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Post by mannmade on Jan 24, 2019 16:25:30 GMT -5
I am not really sure about the costs of afrezza compared to RAA’s. When afrezza’s plant is running all 3 lines at capacity and w maximum shifts the volume should lower costs significantly. And the dreamboat must cost .05 at most to produce so that is negligible when compared to pens w needles. Also mnkd May be able to get better insulin pricing if volumes goes up assuming the future predicted shortage is fixed.
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Post by itellthefuture777 on Jan 24, 2019 16:28:16 GMT -5
I understand that most users will need to take more Afrezza insulin than compared to RAA insulin. My original comment was on the manufacturing cost only. Even with higher volumes, from what I read on proboards, Afrezza will cost more to produce than RAA prefilled pens. So..I figured out..that other insulins must be inactive hexomeric to stabilize them..but then I found out that insulin tends to become hexomeric in fluid..in high consentrations..which then..I had an aha moment...Afrezza is dispersed accross the lung surface which is if streched out litterally the size of a tennis court..but..that seperates the insulin monomers that go right to work while the injected hexomers..disassociate slower...and then..they can reclump back up as hexomers and unclump again later..the sneak up on you thing..which isn't going to happen with Afrezza..hmmm |
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Post by agedhippie on Jan 24, 2019 18:39:38 GMT -5
I understand that most users will need to take more Afrezza insulin than compared to RAA insulin. My original comment was on the manufacturing cost only. Even with higher volumes, from what I read on proboards, Afrezza will cost more to produce than RAA prefilled pens. So..I figured out..that other insulins must be inactive hexomeric to stabilize them..but then I found out that insulin tends to become hexomeric in fluid..in high consentrations..which then..I had an aha moment...Afrezza is dispersed accross the lung surface which is if streched out litterally the size of a tennis court..but..that seperates the insulin monomers that go right to work while the injected hexomers..disassociate slower...and then..they can reclump back up as hexomers and unclump again later..the sneak up on you thing..which isn't going to happen with Afrezza..hmmm When hexamers hit blood they break up immediately. The issue for RAA is that injected insulin is into subcutaneous fat and that does not break up hexamers. RAA insulin is mostly monomers but still with a decent percentage of hexamers and those hexamers are slow to move into the capillaries where they become monomers. It is the movement of insulin, hexamer or monomer, from subcutaneous fat to bloodstream that gives RAA it's long tail. Afrezza uses the lungs to sidestep that problem and hits the bloodstream fast. All insulins act at the same speed if given intravenously - it's immediate. An insulin IV uses Regular human insulin which is slow in and out if injected and clumps into hexamers a lot but is as fast as Afrezza when given in IV. There is a trick Type 1s sometimes use of injecting into a muscle rather than fat. Because the muscle has a high blood vessel density the insulin starts working much faster. It hurts a lot though so it's not popular! |
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Post by sayhey24 on Jan 24, 2019 18:54:51 GMT -5
I understand that most users will need to take more Afrezza insulin than compared to RAA insulin. My original comment was on the manufacturing cost only. Even with higher volumes, from what I read on proboards, Afrezza will cost more to produce than RAA prefilled pens. Maybe that’s wrong, I don’t know. Boca - as you can see from the direct purchase plan the cost of the insulin powder which goes in the cartridge whether 4u,8u or 12u is not much different. For $120 you can get any of the 3 sizes. The big cost is filling the cartridges.
The reason all users will need more afrezza than RAA is a marketing blunder. The cartridges should never have been called 4u, 8u and 12u. Rather they should be called small, medium and large. Their current naming invites confusion and old school insulin users to freak out. The old schoolers have been taught to carb count and precisely measure their subq insulin in the hope of overcoming the unpredictable absorption rates they will encounter with suq insulin.
With afrezza there is no carb counting and no need to be precise, just close. If you think you may need a small but might need the medium, take the medium with no worries as long as you are not taking tzds.
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Post by mango on Jan 24, 2019 18:56:03 GMT -5
You are incorrect. The 39% which you referred to is the carrier particles aka FDKP particles. Consistently, dose-to-dose, greater than 90% of the powder is delivered to the patient with ~70% of that in the respirable range. |
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Post by sayhey24 on Jan 24, 2019 19:20:30 GMT -5
I understand that most users will need to take more Afrezza insulin than compared to RAA insulin. My original comment was on the manufacturing cost only. Even with higher volumes, from what I read on proboards, Afrezza will cost more to produce than RAA prefilled pens. So..I figured out..that other insulins must be inactive hexomeric to stabilize them..but then I found out that insulin tends to become hexomeric in fluid..in high consentrations..which then..I had an aha moment...Afrezza is dispersed accross the lung surface which is if streched out litterally the size of a tennis court..but..that seperates the insulin monomers that go right to work while the injected hexomers..disassociate slower...and then..they can reclump back up as hexomers and unclump again later..the sneak up on you thing..which isn't going to happen with Afrezza..hmmm Itell - with the RAAs they are genetically engineered to limit all the GMO insulin molecules forming hexamers. In the RAA solution you will have monomers, dimmers and hexamers. Here is the absorption rate for each. care.diabetesjournals.org/content/14/11/942
Lungs contain approximately 2,400 kilometres of airways and 300 to 500 million air sacs (alveoli). If stretched out, the total surface area of lungs would be about the same size as half a tennis court. Afrezza only plays half court.
