry using the link provided to ask if they are considering outcome based management for diabetes. I'll post if I get a reply. To that end, I sent an inquiry to Mannkind a while back to ask about the possibility of a trial with Afrezza as a monotherapy for newly diagnosed T2's. I want to see how Afrezza does without all the other oral medications and basal injections. The prior trials, although showing reduce hypos, did not give Afrezza the chance to fully demonstrate its best attribute, no hypos. I never received a reply. If you have a patient low on oxygen, you don't give them smoke, steam or an oxygen-like particle. You give them oxygen. I hope I'm not the only one who thinks insulin should be replaced by insulin. |
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Post by sayhey24 on Aug 9, 2017 20:07:31 GMT -5
Gotta take risks. I'd love to see MNKD and One Drop sign up for some sort of trial with CVS for outcome based management. For instance, if Afrezza truly can avoid hypos as we believe it does, why not sign up for scheme whereby we win if it's true and lose if it is not. Would MNKD be willing to? Would CVS offer it? I actually sent them an inquiry using the link provided to ask if they are considering outcome based management for diabetes. I'll post if I get a reply. To that end, I sent an inquiry to Mannkind a while back to ask about the possibility of a trial with Afrezza as a monotherapy for newly diagnosed T2's. I want to see how Afrezza does without all the other oral medications and basal injections. The prior trials, although showing reduce hypos, did not give Afrezza the chance to fully demonstrate its best attribute, no hypos. I never received a reply. If you have a patient low on oxygen, you don't give them smoke, steam or an oxygen-like particle. You give them oxygen. I hope I'm not the only one who thinks insulin should be replaced by insulin. Insulin should be replaced by insulin, I may need to steal that line. I have so many studies on why T2s should be treated first with insulin one is from the early days of Orinase. However, none of these studies had a great near-natural insulin like afrezza and yet they all said insulin first. Now, if you define a hypo as <70 you will get some but <49 probably not many as long as the liver is healthy and they are not taking other drugs like metformin. |
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Post by thall on Aug 10, 2017 10:03:10 GMT -5
Gotta take risks. I'd love to see MNKD and One Drop sign up for some sort of trial with CVS for outcome based management. For instance, if Afrezza truly can avoid hypos as we believe it does, why not sign up for scheme whereby we win if it's true and lose if it is not. Would MNKD be willing to? Would CVS offer it? I actually sent them an inquiry using the link provided to ask if they are considering outcome based management for diabetes. I'll post if I get a reply. To that end, I sent an inquiry to Mannkind a while back to ask about the possibility of a trial with Afrezza as a monotherapy for newly diagnosed T2's. I want to see how Afrezza does without all the other oral medications and basal injections. The prior trials, although showing reduce hypos, did not give Afrezza the chance to fully demonstrate its best attribute, no hypos. I never received a reply. If you have a patient low on oxygen, you don't give them smoke, steam or an oxygen-like particle. You give them oxygen. I hope I'm not the only one who thinks insulin should be replaced by insulin. In type 2s you wouldn't be replacing insulin with insulin; you would be augmenting insulin with insulin. Type 2s are already hyperinsulinemic; they suffer from insulin resistance. |
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Post by radgray68 on Aug 10, 2017 13:00:46 GMT -5
To that end, I sent an inquiry to Mannkind a while back to ask about the possibility of a trial with Afrezza as a monotherapy for newly diagnosed T2's. I want to see how Afrezza does without all the other oral medications and basal injections. The prior trials, although showing reduce hypos, did not give Afrezza the chance to fully demonstrate its best attribute, no hypos. I never received a reply. If you have a patient low on oxygen, you don't give them smoke, steam or an oxygen-like particle. You give them oxygen. I hope I'm not the only one who thinks insulin should be replaced by insulin. In type 2s you wouldn't be replacing insulin with insulin; you would be augmenting insulin with insulin. Type 2s are already hyperinsulinemic; they suffer from insulin resistance. Perhaps I should have worded it to say something like replacing a lack of insulin with insulin? Whatever the choice of words, early T2's are unable to handle the mealtime