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Post by LosingMyBullishness on Dec 21, 2017 21:47:32 GMT -5
A low price point could imply Afrezza is an inferior product. Doctors are already hesitant to prescribe A based on ignorance and pricing it at the bottom of the rung implies inferiority, and is unnecessary. It is superior and the price should reflect that. When the STAT study results come out, the insurance companies will have no choice but to move it up to the top tier, IMHO. Mannkind just needs to get those results out sooner rather than later. Lowering the price is shooting themselves in the foot and everywhere else. STAT STUDY RESULTS ASAP! I disagree as I found your implication of cheaper with inferior outdated. Your assumptions that study results somewhere in the future will be the catalyst for something big has been refuted by the lack of impact of past study results. If endos really would have digged into unbiased studies then Afrezza would sell like sliced bread. It is the old belief that the best technology wins. Turned out that market power is far often the winner. And if you have not the power you have to great the demand by selling cheap. Let the insurance companies work for you as you can not blast the world with ads.
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Post by LosingMyBullishness on Dec 21, 2017 21:53:46 GMT -5
My guess is that Datsun made money on each car it sold even if they were relatively inexpensive cars. And they also were probably profitable in Japan so they could afford to lose money for a period of time in the USA until they got established. Japanese car manufacturers had always been following a long term strategy. They knew that if they want to make Americans buy Japanese (!) cars with all the prejudice included they have to sell better quality cheaper. Of course they made there homework of not going bankrupt. But they wanted to become a global player and they paid the price. Decent strategy that really hurt all the idiots in Detroit.
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Post by mytakeonit on Dec 22, 2017 1:54:07 GMT -5
These cheap Japanese cars are now the power cars eating up the race tracks. We saw cheap cars come in like ... Datsun ... Honda ... VW ... etc. I had a yellow 1972 Super Beetle that I bought for $2,000 new. Without really trying hard ... I could have sold it for $2500 15years later. I ended up giving it to my sister-in-law who didn't have a car.
When I graduated from high school I went to a Chevy dealer and was pricing out a Boss 302 that had a sticker of $3500. Wow ... imagine that! The sales guy gave me a hard time and told me to come back with my parents ... even though I had the cash to buy it. I had the same problem at the Audi dealer. Now, I refuse to buy anything from those two dealerships. I currently drive 2 Infinitis that has tremendous power and handling capabilities. Really great car !
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Post by hellodolly on Dec 22, 2017 6:45:50 GMT -5
My guess is that Datsun made money on each car it sold even if they were relatively inexpensive cars. And they also were probably profitable in Japan so they could afford to lose money for a period of time in the USA until they got established. Japanese car manufacturers had always been following a long term strategy. They knew that if they want to make Americans buy Japanese (!) cars with all the prejudice included they have to sell better quality cheaper. Of course they made there homework of not going bankrupt. But they wanted to become a global player and they paid the price. Decent strategy that really hurt all the idiots in Detroit. Thanks for the comments LMB. You make a point for me that is over looked by many of the comments here on the thread; this must be a long term strategy and not just some flippant short term gimmick. In the end, the PWDs deserve better priced products, even from the competition and this is how you drive competition in the marketplace (ask the bozos in Detroit).
So, I have a very modern day (right now) version of this strategy: AAXN formerly (last year) known as TASR or Taser International. So, most people here know Taser and that they manufacture and deliver electronic energy devices used by law enforcement agencies around the world. But, they patented their very own unique body cam system and X2 Taser to both capture video and have the ability to store the video. Many people had no idea that the Taser itself is a video device that simply gets plugged into a server that uploads all the content from the event. Their patented Taser devices seem to have a lock on that aspect, but the events in recent history have opened the door for several competitors to come in with their own body cams and compete against AAXN. So, very cleverly AAXN said OK. Let's step this game up and made the decision to give away their body cams for free with every reorder of their Taser device (for existing customers) and new orders for the Tasers, in order to take away dollars from their competitors who don't have the Taser's to offer. The story gets better for AAXN because they have the storage component known as EVIDENCE.COM that requires an annual subscription to store all of the media from every incident around the world involving their body cams and Taser devices. This storage gives access to anyone with a subscription to also view it, such as local prosecutors, other judiciary etc. thus, they have an annual reoccurring revenue stream.