The FDKP coats the monomer human insulin which stabilizes it. When the FDKP particle hits the lung the negative PH is neutralized and the fdkp separates from the insulin molecule. The monomer insulin then passes directly through the lung lining and into capillaries. Boom, its in the blood just like taking insulin IV. The beauty is the process is very predictable and the insulin is always absorbed at the same rate. Subq is all over the place and changes for different and changing reasons like injection sites and body hydration levels. Its a mess and why subq users do all the math and carb counting.
As a side note, afrezza is not a GMOs as the RAAs are and should qualify for legend removal to be sold over the counter.
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Post by sayhey24 on Jan 24, 2019 19:24:44 GMT -5
You are incorrect. The 39% which you referred to is the carrier particles aka FDKP particles. Consistently, dose-to-dose, greater than 90% of the powder is delivered to the patient with ~70% of that in the respirable range. Mango - I think what he is saying is about 40% get down the throat and into the lung. That is correct. The 4u actually contains 10u of insulin. The problem is from person to person is will vary a bit. Some one who still has tonsils will get less powder into the lung. But who cares. If you need a little more take it, no worries. This isn't your GrandMa's RAA.
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Post by mango on Jan 24, 2019 19:30:13 GMT -5
You are incorrect. The 39% which you referred to is the carrier particles aka FDKP particles. Consistently, dose-to-dose, greater than 90% of the powder is delivered to the patient with ~70% of that in the respirable range. Mango - I think what he is saying is about 40% get down the throat and into the lung. That is correct. The 4u actually contains 10u of insulin. The problem is from person to person is will vary a bit. Some one who still has tonsils will get less powder into the lung. But who cares. If you need a little more take it, no worries. This isn't your GrandMa's RAA.
~70% of the dry powder makes it into the lungs. The 39% only refers to FDKP particles, not the dry powder insulin formulation. |
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Post by rockstarrick on Jan 24, 2019 20:04:46 GMT -5
I understand that most users will need to take more Afrezza insulin than compared to RAA insulin. My original comment was on the manufacturing cost only. Even with higher volumes, from what I read on proboards, Afrezza will cost more to produce than RAA prefilled pens. Maybe that’s wrong, I don’t know. Boca - as you can see from the direct purchase plan the cost of the insulin powder which goes in the cartridge whether 4u,8u or 12u is not much different. For $120 you can get any of the 3 sizes. The big cost is filling the cartridges.
The reason all users will need more afrezza than RAA is a marketing blunder. The cartridges should never have been called 4u, 8u and 12u. Rather they should be called small, medium and large. Their current naming invites confusion and old school insulin users to freak out. The old schoolers have been taught to carb count and precisely measure their subq insulin in the hope of overcoming the unpredictable absorption rates they will encounter with suq insulin.
With afrezza there is no carb counting and no need to be precise, just close. If you think you may need a small but might need the medium, take the medium with no worries as long as you are not taking tzds.
I think when people mention the fact that it takes “more” Afrezza than the other RAA’s, they fail to acknowledge a few important facts. #1 “more” Afrezza often results in an A1c less than the current goal of 7 with little or no Hypoglycemia, and #2 PWD are taking “more” Afrezza, resulting in lower A1c’s with little or no Hypoglycemia, because they can !! Why settle for an A1c of 7 when you can get to a 6, because it takes more Insulin ?? DUH ! 🤪 Most PWD, at least the ones I know, would never target an A1c of less than 6 with current injectable RAA products, they take less but they don’t see the results that “Afrezza users” get by taking more. My Expedition takes more gas than my Hyundai, but it goes places that you just can’t get to with a Hyundai, if you want to get “there”, you have to drive the Expedition. They’re both vehicles, but they’re completely different, Kinda like Afrezza vs the other Mealtime products. There’s no comparison even though they are all Mealtime Insulin products. ✌🏻😎 |
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Post by sayhey24 on Jan 24, 2019 21:04:52 GMT -5
Mango - I think what he is saying is about 40% get down the throat and into the lung. That is correct. The 4u actually contains 10u of insulin. The problem is from person to person is will vary a bit. Some one who still has tonsils will get less powder into the lung. But who cares. If you need a little more take it, no worries. This isn't your GrandMa's RAA.
~70% of the dry powder makes it into the lungs. The 39% only refers to FDKP particles, not the dry powder insulin formulation. Mango - the FDKP absorbs the insulin molecule and they enter the lung as a unit. What you may be thinking is how fast the fdkp exits the body.
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Post by mango on Jan 24, 2019 22:01:51 GMT -5
~70% of the dry powder makes it into the lungs. The 39% only refers to FDKP particles, not the dry powder insulin formulation. Mango - the FDKP absorbs the insulin molecule and they enter the lung as a unit. What you may be thinking is how fast the fdkp exits the body.
When utilized with Technosphere® formulations, greater than 90% of the powder is delivered to the patient with ~70% of that in the respirable range. MannKind’s inhalers show very little change in performance over a wide range of inhalation efforts and produce high bioavailability. In a handling study, pediatric subjects as young as four years old were readily able to use the inhaler. www.mannkindcorp.com/research-development/tech-platforms/oral-inhalers/ |
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Post by sayhey24 on Jan 25, 2019 6:36:24 GMT -5
OK - more than 90% gets out of the whistle with 70% having enough speed to get to the lung. However, some sticks to throat, tonsils, etc and only about 40% gets into the lung. This write-up is about 4 year old kids and can they suck hard enough.
Thats where the 4u name came from. There is 10u of powder in the cartridge. Only about 40% gets into the lung/blood.
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Post by mnholdem on Jan 25, 2019 9:39:28 GMT -5
Folks are getting a bit off-topic here.
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