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Post by matt on Aug 2, 2018 7:17:16 GMT -5
What's wrong? It's not your business. Dexcom is a device manufacturer, not a venture capital company. That is a very important distinction. While CGM devices are used by diabetics, the device world is entirely, completely different from pharmaceutical manufacturing. It operates under a different regulatory structure that creates a rapid path to market, product life cycles are shorter, manufacturing is a different beast, and so on. Ultimately a device company is in business to sell devices; they don't play favorites when it comes to therapeutics. Glucose monitoring is their business and they really don't care if the user they sell to is using Mannkind product, Lilly product, or Novo Nordisk product just so long as they are buying the device from DexCom. At the end of the day, the market will dictate the winners and losers and DexCom will likely be one of the winners, at least in the short term. Unlike pharmaceuticals, there really is no long term in the device sector for products that are eligible for 510(k) registration.
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Post by kbrion77 on Aug 2, 2018 7:27:42 GMT -5
Unreal I should have went with my gut and loaded up last October when they got crushed.
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Post by kite on Aug 2, 2018 7:46:31 GMT -5
Unreal I should have went with my gut and loaded up last October when they got crushed. MNKD is kinda getting crushed now and probably a good time to load up too
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Post by Deleted on Aug 2, 2018 9:32:19 GMT -5
What's wrong? It's not your business. Dexcom is a device manufacturer, not a venture capital company. That is a very important distinction. While CGM devices are used by diabetics, the device world is entirely, completely different from pharmaceutical manufacturing. It operates under a different regulatory structure that creates a rapid path to market, product life cycles are shorter, manufacturing is a different beast, and so on. Ultimately a device company is in business to sell devices; they don't play favorites when it comes to therapeutics. Glucose monitoring is their business and they really don't care if the user they sell to is using Mannkind product, Lilly product, or Novo Nordisk product just so long as they are buying the device from DexCom. At the end of the day, the market will dictate the winners and losers and DexCom will likely be one of the winners, at least in the short term. Unlike pharmaceuticals, there really is no long term in the device sector for products that are eligible for 510(k) registration. What will be interesting as we move forward into the world of fee for outcomes vs the current fee for service is how the money gets allocated. Right now, MDT has a fee for outcome trial going on with their 670 pump. To repeat ad nauseam, MDT diabetes is minimed which is the company Al Mann started and ultimately sold to MDT for around $4B. In addition to Kevin Sayer, Terry Gregg and a whole slew of other senior DXCM people worked for Al. So back to how in the future, the $$ gets divided amongst the players providing direct and indirect care to patients in the fee for outcomes world. DXCM has the relationship with Verily (Google) and from what I understand, Dex will get the first Billion of revenue which to me means there is a seriously big pile of money waiting for Verily to warehouse, analyze and share data with payors, providers and of course, patients. Given how our world is changing, business as usual is no more so I do wonder what kinds of alliances we see in the future that we could not have imagined in the past or even today. Side note, lots more $$ flowing into development of continuous glucose monitoring tech. Diabetes, given its prevalence and associated costs has the potential to bankrupt the US healthcare system so by default, it will get even more attention in the future. Side note 2, while I have not been happy lately with my investment, I do understand that if a company has a product that is easy to use and controls blood glucose levels much better than any other competitive product, it should have enormous value and like Dr. David K said in the NYC presentation, nothing over the last decade or so has providing meaningful improvement in control of BG levels except for one product.
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Post by joeypotsandpans on Aug 2, 2018 10:08:02 GMT -5
Kevin said something similar in an interview at ADA2015. I was looking for the interview but can't find it. The big market for Dexcom is of course the T2s. Medicare, if I remember correctly, limits CGM payments to "injected insulin" only. For those conspiracy theory deniers the word "injected" was intentionally put in the coverage. The big market for MNKD are the early T2s. Dr. Kendall needs to get the T2 standard updated. Medicare coverage will then follow for the CGMs and Dexcom can then introduce a cheaper CGM targeted at the afrezza users. Then again Google might enter the market in a big way and buys Dexcom. We will have to see. Dexcom are supply constrained at the moment - they are selling everything they can produce and still have demand they cannot meet. Dexcom want the T1 market, and the integrated CGM market. Medicare is a big deal because until recently if you were a T1 on Medicare a CGM was not covered. They are not after the T2 market and they explained why on their earnings call. They do not expect insurers to cover CGMs for T2 any time soon because they are cost prohibitive. Instead they expect insurers will cover a CGM for maybe a month a year to check if all is well. They will cover that market with the disposable Verily/Dexcom sensor at the end of 2020, into early 2021. Listen to the call, there was interesting stuff in it. Precisely my point in previous post in this thread and why Mike was excited when Libre came out and the price point advantage they have. Libre is covered, cost currently for me is $40/mo., it may not have the bells and whistles but they are not needed, the other benefits of Libre far outweigh relative to cost and ease of use for T2's. Libre/Afrezza combo is a no brainer whether marketed that way or just suggested by the physicians after seeing the numbers and testimonials that continue to come in. Reminds me of ol' blue eyes....Try, try, try to separate them: www.youtube.com/watch?v=xtS46Wfsxnw