My point, again is not that MNKD can duplicate every point-by-point aspect of either the Datsun or AAXN model, but MNKD can offer Afrezza on the cheap for a few years and then slowly raise the price. They have the damn goods (and the only company to have it) and they can find the right BP partner that will execute, they can both generate new and recurring revenue and provde the PWDs with this life changing superior drug. One more point, all of the events leading up to Afrezza's development, approval, launch and acceptance are aligned with what is happening both inside and outside the market, just as they did in the 70's for Datsun and 2000's for AAXN.
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Post by uvula on Dec 22, 2017 8:30:49 GMT -5
All of these grand ideas require lots of money. You cannot have a long term strategy if you can't fund it.
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Post by kball on Dec 22, 2017 8:38:35 GMT -5
I seem to recall the Datsun B210 back in the day. Maybe that was the vehicle?
When that 240z appeared, wow.
Datsun was also the first major company i recall that did a risky name change strategy.
And of course these were large companies with very big work forces already entrenched in home markets
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Post by hellodolly on Dec 22, 2017 10:12:40 GMT -5
All of these grand ideas require lots of money. You cannot have a long term strategy if you can't fund it. Hence my reiterations : "They have the damn goods (and the only company to have it) and they can find the right BP partner that will execute, they can both generate new and recurring revenue and provide the PWDs with this life changing superior drug."
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Post by vdexdiabetes on Dec 22, 2017 12:06:19 GMT -5
Tiberious, I agree that a lower price may help insurance companies and doctors get more interested in Afrezza but I have another concern: the drop rate. While the exact rate that patients drop the use of Afrezza is unclear, it looks to be well above 50%. If more docs prescribe, I suspect it'll go even higher. Afrezza is so unique that a doc can't simply prescribe the product and leave it to the patient. There are lots of little ways patients can screw it up. Now, that's not to say that it'll harm them if they misuse, but rather they will fail to see the advantages and drop because "it didn't work for me." We have heard this many times and it is a classic sign of misuse. Afrezza works, period. It's a fantastic tool...but it needs to be used right. As I like to say, if you give someone a shovel and they try to dig with the wrong end, it won't work well. You've got to use the tool correctly.
We've developed the metaphor of learning to ride a bike to describe the process of getting patients on Afrezza. You cannot simply give a kid a bike and let them go ride. They'll never learn, or it'll take a long time. Theres a hand-holding with the kid. After a certain point, the kid gains confidence, learns to balance on his own, and rides off never to need help again. It's the same with Afrezza. This is where there's a huge problem.
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Post by dreamboatcruise on Dec 22, 2017 12:55:36 GMT -5
vdexdiabetes... do you think the learning curve is worse for Afrezza compared to RAA, or just that clinical staff is much more familiar with RAAs as well as other sources of advice such as online diabetes forums with huge numbers of RAA users?
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Post by vdexdiabetes on Dec 22, 2017 13:34:26 GMT -5
Interesting question dreamboat. I've discussed this with some docs and they feel Afrezza has the added element of rapid on-off that RAAs paradoxically don't have, and that that makes it more difficult to learn. I don't have a strong opinion. I do think because docs fear injected insulin so much, they put a lot of time into teaching after trying to stave off the use of insulin for years.
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Post by straightly on Jan 25, 2018 7:46:48 GMT -5
So, during the gas crisis of the 70's a Japanese owned automobile manufacturing company saw an opportunity to get a foothold in the American dominated new car market. The market, dominated for decades existed essentially since the invention of the automobile, by American manufacturers. Sure there were the high end luxury cars like Ferrari, Rolls Royce and a few others but, not a car for the masses.