spikes in blood sugar. Whether all are hyperinsulinemic as you say is not my point. Al believed that mealtime supplementation should be the first line of defense against the disease. The body seems to like it better than metformin and the like. I'm also for changing the packaging from 4,8,and 12 to "Small" "Medium" and "Large" mealtime doses for patients to more easily accept the dosing. With regard to your statement "they suffer from insulin resistance" Are you referring to all patients? And, if so, have all these patients already had their bodies poisoned by the current "step" therapy that forces the use of several combinations of pills first. And, is this insulin resistance before or after taking all that other crap? I just want to see a study with Afrezza used at mealtime only, just like the pancreas does it. |
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Post by sophie on Aug 10, 2017 13:23:59 GMT -5
In type 2s you wouldn't be replacing insulin with insulin; you would be augmenting insulin with insulin. Type 2s are already hyperinsulinemic; they suffer from insulin resistance. Perhaps I should have worded it to say something like replacing a lack of insulin with insulin? Whatever the choice of words, early T2's are unable to handle the mealtime spikes in blood sugar. Whether all are hyperinsulinemic as you say is not my point. Al believed that mealtime supplementation should be the first line of defense against the disease. The body seems to like it better than metformin and the like. I'm also for changing the packaging from 4,8,and 12 to "Small" "Medium" and "Large" mealtime doses for patients to more easily accept the dosing. With regard to your statement "they suffer from insulin resistance" Are you referring to all patients? And, if so, have all these patients already had their bodies poisoned by the current "step" therapy that forces the use of several combinations of pills first. And, is this insulin resistance before or after taking all that other crap? I just want to see a study with Afrezza used at mealtime only, just like the pancreas does it. Type 2 diabetes is a metabolic disease, not an autoimmune disease like type 1. With type 1 diabetes, one's immune system attacks the pancreas to destroy the insulin-secreting beta cells until there are too few to support life. They need exogenous (outside) insulin. Type 2 diabetes doesn't start out as being insulin deficient. As thall was saying, the disease process (for all) actually starts out with insulin resistance, causing the hardwiring of the pancreas to go into overdrive to fix the high blood sugar. Eventually, the cells in the pancreas burn out as they become overworked. At that point, they lose the ability to secrete insulin. Insulin resistance is the inability for predominantly fat and muscle tissue in the body to absorb insulin. The effects of not absorbing insulin is that there is no way for glucose to enter into those cells, leaving it in the blood. The pancreas doesn't need insulin receptors... it produces it... so it is, in effect, "blind" to the body's insulin levels. The main job of the pancreas is to regulate glucose levels, so it has plenty of glucose receptors on it. So even though the pancreas did its job, it doesn't know that the reason the body is high in glucose is a problem with other organ systems, so it works harder to compensate for where the other tissues have failed. mnholdem has provided studies that show early insulin intervention delays beginning stages of the disease. The current recommendation is a change in diet and exercise. Exercise reduces insulin resistance in the tissues and diet lowers the amount of glucose that is being consumed. However, it was likely one's lifestyle that led them to their disease. Asking them to change their habits when they could pop a pill and achieve moderate results is unfortunately the path many have chosen to go. |
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Post by radgray68 on Aug 10, 2017 13:49:22 GMT -5
"However, it was likely one's lifestyle that led them to their disease. Asking them to change their habits when they could pop a pill and achieve moderate results is unfortunately the path many have chosen to go."
I guess the capitalist in me is alright with people continuing their lifestyle as long as they "augment" their insulin at mealtimes with Afrezza. So, what kind of trials do we need to do to be able to say "Eat what you want, when you want with Afrezza, the only medicine most type 2's need. The hope is to eventually become the first and the only therapy on that CVS formulary. Probably would take like a decade and several large, expensive studies to accomplish all that.
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