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Post by nylefty on Jan 18, 2019 20:18:44 GMT -5
Mike C said in the last call:
The third topic here I want address is payers/patient access. We are continuing to see positive payer coverage as we start out 2019 as evidenced by our recent signing of the contract with Kaiser [ph] and ongoing discussions with other key payers.
What does the contract with Kaiser cover? Anybody know?
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Post by brotherm1 on Jan 18, 2019 21:40:57 GMT -5
I wondered the same, and is it common or standard for pharma’s to have contracts with health insurance companies?
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Post by sportsrancho on Jan 18, 2019 22:39:37 GMT -5
I wondered the same, and is it common or standard for pharma’s to have contracts with health insurance companies? IDK , but I heard somewhere that it supposed to be a pretty big deal.😉 |
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Post by mnkdfann on Jan 18, 2019 23:40:04 GMT -5
I wondered the same, and is it common or standard for pharma’s to have contracts with health insurance companies? I guess it depends what sort of contract it is. According to a document from the Kaiser Family Foundation, it sounds as though at least some contracts are standard practice. "PBMs negotiate with pharmaceutical manufacturers for rebates on products selected for the formulary. Rebate amounts are based on the contracts negotiated between the PBM and plan sponsors and the PBM and manufacturers. Typically, contracts are structured so that PBMs retain a portion of the rebate in exchange for developing the formulary and negotiating with manufacturers." Pharmacy Benefit Managers (PBMs): Approximately two-thirds of all prescriptions written in the U.S. are processed by a PBM; PBMs may achieve savings for their customers by negotiating discounts and through cost containment programs, including use of formularies and cost sharing. The above is all from a document titled "Follow the Pill: Understanding the U.S. Commercial Pharmaceutical Supply Chain". The link is too long to post, but you can google the document. From Wikipedia: As of 2016, PBMs managed pharmacy benefits for 266 million Americans. PBMs operate inside of integrated healthcare systems (e.g., Kaiser or VA), as part of retail pharmacies (e.g., CVS Pharmacy or Rite-Aid), and as part of insurance companies (e.g., UnitedHealth Group). |
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Post by sweedee79 on Jan 19, 2019 0:17:32 GMT -5
Very informative
.. PBMs .. just another cog in our for profit health Care system ..
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Post by cretin11 on Jan 19, 2019 23:10:13 GMT -5
Very informative .. PBMs .. just another cog in our for profit health Care system .. Indeed. And I have to assume that the existence of PBMs in our convoluted system only makes it more difficult for a tiny pharma like MNKD. |
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Post by theebavarian on Oct 5, 2019 14:55:20 GMT -5
For all the years we've been participating in, following, investing in the fortunes of MNKD, we're at our lowest point right now(at least with regard to Afrezza). On this board there's the full range of opinions from the ever-optimists to the permanent-bears. Tons of speculation about all aspects of the company. Lets start with what we know: 1. Afrezza seems like a valuable product. 2. Neither MNKD management, nor any other entity has proven itself capable of selling Afrezza at a commercially viable level. 3. At the current trajectory of sales there is little prospect of profitability in 2019. 4. There is a finite amount of cash and at some point, without more success from Afrezza sales, the company may find it impossible to raise capital. 5. The MNKD management team has a poor record: of communication and of achievement. 6. The first responsibility of a Board of Directors is to protect the interests of shareholders. To introduce a sports analogy, if such were the situation with a football team, the coaching staff would be replaced and likely some in the front office as well. I think that's where we should start. The MNKD Board has been an utter failure any way you look at it. I don't care what companies they were associated with in their careers. I don't care if they love America or kick their dogs. In this situation we employ them to look out for us and they've failed. So, fire 'em. Simple. Let's be honest, we could replace the board with mannequins and do as well as we have. Now as to management, I have nothing better to say. I start from the position of being neither fan nor hater of Mike C. How has he done? I think if one were handing out letter grades, he'd get at best a C and probably a C-. Surely, the Board's grading can't be that much different. Yet the Board pays Mike and the team like they're B+/A performers. The Board has failed here. Afrezza may be the greatest thing to hit diabetes, but that doesn't matter if you can't sell it. Sanofi tried and failed. The contract sales force tried and failed. Now the dedicated sales force has tried and failed. Maybe it can't be sold. Maybe it won't work. I don't know the answer to selling Afrezza, but neither does anyone associated with MNKD. So, jettison the product to someone else. Presumably, there's still some value there. Management has fallen in love with product (as have many of us), but maybe that love with never be returned. The Board should force a sale. To permit MNKD management to pursue some new sales strategy in 2019 is foolish. Of course, management doesn't want to give up and have that on their resume, but this is why there's a Board. Another failure of the Board. This really isn't that difficult to figure out. We need a new Board. Now. They've had several seasons to win games. They've been associated with winning teams in their past. But, they've repeatedly failed our team. We should remove them this May. This thread Think Differently... is an interesting read. It was started by galileo, a day after registering on ProBoards. In this thread Galileo really goes after the board and MC, suggesting that the board should be removed, that it has failed. This was the first real "throw the bums out!" thread posted after the December Massacre. What is interesting is that many that today agree with what Galileo says here, at the time of posting (December 30th, 2018) largely did not agree. And at least for me, things are better now than when "Think Differently..." was first created.
