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Post by dreamboatcruise on May 10, 2018 13:56:16 GMT -5
mango... I know all the ways Afrezza it IS and ISN'T the same as a pancreas. I've probably researched insulin physiology in more depth than anything other than my own dissertation topic. I am not creating deception. Some people manage to have very good results with RAAs... it basically requires eating to match the profile of the insulin. And if you actually READ what I say I mention "weight gain" as a likely result if trying to optimize TIR for RAA. If one has a CGM, which this study uses, more agressive dosing of RAAs can be done if one is willing to keep on top of the CGM and do defensive eating to avoid hypos. Bottom line, Afrezza isn't a working pancreas, but I'd certainly rather use it if I ever need mealtime insulin. Hence why I've made a huge financial bet on Mannkind. You are paranoid by the way.
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Post by agedhippie on May 10, 2018 14:51:12 GMT -5
mango ... I know all the ways Afrezza it IS and ISN'T the same as a pancreas. I've probably researched insulin physiology in more depth than anything other than my own dissertation topic. I am not creating deception. Some people manage to have very good results with RAAs... it basically requires eating to match the profile of the insulin. And if you actually READ what I say I mention "weight gain" as a likely result if trying to optimize TIR for RAA. If one has a CGM, which this study uses, more agressive dosing of RAAs can be done if one is willing to keep on top of the CGM and do defensive eating to avoid hypos.Bottom line, Afrezza isn't a working pancreas, but I'd certainly rather use it if I ever need mealtime insulin. Hence why I've made a huge financial bet on Mannkind. That bolded section needs a bit of explanation. The practical aspect of using a CGM is twofold; you can see the direction of trend when you are about to dose, and the CGM will alert you before a trend accelerates. As an example, when I use a CGM if I am trending down before a meal then when I will round the number of units down, if I am trending up I will round the number of units up. If you you use a meter then you lack the trend data and it's a lottery. The other thing you do is set guardrails so if you start to drop you get a warning before you go low and can avoid a hypo (or high level)
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Post by joeypotsandpans on May 10, 2018 14:54:57 GMT -5
This isn't about contests between individual's and their "track records", this is about real life reality regarding people's lives. This isn't about day trader's and investments, this is about saving people's limbs, kidney's, eyes, hearts, and having a better way of life with one's family, etc. Having said that there is a 30 million share debt out there that still has to be paid, you can believe it will happen through dilution as he keeps professing, the fact is it hasn't happened yet and could have happened at close to minimal cost for almost a 100% gain. Regarding Matt's statement about the COGS, again what price is one willing to pay to extend their lives, limbs, and organs when there is a viable option that is proven to be superior, maybe not via current "labels" saddled by corrupt former administrators but by the eye test "label" when reading CGM's, etc. Sure there are those that are not fortunate enough to pay out of pocket or have coverage at this time but as the message gets out via studies like the STAT study it could help change some of the dynamics for those people as well. That is why the ignorant statement from him about the lack of effect of the STAT study is so absurd and quite frankly stupid. The "MNKD choir" are not just made up of traders and investors, it is also made up of users that take offense to those that continue to pound on a company and it's executives that are out there fighting everyday to help people. Take off your monetary glasses, it's not always about the money Dennis, Matt, Spencer, etc etc, take if from someone that is afflicted by the disease and has experienced the difference in a relatively very short period of time. So far people have not paid the price of Afrezza, not has the general community of Endocronologists have joined the bandwagon yet. Yes I look at this as an investment, I would invest long term in MNKD if it would go through a chapter 11 reorganization and get rid of the the toxic balance sheet items. Until then this is a bad investment. How can they pay the price when 98% of the PWD population still aren't aware of it? As for the Endo's that haven't joined the bandwagon yet, MC: We believe the complete dataset when you look at the hypoglycemia plus STAT plus the history of the safety and efficacy of this product across the 65 trials, we start to educate the physicians on all the data we have, and they're very responsive." (again, why the STAT combined with the superiority regarding hypo's along with the rest of what MC states carries much more weight than what the ignorant one thinks). Speaking of the ignorant one, he makes it too easy to dismiss his take, in his own words: Investing in MNKD is not about "helping diabetics". In fact, most shares people buy are not funding the company, but instead funding the pockets of the investor that sold the stock. If someone thinks they are "helping diabetics" by buying the stock, not selling the stock, or holding the stock, they are unfortunately misguided.