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Post by agedhippie on Aug 2, 2018 10:42:06 GMT -5
Dexcom are supply constrained at the moment - they are selling everything they can produce and still have demand they cannot meet. Dexcom want the T1 market, and the integrated CGM market. Medicare is a big deal because until recently if you were a T1 on Medicare a CGM was not covered. They are not after the T2 market and they explained why on their earnings call. They do not expect insurers to cover CGMs for T2 any time soon because they are cost prohibitive. Instead they expect insurers will cover a CGM for maybe a month a year to check if all is well. They will cover that market with the disposable Verily/Dexcom sensor at the end of 2020, into early 2021. Listen to the call, there was interesting stuff in it. Precisely my point in previous post in this thread and why Mike was excited when Libre came out and the price point advantage they have. Libre is covered, cost currently for me is $40/mo., it may not have the bells and whistles but they are not needed, the other benefits of Libre far outweigh relative to cost and ease of use for T2's. Libre/Afrezza combo is a no brainer whether marketed that way or just suggested by the physicians after seeing the numbers and testimonials that continue to come in. Reminds me of ol' blue eyes....Try, try, try to separate them: www.youtube.com/watch?v=xtS46Wfsxnw Dexcom talked about this on the call as well. They said they are not concerned about Libre because it's a huge market and there is room for several players. I know people twitch visibly at the mention of Seeking Alpha, but here is a link to the Dexcom call transcript - seekingalpha.com/article/4193480-dexcom-dxcm-q2-2018-results-earnings-call-transcript?part=single
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Post by peppy on Aug 2, 2018 11:05:32 GMT -5
Precisely my point in previous post in this thread and why Mike was excited when Libre came out and the price point advantage they have. Libre is covered, cost currently for me is $40/mo., it may not have the bells and whistles but they are not needed, the other benefits of Libre far outweigh relative to cost and ease of use for T2's. Libre/Afrezza combo is a no brainer whether marketed that way or just suggested by the physicians after seeing the numbers and testimonials that continue to come in. Reminds me of ol' blue eyes....Try, try, try to separate them: www.youtube.com/watch?v=xtS46Wfsxnw Dexcom talked about this on the call as well. They said they are not concerned about Libre because it's a huge market and there is room for several players. I know people twitch visibly at the mention of Seeking Alpha, but here is a link to the Dexcom call transcript - seekingalpha.com/article/4193480-dexcom-dxcm-q2-2018-results-earnings-call-transcript?part=single
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Post by sportsrancho on Aug 2, 2018 11:23:36 GMT -5
TO FUNNY!
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Post by harryx1 on Aug 2, 2018 12:43:57 GMT -5
I have to ask the question "When will HCPs especially Endos start to realize the enormous benefits of Afrezza"? I have no credentials, a nobody, just an average Sasquatch but I do realize the enormous benefits of Afrezza. Here's a publication authored by some heavy weights in diabetes (Irl B. Hirsch, MD, Richard M. Bergenstal, MD, Christopher G. Parkin, MS, Eugene Wright, Jr., MD and John B. Buse, MD, PhD) that, wait for it, was published in 2005! I recommend every member of this board read this publication mainly geared toward Type 2 diabetes: A Real-World Approach to Insulin Therapy in Primary Care Practiceclinical.diabetesjournals.org/content/23/2/78Also Dr. Hirsch was compensated by Mannkind back in 2005!?!?! Notes of disclosure: Dr. Hirsch has received consulting fees or honoraria for speaking engagements from Eli Lilly, Novo Nordisk, and Sanofi-Aventis Pharmaceuticals. He also receives research support from Mannkind Corporation.
Come on Dr. Kendall, as you stated, it should be a very easy job for you!!!!!
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Post by goyocafe on Aug 2, 2018 12:49:51 GMT -5
I have to ask the question "When will HCPs especially Endos start to realize the enormous benefits of Afrezza"? I have no credentials, a nobody, just an average Sasquatch but I do realize the enormous benefits of Afrezza. Here's a publication authored by some heavy weights in diabetes (Irl B. Hirsch, MD, Richard M. Bergenstal, MD, Christopher G. Parkin, MS, Eugene Wright, Jr., MD and John B. Buse, MD, PhD) that, wait for it, was published in 2005! I recommend every member of this board read this publication mainly geared toward Type 2 diabetes: A Real-World Approach to Insulin Therapy in Primary Care Practiceclinical.diabetesjournals.org/content/23/2/78Also Dr. Hirsch was compensated by Mannkind back in 2005!?!?! Notes of disclosure: Dr. Hirsch has received consulting fees or honoraria for speaking engagements from Eli Lilly, Novo Nordisk, and Sanofi-Aventis Pharmaceuticals. He also receives research support from Mannkind Corporation.