Also noteworthy is that Galileo levies some real allegations against Mike Castagna and management... here and here. Again, many did not agree with Galileo then, but do now... though things are better - from my perspective.
Finally, what is noteworthy is that this post was Galileo's most accusatory. It was made on January 12th, which was also the last time Galileo signed in to ProBoards. The identity of Galileo and the validity of Galileo's accusations were never validated, yet comments made by Galileo have been reposted on other threads and boards (if I remember correctly).
I just hope people weren't duped by Galileo.
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Post by veritasfiliatemporis on Oct 5, 2019 15:40:55 GMT -5
For all the years we've been participating in, following, investing in the fortunes of MNKD, we're at our lowest point right now(at least with regard to Afrezza). On this board there's the full range of opinions from the ever-optimists to the permanent-bears. Tons of speculation about all aspects of the company. Lets start with what we know: 1. Afrezza seems like a valuable product. 2. Neither MNKD management, nor any other entity has proven itself capable of selling Afrezza at a commercially viable level. 3. At the current trajectory of sales there is little prospect of profitability in 2019. 4. There is a finite amount of cash and at some point, without more success from Afrezza sales, the company may find it impossible to raise capital. 5. The MNKD management team has a poor record: of communication and of achievement. 6. The first responsibility of a Board of Directors is to protect the interests of shareholders. To introduce a sports analogy, if such were the situation with a football team, the coaching staff would be replaced and likely some in the front office as well. I think that's where we should start. The MNKD Board has been an utter failure any way you look at it. I don't care what companies they were associated with in their careers. I don't care if they love America or kick their dogs. In this situation we employ them to look out for us and they've failed. So, fire 'em. Simple. Let's be honest, we could replace the board with mannequins and do as well as we have. Now as to management, I have nothing better to say. I start from the position of being neither fan nor hater of Mike C. How has he done? I think if one were handing out letter grades, he'd get at best a C and probably a C-. Surely, the Board's grading can't be that much different. Yet the Board pays Mike and the team like they're B+/A performers. The Board has failed here. Afrezza may be the greatest thing to hit diabetes, but that doesn't matter if you can't sell it. Sanofi tried and failed. The contract sales force tried and failed. Now the dedicated sales force has tried and failed. Maybe it can't be sold. Maybe it won't work. I don't know the answer to selling Afrezza, but neither does anyone associated with MNKD. So, jettison the product to someone else. Presumably, there's still some value there. Management has fallen in love with product (as have many of us), but maybe that love with never be returned. The Board should force a sale. To permit MNKD management to pursue some new sales strategy in 2019 is foolish. Of course, management doesn't want to give up and have that on their resume, but this is why there's a Board. Another failure of the Board. This really isn't that difficult to figure out. We need a new Board. Now. They've had several seasons to win games. They've been associated with winning teams in their past. But, they've repeatedly failed our team. We should remove them this May. This thread Think Differently... is an interesting read. It was started by galileo, a day after registering on ProBoards. In this thread Galileo really goes after the board and MC, suggesting that the board should be removed, that it has failed. This was the first real "throw the bums out!" thread posted after the December Massacre. What is interesting is that many that today agree with what Galileo says here, at the time of posting (December 30th, 2018) largely did not agree. And at least for me, things are better now than when "Think Differently..." was first created.
Also noteworthy is that Galileo levies some real allegations against Mike Castagna and management... here and here. Again, many did not agree with Galileo then, but do now... though things are better - from my perspective.
