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Post by peppy on Dec 5, 2018 13:21:26 GMT -5
6." The company booked $5.5 million in losses per month on the Amphastar contract in 2015. That contract has not gone away and the current year exposure based on the last 10Q was $13 million." Can someone please tell me why MNKD is not making money on this Amphastar contract by selling the amount in excess of our current needs. We can sell it back to Amphastar at a slight price off current market prices or sell it on the open market at going market prices. That windfall can be used to reduce the $5.5 million penalty we currently incur? Read more: mnkd.proboards.com/thread/10681/path-improved-insurance-coverage-tiering?page=1#ixzz5YpgxYemPThis is what I have found out over the years. - NPH. Afrezza is made with NPH. reference.medscape.com/drug/humulin-n-novolin-n-insulin-nph-999006which is over the counter. - Insulins need to be approved. The Amphastar NPH has been approved to be the insulin used to make afrezza. What is the actual demand for NPH? Absorption NPH Bioavailability (IM, SC, IP): Well absorbed Onset: 1-1.5 hr (a combination insulin product, insulin NPH and insulin regular, also has intermediate action, but it has a more rapid onset than does insulin NPH alone); 4-12 hr peak effectDuration: 14-24 hrPeak plasma time: 6-10 hr |
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Post by traderdennis on Dec 5, 2018 14:47:09 GMT -5
6." The company booked $5.5 million in losses per month on the Amphastar contract in 2015. That contract has not gone away and the current year exposure based on the last 10Q was $13 million." Can someone please tell me why MNKD is not making money on this Amphastar contract by selling the amount in excess of our current needs. We can sell it back to Amphastar at a slight price off current market prices or sell it on the open market at going market prices. That windfall can be used to reduce the $5.5 million penalty we currently incur? I believe what you (and peppy) quoted was originally written in 2016. The numbers today are different. A chart in SO's latest article outlines the Amphastar payments. You can find it here: seekingalpha.com/article/4226080-mannkind-afrezza-scripts-take-expected-holiday-dip-good-badIf I read it correctly, there is only a $3,550,000 payment in 2019 and another for the same in 2020. Not sure what happens after that. Per SO, it is 3.55M per quarter in 2019 and 2020. |
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Post by peppy on Dec 5, 2018 14:58:00 GMT -5
The contract was renegotiated.
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Post by mnkdfann on Dec 5, 2018 16:15:39 GMT -5
Per SO, it is 3.55M per quarter in 2019 and 2020. Thank you for the correction. I was misled by the colour grouping. With a quick glance I thought each alternating colour was a new year, not a new quarter. |
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Post by agedhippie on Dec 5, 2018 18:22:20 GMT -5
This is what I have found out over the years. - NPH. Afrezza is made with NPH. reference.medscape.com/drug/humulin-n-novolin-n-insulin-nph-999006which is over the counter. - Insulins need to be approved. The Amphastar NPH has been approved to be the insulin used to make afrezza. What is the actual demand for NPH? Absorption NPH Bioavailability (IM, SC, IP): Well absorbed Onset: 1-1.5 hr (a combination insulin product, insulin NPH and insulin regular, also has intermediate action, but it has a more rapid onset than does insulin NPH alone); 4-12 hr peak effectDuration: 14-24 hrPeak plasma time: 6-10 hr Actually Afrezza is made from Regular insulin rather than NPH. NPH is what you use if you can't afford the analog basals like Lantus, and it's a pain to use because it has lots of peaks and troughs. |
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Post by agedhippie on Dec 5, 2018 18:33:41 GMT -5
6." The company booked $5.5 million in losses per month on the Amphastar contract in 2015. That contract has not gone away and the current year exposure based on the last 10Q was $13 million." Can someone please tell me why MNKD is not making money on this Amphastar contract by selling the amount in excess of our current needs. We can sell it back to Amphastar at a slight price off current market prices or sell it on the open market at going market prices. That windfall can be used to reduce the $5.5 million penalty we currently incur? I am not sure why Amphastar would buy the insulin back, they want to sell it and if they buy it back from Mannkind they are going to have to sell it all over again. Selling at the open market price would be difficult for a few reasons, the big one is that they do not have FDA approval to sell it. That's not hard to overcome, but it means going through the FDA approvals process, packing approvals, and so on which is all time and money. Once that was done they would then need to find someone who wants to sell a product with unpredictable supplies (the supply would vary with Afrezza sales). |
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Post by peppy on Dec 5, 2018 18:53:10 GMT -5
This is what I have found out over the years. - NPH. Afrezza is made with NPH. reference.medscape.com/drug/humulin-n-novolin-n-insulin-nph-999006which is over the counter. - Insulins need to be approved. The Amphastar NPH has been approved to be the insulin used to make afrezza. What is the actual demand for NPH? Absorption NPH Bioavailability (IM, SC, IP): Well absorbed Onset: 1-1.5 hr (a combination insulin product, insulin NPH and insulin regular, also has intermediate action, but it has a more rapid onset than does insulin NPH alone); 4-12 hr peak effectDuration: 14-24 hrPeak plasma time: 6-10 hr Actually Afrezza is made from Regular insulin rather than NPH. NPH is what you use if you can't afford the analog basals like Lantus, and it's a pain to use because it has lots of peaks and troughs. Damn, and thank you aged. Regular. reference.medscape.com/drug/humulin-r-novolin-r-insulin-regular-human-999007Mechanism of Action Regulates glucose metabolism Insulin and its analogues lower blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production; insulin inhibits lipolysis and proteolysis and enhances protein synthesis; targets include skeletal muscle, liver, and adipose tissue Absorption Bioavailability: 55-77% (SC) Onset: 0.5 hr (early effect); 2.5-5 hr (peak effect)
Duration: 4-12 hr (U-100); up to 24 hr (U-500)Peak plasma time: 0.8-2 hr (SC) |
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Post by #NoMoreNeedles on Jan 27, 2019 20:23:29 GMT -5
Where do we stand at the beginning of 2019 and will running more commercials move the needle?