Oh ok, guess when the company sells "at the market" if doesn't help them and it isn't funding the company? Your own words and inference/thesis is that is going to be a funding vehicle for them going forward to deal with cash needs. Obviously those shares are getting "soaked up"
Dilution has been happening. After the reverse split there were 95 million shares outstanding. Today that number is 140 million... yes, and the short position remains close to record levels. Savvy investors grasp the rules of the game on the street. If you want to invest with some form of "moral compass", that is fine...As long as you grasp that the bulk of investors do not use a moral compass with regard to their investment. Investing with a moral compass puts you at a disadvantage against the masses that do not share your belief or have less convection about it as you.
Your opinion, and fyi there are many institutional funds that invest with "moral compass" and therefore never would invest in tobacco companies, companies revolving around the porn industry, gaming, spirits, etc. and on the contrary would invest in a company that can be a disrupter in a space that will absolutely save limbs, organs, and lives and have enjoyed great success in doing so.
Whatever you, me, or anyone feels about Afrezza does not matter from an investment standpoint. The drama of "saving lives limbs and organs is just that....drama. If someone want to "help", then perhaps they should consider selling their shares, and simply taking that money and cutting a check to MannKind so they can spend that money spreading the word. Somehow I highly doubt these "moral investors" would do that.
Again drama to you but quality of life for others and you can believe that there is a contingent of investors that are users and believers in the product, and they are buying the shares that are sold from the company into the market, so indirectly they are "cutting their checks" to MNKD
My statement about the STAT trial is based on what it means to the equity. As I stated, it is a small trial that will deliver predictable results. I am not saying the results are bad. I am simply saying that they will not move the needle on the equity by much.
10 May 2018, 02:25 PWhat it means to the equity is directly a result of what it means to the providers, insurers, PBM's and obviously one very prominent KOL is presenting with that in mind, you can think he joined the company for sh*ts and giggles and some type of masquerade only to make a "not so meaningful difference with his presentation" but most logical unbiased minds would have to question your line of "thinking"
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Post by rockstarrick on May 10, 2018 14:55:49 GMT -5
The latest this am. deadaim Comments (1881) |+ Follow |Send Message | Mike Castagna.. "...we had an ADA late-breaking poster accepted around hypoglycemia and really demonstrating the differences of Afrezza versus other meal time insulin options. We believe the complete dataset when you look at the hypoglycemia plus STAT plus the history of the safety and efficacy of this product across the 65 trials, we start to educate the physicians on all the data we have, and they're very responsive." Great Innovation and science always wins!
10 May 2018, 09:12 AM Report Abuse Reply1Like Spencer Osborne, Contributor Comments (14436) |+ Follow |Send Message | Author’s reply » Deadaim.... The weight that people are placing on the STAT trial is misguided in my opinion. It is a very small and simple trial that has very predictable results.... simply by looking at the design.
If you adjust after your meal, you will be in range more often. It is really that simple. Investors keying in on this is reminiscent of investors keying in on the label change. Umm, DUH!! The fact that THIS INSULIN allows you to adjust after your meal to maintain better control and time in range with much reduced incident of hypo IS THE DIFFERENCE and the point of the STAT study. If they did that with the current Raa's they may have killed some folks along the way. Maybe that is what is needed to drill it into some people's gray matter, as the thread is titled "you can't fix stupid" ....let's compare Kendall or Osborne, nevermind I wouldn't even disrespect Kendall in that manner. Go ahead pigeon's fly this one over to your ignorant friend, maybe he wants to risk doing a controlled study stacking Raa's vs. Afrezza post dosing, better have some paramedics around, and again if you're going to quote me please quote the entire post, not selected segments. Thank you -J Tell him to give stacking a try after almost every meal with the other RAA’s, then write about his experience.