Finally, what is noteworthy is that this post was Galileo's most accusatory. It was made on January 12th, which was also the last time Galileo signed in to ProBoards. The identity of Galileo and the validity of Galileo's accusations were never validated, yet comments made by Galileo have been reposted on other threads and boards (if I remember correctly).
I just hope people weren't duped by Galileo.
Maybe you are the Galileo spirit... or only one of the basher... another one |
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Post by theebavarian on Oct 6, 2019 12:30:02 GMT -5
For all the years we've been participating in, following, investing in the fortunes of MNKD, we're at our lowest point right now(at least with regard to Afrezza). On this board there's the full range of opinions from the ever-optimists to the permanent-bears. Tons of speculation about all aspects of the company. Lets start with what we know: 1. Afrezza seems like a valuable product. 2. Neither MNKD management, nor any other entity has proven itself capable of selling Afrezza at a commercially viable level. 3. At the current trajectory of sales there is little prospect of profitability in 2019. 4. There is a finite amount of cash and at some point, without more success from Afrezza sales, the company may find it impossible to raise capital. 5. The MNKD management team has a poor record: of communication and of achievement. 6. The first responsibility of a Board of Directors is to protect the interests of shareholders. To introduce a sports analogy, if such were the situation with a football team, the coaching staff would be replaced and likely some in the front office as well. I think that's where we should start. The MNKD Board has been an utter failure any way you look at it. I don't care what companies they were associated with in their careers. I don't care if they love America or kick their dogs. In this situation we employ them to look out for us and they've failed. So, fire 'em. Simple. Let's be honest, we could replace the board with mannequins and do as well as we have. Now as to management, I have nothing better to say. I start from the position of being neither fan nor hater of Mike C. How has he done? I think if one were handing out letter grades, he'd get at best a C and probably a C-. Surely, the Board's grading can't be that much different. Yet the Board pays Mike and the team like they're B+/A performers. The Board has failed here. Afrezza may be the greatest thing to hit diabetes, but that doesn't matter if you can't sell it. Sanofi tried and failed. The contract sales force tried and failed. Now the dedicated sales force has tried and failed. Maybe it can't be sold. Maybe it won't work. I don't know the answer to selling Afrezza, but neither does anyone associated with MNKD. So, jettison the product to someone else. Presumably, there's still some value there. Management has fallen in love with product (as have many of us), but maybe that love with never be returned. The Board should force a sale. To permit MNKD management to pursue some new sales strategy in 2019 is foolish. Of course, management doesn't want to give up and have that on their resume, but this is why there's a Board. Another failure of the Board. This really isn't that difficult to figure out. We need a new Board. Now. They've had several seasons to win games. They've been associated with winning teams in their past. But, they've repeatedly failed our team. We should remove them this May. This thread Think Differently... is an interesting read. It was started by galileo , a day after registering on ProBoards. In this thread Galileo really goes after the board and MC, suggesting that the board should be removed, that it has failed. This was the first real "throw the bums out!" thread posted after the December Massacre. What is interesting is that many that today agree with what Galileo says here, at the time of posting (December 30th, 2018) largely did not agree. And at least for me, things are better now than when "Think Differently..." was first created.
Also noteworthy is that Galileo levies some real allegations against Mike Castagna and management... here and here. Again, many did not agree with Galileo then, but do now... though things are better - from my perspective.
Finally, what is noteworthy is that this post was Galileo's most accusatory. It was made on January 12th, which was also the last time Galileo signed in to ProBoards. The identity of Galileo and the validity of Galileo's accusations were never validated, yet comments made by Galileo have been reposted on other threads and boards (if I remember correctly).
I just hope people weren't duped by Galileo.
But someone seems to know who Galileo was... here (link edited - "that guy had a friend who worked high up in Mannkind") Interesting read between pages 113-115. This was in June, six months after the initial, unsubstantiated post made on the Six weeks from January 14th thread. It started with Galileo, seemingly a plant. |
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Post by letitride on Oct 6, 2019 12:53:43 GMT -5
I think we all think to much.
Let it Ride!