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Post by mnholdem on Jan 27, 2019 21:50:17 GMT -5
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Post by porkini on Jan 27, 2019 22:19:41 GMT -5
"Illinios" is still spelled wrong.  |
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Post by pguererro on Jan 28, 2019 22:41:05 GMT -5
1500 units of novolog is $580
Afrezza requires AT LEAST a 1.5X conversion ratio at a minimum for equal potency
2250 units of Afrezza would be our new titration kit of 8’s and 12’s which totals 1800 units PLUS 90 4 unit cartridges and that still doesn’t technically cover the 2250 units. Many patients (like the ones in the STAT trial) need TWICE as much insulin vs novolog.
90X8, 90x12 kit. $1800
90x4. $340
$2140 for Afrezza. Vs $580 for novolog. Nobody wants to point this out but it’s true. Our managed care situation is not a head scratcher.
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Post by travis1953 on Jan 29, 2019 0:57:34 GMT -5
1500 units of novolog is $580 Afrezza requires AT LEAST a 1.5X conversion ratio at a minimum for equal potency 2250 units of Afrezza would be our new titration kit of 8’s and 12’s which totals 1800 units PLUS 90 4 unit cartridges and that still doesn’t technically cover the 2250 units. Many patients (like the ones in the STAT trial) need TWICE as much insulin vs novolog. 90X8, 90x12 kit. $1800 90x4. $340 $2140 for Afrezza. Vs $580 for novolog. Nobody wants to point this out but it’s true. Our managed care situation is not a head scratcher. Relevance? In the STAT trial, if I read it correctly, improving time in range could require 2-3 times as much afrezza -- dose before or during meal, additional dose if needed an hour later and ditto 2 hours later. If time in range became relevant to managed care, would PBMs be willing to pay up for it? |
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Post by steelers on Jan 29, 2019 1:24:08 GMT -5
1500 units of novolog is $580 Afrezza requires AT LEAST a 1.5X conversion ratio at a minimum for equal potency 2250 units of Afrezza would be our new titration kit of 8’s and 12’s which totals 1800 units PLUS 90 4 unit cartridges and that still doesn’t technically cover the 2250 units. Many patients (like the ones in the STAT trial) need TWICE as much insulin vs novolog. 90X8, 90x12 kit. $1800 90x4. $340 $2140 for Afrezza. Vs $580 for novolog. Nobody wants to point this out but it’s true. Our managed care situation is not a head scratcher. It doesn't seem like this is an issue that can be overcome (and always has been)... unless the SOC is changed of course but there doesn't seem to have been enough significant progress in that area yet either.. |
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Post by brotherm1 on Jan 29, 2019 6:20:56 GMT -5
I wonder how much Kaiser is paying for it under our recent agreement
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Post by matt on Jan 29, 2019 8:01:09 GMT -5
If time in range became relevant to managed care, would PBMs be willing to pay up for it? There are three factors working here: 1. If we use the numbers put forth above, Afrezza is roughly four times as expensive as Novolog at full retail. Time is range becomes relevant to managed care if, and only if, the improved time in range translates to reduced costs for the managed care provider. Realistically, managed care will have to pay the premium price for Afrezza on many patients to save the additional costs for a few patients that do not stay in range. Can Afrezza be economically justified on this basis? Perhaps, but it certainly isn't an obvious conclusion or there wouldn't be an issue. The cost and difficulty of doing a large study that tracks all costs of diabetic care and differences in outcomes is what is needed, and MNKD simply doesn't have the money or the organization to generate that data. 2. Never forget the impact of competition. Novo and Lilly both boosted their insulin prices over the last ten years and enjoy very sizeable profit margins on these legacy products. If MNKD were able to do a detailed pharmacoeconomic study that proves that time in range is economically relevant for the providers, what keeps Novo or Lilly from simply dropping prices back to 2010 levels? The legacy products are probably still marginally profitable at less than $100 / month, and that is a tough price point for MNKD to compete against. Novo, especially, would rather sell their legacy product at $100 than to lose market share to MNKD, and Lilly is not much different. 3. Managed care looks at incremental prices after all rebates and discounts. The large PBMs don't pay retail and a lot of the rebates they enjoy get passed back to the managed care group that contracted them. They are going to compare the cost of Novo or Lilly product,, net of rebates, against the negotiated prices for extra medical services for those patients that do not stay in range. Only if the net costs make sense will managed care make a change, and the net costs are hard to know from the outside looking inward. |
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