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Post by agedhippie on May 10, 2018 14:58:49 GMT -5
Umm, DUH!! The fact that THIS INSULIN allows you to adjust after your meal to maintain better control and time in range with much reduced incident of hypo IS THE DIFFERENCE and the point of the STAT study. If they did that with the current Raa's they may have killed some folks along the way. Maybe that is what is needed to drill it into some people's gray matter, as the thread is titled "you can't fix stupid" Just to be clear. If you are using RAA your endo will explicitly tell you to routinely check and correct 2 hours after the meal. In practice almost nobody ever does that second test, not because of fear but rather because they cannot be bothered. There is an exception for somethings like pizza where you absolutely know you need to bolus later - pumps have a built in function to do this automatically. And no, nobody gets kill so I can put your mind at rest.
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Post by joeypotsandpans on May 10, 2018 15:04:00 GMT -5
The latest this am. deadaim Comments (1881) |+ Follow |Send Message | Mike Castagna.. "...we had an ADA late-breaking poster accepted around hypoglycemia and really demonstrating the differences of Afrezza versus other meal time insulin options. We believe the complete dataset when you look at the hypoglycemia plus STAT plus the history of the safety and efficacy of this product across the 65 trials, we start to educate the physicians on all the data we have, and they're very responsive." Great Innovation and science always wins!
10 May 2018, 09:12 AM Report Abuse Reply1Like Spencer Osborne, Contributor Comments (14436) |+ Follow |Send Message | Author’s reply » Deadaim.... The weight that people are placing on the STAT trial is misguided in my opinion. It is a very small and simple trial that has very predictable results.... simply by looking at the design.
If you adjust after your meal, you will be in range more often. It is really that simple. Investors keying in on this is reminiscent of investors keying in on the label change. Umm, DUH!! The fact that THIS INSULIN allows you to adjust after your meal to maintain better control and time in range with much reduced incident of hypo IS THE DIFFERENCE and the point of the STAT study. If they did that with the current Raa's they may have killed some folks along the way. Maybe that is what is needed to drill it into some people's gray matter, as the thread is titled "you can't fix stupid" ....let's compare Kendall or Osborne, nevermind I wouldn't even disrespect Kendall in that manner. Go ahead pigeon's fly this one over to your ignorant friend, maybe he wants to risk doing a controlled study stacking Raa's vs. Afrezza post dosing, better have some paramedics around, and again if you're going to quote me please quote the entire post, not selected segments. Thank you -J Tell him to give stacking a try after almost every meal with the other RAA’s, then write about his experience. He would have to understand what stacking is first , the only stacking he understands is stacking articles centered around one company, only recently has he really started any real meaningful mix of articles surrounding other companies....and Dennis I would preach to the "SA choir" if allowed but we know what that situation is don't we
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Post by rockstarrick on May 10, 2018 15:21:40 GMT -5
For the most part, to me anyway, the difference in the way PWD make corrections when using one or the other products, (Afrezza vs RAA’s), is,,,
Using RAA’s, PWD tend to lean towards the “defensive eating” that dbc speaks of, or eat more carbs to prevent going too low. And when using Afrezza, they use more Insulin, (product), to prevent going too high.
If I had to choose, I would definitely choose Afrezza to avoid the weight gain associated with trying to keep tight glucose control using RAA’s.
How this feature of the ability to use more product prevent highs vs eat more carbs to prevent lows doesn’t prove superiority is beyond me !!
It just seems obvious,, There are certain people that are either playing dumb, or just plain stupid. Just my opinion.
✌🏻
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Post by dreamboatcruise on May 10, 2018 15:31:32 GMT -5
joeypotsandpans... the ignorant one as you call him was skeptical about the label change impact. On the call management admitted that they overestimated the impact of the label change. So the person that got it right is ignorant and the one that got it wrong is brilliant? As I posted earlier I think that he is missing the point of STAT a little, but I also think you are far too critical of someone that in general presents pretty reasoned commentary. No one has a crystal ball about the behavior of doctors, as witnessed by management's self confessed mistake on label change. It may end up that SO's assessment of impact of STAT is off the mark now, but even if that comes to pass I'd put it in the same category as management's mistake on label... i.e. can't read the collective minds of doctors. I'm humble enough that I realize I'm only guessing at what impact I think the STAT study will have, as I was only guessing on label.