Come on Dr. Kendall, as you stated, it should be a very easy job for you!!!!! The mouse in the room that none of the elephants seem to notice, YET!
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Post by gareaudan on Aug 2, 2018 13:25:20 GMT -5
I have to ask the question "When will HCPs especially Endos start to realize the enormous benefits of Afrezza"? I have no credentials, a nobody, just an average Sasquatch but I do realize the enormous benefits of Afrezza. Here's a publication authored by some heavy weights in diabetes (Irl B. Hirsch, MD, Richard M. Bergenstal, MD, Christopher G. Parkin, MS, Eugene Wright, Jr., MD and John B. Buse, MD, PhD) that, wait for it, was published in 2005! I recommend every member of this board read this publication mainly geared toward Type 2 diabetes: A Real-World Approach to Insulin Therapy in Primary Care Practiceclinical.diabetesjournals.org/content/23/2/78Also Dr. Hirsch was compensated by Mannkind back in 2005!?!?! Notes of disclosure: Dr. Hirsch has received consulting fees or honoraria for speaking engagements from Eli Lilly, Novo Nordisk, and Sanofi-Aventis Pharmaceuticals. He also receives research support from Mannkind Corporation.
Come on Dr. Kendall, as you stated, it should be a very easy job for you!!!!! The mouse in the room that none of the elephants seem to notice, YET! this Graph is so telling, combined with the fact that afrezza is safe. Afrezza should already be the SOC. No pills will ever beat a healthy pancreas but afrezza is what come the closest imo.
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Post by mnholdem on Aug 2, 2018 14:00:51 GMT -5
Precisely my point in previous post in this thread and why Mike was excited when Libre came out and the price point advantage they have. Libre is covered, cost currently for me is $40/mo., it may not have the bells and whistles but they are not needed, the other benefits of Libre far outweigh relative to cost and ease of use for T2's. Libre/Afrezza combo is a no brainer Dexcom talked about this on the call as well. They said they are not concerned about Libre because it's a huge market and there is room for several players.[Clipped] That certainly sounds to me like Dexcom is conceding that they may lose a chunk of the future CGM market to Libre. Of course, the $1 billion question is "how much of the market"?
Joey makes a very good point about the Libre, especially since 3rd Party payers seem to place a higher criteria on cost. Cost will become even more critical if the current industry practice of rebates gets gutted by regulators/lawmakers.
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Post by agedhippie on Aug 2, 2018 14:37:22 GMT -5
Dexcom talked about this on the call as well. They said they are not concerned about Libre because it's a huge market and there is room for several players.[Clipped] That certainly sounds to me like Dexcom is conceding that they may lose a chunk of the future CGM market to Libre. Of course, the $1 billion question is "how much of the market"?
Joey makes a very good point about the Libre, especially since 3rd Party payers seem to place a higher criteria on cost. Cost will become even more critical if the current industry practice of rebates gets gutted by regulators/lawmakers.
Dexcom see Libre as being in a different market segment. They think the Type 1 market will belong to CGMs, and initially at least they Type 2 market will belong to Libre. This makes sense because the sensor cost is about the same, but the transmitter adds another 50% to the cost and if you don't need continuous connectivity why pay for it. I think they will circle back when they have the cheap all-in-one Verily sensor available. Dexcom see Medtronics as the competition, not the Abbott. That may turn out to be an error since Abbott are working on an all-in-one sensor for the Artificial pancreas and used to have the Navigator which was a nice CGM.
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Post by morgieporgie on Aug 2, 2018 17:15:27 GMT -5
I have to ask the question "When will HCPs especially Endos start to realize the enormous benefits of Afrezza"? I have no credentials, a nobody, just an average Sasquatch but I do realize the enormous benefits of Afrezza. Here's a publication authored by some heavy weights in diabetes (Irl B. Hirsch, MD, Richard M. Bergenstal, MD, Christopher G. Parkin, MS, Eugene Wright, Jr., MD and John B. Buse, MD, PhD) that, wait for it, was published in 2005! I recommend every member of this board read this publication mainly geared toward Type 2 diabetes: A Real-World Approach to Insulin Therapy in Primary Care Practiceclinical.diabetesjournals.org/content/23/2/78Also Dr. Hirsch was compensated by Mannkind back in 2005!?!?! Notes of disclosure: Dr. Hirsch has received consulting fees or honoraria for speaking engagements from Eli Lilly, Novo Nordisk, and Sanofi-Aventis Pharmaceuticals. He also receives research support from Mannkind Corporation.
Come on Dr. Kendall, as you stated, it should be a very easy job for you!!!!! They got you man. Transferred YOUR money to THEIR account. Everyone can't win.
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