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Post by theebavarian on Oct 9, 2019 7:20:25 GMT -5
I like how you think mnholdem. We've thought about things like this. We're holding back a little longer before we "go nuclear," but I believe you're right. "We've thought about things like this. We're holding back a little longer before we " go nuclear"..." VDEX Diabetes January 6, 2019. Read carefully. The context of mnholdem's quote was going nuclear on endo's in the press, but as we now know, VDEX went nuclear on the company ... Then there's this nifty one-page, easy to read ProBoards thread, just a couple of weeks after the quote above (January 21st, 2019). WOW! WOW! WOW! So, maybe we do think to much. Much more people should, and WAKE UP in the process. Who is Galileo? |
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Post by mnholdem on Oct 9, 2019 7:37:16 GMT -5
I think the term “going nuclear” was not mine but came from vdexdiabetes response to my suggestion of using localized media coverage.
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Post by matt on Oct 9, 2019 7:39:49 GMT -5
PBMs negotiate with pharmaceutical manufacturers for rebates on products selected for the formulary. Technically, this is not the case. If a manufacturer and a PBM negotiate a deal effectively to exclude another provider from the formulary then this is generally interpreted as crossing the line with respect to anti-trust law. Similarly, contracts that require the PBM to fill a particular number of scripts with the manufacturer's product may run afoul of various federal and state laws on kick-backs, especially if there are lower priced products in the market. All of this may seem like a distinction without a difference, but that is not how the Justice Department views the world. However, a manufacturer can make a unilateral offer to grant a rebate based upon the percentage of scripts filled by the PBM that use the company's product. In such a contract the PBM is not obligated to buy anything at all, it can fill scripts with any brand of medication, and it is always free to accept rebates from other manufacturers. This is equivalent to a Ford dealer offering $2,000 cash back on the purchase of a new car. If the customer buys a Ford then the dealer is legally obligated to pay the money, but the consumer is always free to buy a Chevy and forego the rebate. It is the lack of mutual promises that makes rebates legal which is why PBMs choose from the rebates on offer rather than negotiating deals directly. That said, everybody in the industry knows how the game is played! |
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Post by peppy on Oct 9, 2019 7:52:28 GMT -5
PBMs negotiate with pharmaceutical manufacturers for rebates on products selected for the formulary. Technically, this is not the case. If a manufacturer and a PBM negotiate a deal effectively to exclude another provider from the formulary then this is generally interpreted as crossing the line with respect to anti-trust law. Similarly, contracts that require the PBM to fill a particular number of scripts with the manufacturer's product may run afoul of various federal and state laws on kick-backs, especially if there are lower priced products in the market. All of this may seem like a distinction without a difference, but that is not how the Justice Department views the world.
However, a manufacturer can make a unilateral offer to grant a rebate based upon the percentage of scripts filled by the PBM that use the company's product. In such a contract the PBM is not obligated to buy anything at all, it can fill scripts with any brand of medication, and it is always free to accept rebates from other manufacturers. This is equivalent to a Ford dealer offering $2,000 cash back on the purchase of a new car. If the customer buys a Ford then the dealer is legally obligated to pay the money, but the consumer is always free to buy a Chevy and forego the rebate. It is the lack of mutual promises that makes rebates legal which is why PBMs choose from the rebates on offer rather than negotiating deals directly. That said, everybody in the industry knows how the game is played! Quote: It is the lack of mutual promises that makes rebates legal quote: but that is not how the Justice Department views the world. Reply: so not quid, pro, quo? oh, hahahaha (a favor or advantage granted or expected in return for something.) |
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Post by theebavarian on Oct 9, 2019 7:57:12 GMT -5
I like how you think mnholdem. We've thought about things like this. We're holding back a little longer before we "go nuclear," but I believe you're right. "We've thought about things like this. We're holding back a little longer before we " go nuclear"..." VDEX Diabetes January 6, 2019. Read carefully. The context of mnholdem's quote was going nuclear on endo's in the press, but as we now know, VDEX went nuclear on the company ... Then there's this nifty one-page, easy to read ProBoards thread, just a couple of weeks after the quote above (January 21st, 2019). WOW! WOW! WOW! So, maybe we do think to much. Much more people should, and WAKE UP in the process. Who is Galileo? "I think the term “going nuclear” was not mine but came from vdexdiabetes response to my suggestion of using localized media coverage." You are correct, mnholdem. You were talking about going to the press on what endo's (one in particular) had said about VDEX, and it was VDEXDiabetes that responded with its "go nuclear" statement above. Sorry for the confusion. I could have worded that better I guess. My apologies. |
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