An American, W. Ed Deming, worked with this Japanese company who adopted and applied many of his "14 Points" of Total Quality Management, and he was considered a hero by Japanese corporations post WWII. He convinced them that they made the highest quality products anywhere in the world. In this example, the Japanese company built cheap, small, economical, fuel efficient cars and started selling them here. The moment in history of long gas lines, gas shortages, OPEC bringing this country to our knees opened the door for Datsun. They offered their cars so cheap, had competitive new car warranty's that consumers couldn't resist. Once a foothold was established, Datsun began introducing another line of cars, more expensive but who cared? Datsun was proving to be a reliable manufacturer of cars. You know the rest of the history, as Datsun became Nissan and now they sell their luxury line, known as Infiniti. Toyota adopted the same model and thus...Deming's influence had profound implications in the Japanese business culture (plus it helped that the Japanese are hard driving individuals).
So, where is the link to MNKD? While I believe that most of Deming's TQM principles (now replaced by Quality Management Principles) are hard at work at MNKD, I see this as the "exact right moment" to offer Afrezza so cheap, that it can't be ignored. Everything is in place, with insurers not too far behind. Once the Afrezza foothold and growth trajectories are attained, Rx prices can increase over time. Just as Datsun introduced cheap cars and later became a household name in America, consideration by MNKD for this strategy has a proven place in American history. There is only a very small issue of your thesis and it is called cash. Like Chineses say: Money may not accomplish everything, but no money is surely not to accomplish anything. IF there is a way for MNKD to cash flow positive, we are talking about a blockbuster stock. Only IF!
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Post by boca1girl on Jan 25, 2018 9:00:35 GMT -5
The CEO of Humana was just on CNBC (8:45am EST) talking about the new approach to health care.
He gave diabetes as an example and talked about the old silo approach to medical care. He said we need to treat the underlying disease better instead of spending so much on the complications such as neuropathy, amputations, and loss of eye sight.
He also stressed how important it was to keep customers with the same insurer for multiple years and gave that as the reason why they pulled out of the ACA.
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Post by agedhippie on Jan 25, 2018 9:34:48 GMT -5
The CEO of Humana was just on CNBC (8:45am EST) talking about the new approach to health care. He gave diabetes as an example and talked about the old silo approach to medical care. He said we need to treat the underlying disease better instead of spending so much on the complications such as neuropathy, amputations, and loss of eye sight. He also stressed how important it was to keep customers with the same insurer for multiple years and gave that as the reason why they pulled out of the ACA. The problem is that the option to remain with the same insurer is in the hands of the employer in most cases. Counter to his argument ACA is one of the few cases where it is possible to remain with the same insurer since it's not the employers call.
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Post by Deleted on Jan 25, 2018 9:37:43 GMT -5
Amazon continues to increase headcount for a potential entry into the retail pharmacy business. Would be mail order of course and there is no longer a question, they are coming and it will be disruptive. Diabetes remains the 500 lb gorilla in healthcare in terms of prevalence and cost.
BTW - Toys R Us closing another 180 stores. 9 West getting ready to file. More retail carnage in 2018 followed by weakening mall debt.
Amazon can run their PBM on much smaller margins and be happy with the $$ they will make. From what I have read, it will be on an outsourced platform.
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Post by peppy on Jan 25, 2018 9:39:32 GMT -5
The CEO of Humana was just on CNBC (8:45am EST) talking about the new approach to health care. He gave diabetes as an example and talked about the old silo approach to medical care. He said we need to treat the underlying disease better instead of spending so much on the complications such as neuropathy, amputations, and loss of eye sight. He also stressed how important it was to keep customers with the same insurer for multiple years and gave that as the reason why they pulled out of the ACA. so the man is skilled in lip service? That is why he makes the big bucks? Did he say metformin by name? oh hahahah. Humana has a pill for you!
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