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Post by dreamboatcruise on May 10, 2018 15:40:06 GMT -5
For the most part, to me anyway, the difference in the way PWD make corrections when using one or the other products, (Afrezza vs RAA’s), is,,, Using RAA’s, PWD tend to lean towards the “defensive eating” that dbc speaks of, or eat more carbs to prevent going too low. And when using Afrezza, they use more Insulin, (product), to prevent going too high. If I had to choose, I would definitely choose Afrezza to avoid the weight gain associated with trying to keep tight glucose control using RAA’s. How this feature of the ability to use more product prevent highs vs eat more carbs to prevent lows doesn’t prove superiority is beyond me !! It just seems obvious,, There are certain people that are either playing dumb, or just plain stupid. Just my opinion. ✌🏻 In addition to defensive eating eating between meals to counter the RAA tail, I think the other approach that can work with RAAs is to maintain a very low carb diet so that not much prandial is actually needed because of not needing to suppress a carb induced spike... but for many that is simply an unacceptable lifestyle. If they do the trials to show what you and I are speculating on, then that will prove superiority. Just need to have trials with proper dosing regimen. With the one caveat that it seems impossible to optimally dose Afrezza in a double blind trial.
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Post by cedafuntennis on May 10, 2018 16:13:35 GMT -5
Spencer is strictly a numbers guy. He does NOT understand the science but at times he claims he does. That in my opinion greatly diminishes the accuracy (so far) of his forecasts as he shows ignorance and bias.
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Post by dreamboatcruise on May 10, 2018 16:27:03 GMT -5
Spencer is strictly a numbers guy. He does NOT understand the science but at times he claims he does. That in my opinion greatly diminishes the accuracy (so far) of his forecasts as he shows ignorance and bias. Script growth has been lower than his forecast models (so far). If he understood the science he would have projected slower growth? That doesn't make sense.
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Post by sweedee79 on May 10, 2018 16:42:44 GMT -5
Afrezza is better .. when dad was on Afrezza everything was better..
He lost weight.. had more energy.. blood pressure was lower.. as were his numbers..
No one can convince me that sub q is even close to Afrezza when it was obvious that my dad's body was functioning in a much healthier state while on Afrezza..
Endos need to get with it.. They aren't doing a service to PWD by ignoring the benefits of this amazing insulin.
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Post by lennymnkd on May 10, 2018 16:46:34 GMT -5
To whom it may concern ! 😀 if afrezza Gains traction in the foreign markets it a big way , will there be consequences to the medical and healthcare industry in America, will that be the story told by ( 60 MINUTES) that we have been waiting for ?
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Post by dreamboatcruise on May 10, 2018 16:50:27 GMT -5
Afrezza is better .. when dad was on Afrezza everything was better.. He lost weight.. had more energy.. blood pressure was lower.. as were his numbers.. No one can convince me that sub q is even close to Afrezza when it was obvious that my dad's body was functioning in a much healthier state while on Afrezza.. Endos need to get with it.. They aren't doing a service to PWD by ignoring the benefits of this amazing insulin. If only MNKD had been sitting on a few hundred million to really push trials to show these results. It will come eventually, but because of financial situation it's a slow tough climb. STAT will hopefully be useful but it isn't large/long enough to show the likely cardiovascular benefits of tight TIR. I think some docs will inherently believe in benefits from good TIR... but some likely not, and payers may play dumb until consensus forces them to do otherwise.
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Post by agedhippie on May 10, 2018 17:21:26 GMT -5
That is an interesting suggestion and goes to a wider problem. First, stacking is not an issue provided you do it properly. Stacking is a problem if you just blindly bolus without accounting for insulin onboard, and that is the case with any insulin. Second you are told to check and correct after two hours which means stacking RAA. The reason people don't do that is not because they are scared of stacking insulin, it's because they cannot be bothered to disrupt whatever they are doing to test and correct. Meters even have alarms built into them to remind you to test (nobody enables the alarms...) Right now you are seeing CGM shots from people who are using Afrezza properly. What happens when you start getting broader uptake and the patients cannot be bothered to disrupt whatever they are doing to take the follow up dose? Is the fact that they don't get the results you expect their fault or Afrezza? If it is their fault then why isn't it their fault when they do that with RAA?
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