change my mind

[jonny80s]

Since my previous thread was removed before I could follow up with more info....

Previously holding strong for the last 6 years with cutting/adding to reduce average SPP.... Finally have my average ASPP below $2 after cutting all of my major losses and adding when appropriate to avoid WASH.



If Mike doesn't start supporting SP with some news ramp going into the ASM I'm done.



6 years and 80% loss with no positive outlook for 2 years.



Let us call UTHR what it is... A lifeline from an old friend to help kick the can down the road for another year. If it was serious the 2nd product would have been formally announced to further the momentum of the last run-up. Nothing, crickets.

And Mike contradicting himself from year to year isn't helping.  Mike, "potential users need to see advertising multiple times over a period of time to become motivated to compound that with the time to get an appointment, spirommetry test, fighting with insurance company.. etc.  6-12 months to start Afrezza."  Most recently....  "we expect a ramp up of prescriptions within 6-8 weeks of the add campaign."   

What gives?

Someone change my mind, May 14 approaches ever so slowly....

[Deleted]

Apr 18, 2019 9:42:48 GMT -5 jonny80s said:

Since my previous thread was removed before I could follow up with more info....

Previously holding strong for the last 6 years with cutting/adding to reduce average SPP.... Finally have my average ASPP below $2 after cutting all of my major losses and adding when appropriate to avoid WASH.



If Mike doesn't start supporting SP with some news ramp going into the ASM I'm done.



6 years and 80% loss with no positive outlook for 2 years.



Let us call UTHR what it is... A lifeline from an old friend to help kick the can down the road for another year. If it was serious the 2nd product would have been formally announced to further the momentum of the last run-up. Nothing, crickets.

And Mike contradicting himself from year to year isn't helping.  Mike, "potential users need to see advertising multiple times over a period of time to become motivated to compound that with the time to get an appointment, spirommetry test, fighting with insurance company.. etc.  6-12 months to start Afrezza."  Most recently....  "we expect a ramp up of prescriptions within 6-8 weeks of the add campaign."   

What gives?

Someone change my mind, May 14 approaches ever so slowly....

I'm not trying to change your mind but there's no basis for your UTHR synopsis.  Martine has stated publicly that TreT will replace Tyvaso as a treatment for PAH.  So there is no LIFELINE to accommodate Mannkind.   Because this is a new technology UTHR wants to see progress with TreT before they fully commit additional resources for a 2nd molecule.   Also since Martine has stated Technosphere is the platform of the future which means she has great confidence in Mannkind. 

Regarding their current marketing strategy - Mike will have to account for it.  From the beginning I said their TV Ad was not great but then again I am not an expert with marketing.  Maybe this is a strategy to introduce and now with their 2nd Ad will highlight the benefits of Afrezza.  I'm sure there will be a lot of discussion at the ASM this year. 

[awesomo]

Well, you’ve come this far, might as well see what the ASM brings to make your investment decision. Just remember how extremely optimistic everyone was after last year’s ASM with Dr. Kendall supposedly leading the Afrezza charge...

[cjm18]

Makings decisions based on emotion is not the way to go. Your post sounds emotional.

The second (secret) molecule formulation is expected in the first half of this year. I don’t agree with the logic to conclude the molecule is a nothing burger Bc it’s a secret.

[#NoMoreNeedles]

Creating a new ad takes at least 6 months until they would get the nod of the FDA! The TV ad campaign approach is over!

[scottmnkd]

Afrezza has been a huge disappointment thus far but still has potential. The agreements with UTHR and Receptor Life Sciences can possibly turn things around.

Having said that... I believe the low price per share is reflective of two things: 1) dilution, which is obvious, and 2) management which is not so obvious. I think Mike C is a very lucid and good speaker, but after his Christmas present last year, I've lost all confidence in his leadership as CEO. He's been "very" wrong about Afrezza sales thus far. Remember "guidance" and the recent TV add sales projections? I also heard that Mannkind had a great Hawaiian sales meeting last year while investors like me were saying WTF? Mike has had plenty of time to show improvement in sales and bolster Mannkind's image, but the company is still struggling on most fronts. The good news is that Mannkind is still in business. Do we have the CEO or CFO to thank for that? I don't know...

So, I believe in the products Mannkind is developing, but IMHO, I believe Mike C needs to be replaced due to credibility issues (gasp). If Mike C is replaced by someone well connected, I believe things will turn around. If Mike C isn't replaced, the company will grow, but at a much slower pace with investors always in doubt of what's next.

Looking at MNKD simply from a risk/reward standpoint, I'm in it to win it, so I'll stick around and see what happens. After about 6 years It's been an interesting story thus far and I've enjoyed following this board, which is part of my daily routine.

Hope this help...

[cretin11]

Jonny i certainly have no interest or desire to change your mind, but I agree with the others above that UTHR is a serious partnership, TreT has real potential and the fact that a 2nd molecule hasn't been announced yet doesn't mean it won't be. UTHR would have no reason to try to "time the announcement" to further MNKD's momentum from last run up.

On the other hand, i agree with you on the Afrezza ad campaign and that Mike C owes us an explanation of what has gone wrong with it. He predicted significant results within a time frame that has come and gone.

I am with you on the frustration of being wrong for so many years on this pathetic (in terms of pure share price performance) stock. Pinning your decision to a May 14 timetable to hear news seems like an artificial deadline (and highly likely nothing will happen by then). But i'm the last one to give advice, as my track record is horrendous with MNKD thus far.

[bill]

Apr 18, 2019 11:22:52 GMT -5 scottmnkd said:

Afrezza has been a huge disappointment thus far but still has potential. The agreements with UTHR and Receptor Life Sciences can possibly turn things around.

Having said that... I believe the low price per share is reflective of two things: 1) dilution, which is obvious, and 2) management which is not so obvious. I think Mike C is a very lucid and good speaker, but after his Christmas present last year, I've lost all confidence in his leadership as CEO. He's been "very" wrong about Afrezza sales thus far. Remember "guidance" and the recent TV add sales projections? I also heard that Mannkind had a great Hawaiian sales meeting last year while investors like me were saying WTF? Mike has had plenty of time to show improvement in sales and bolster Mannkind's image, but the company is still struggling on most fronts. The good news is that Mannkind is still in business. Do we have the CEO or CFO to thank for that? I don't know...

So, I believe in the products Mannkind is developing, but IMHO, I believe Mike C needs to be replaced due to credibility issues (gasp). If Mike C is replaced by someone well connected, I believe things will turn around. If Mike C isn't replaced, the company will grow, but at a much slower pace with investors always in doubt of what's next.

Looking at MNKD simply from a risk/reward standpoint, I'm in it to win it, so I'll stick around and see what happens. After about 6 years It's been an interesting story thus far and I've enjoyed following this board, which is part of my daily routine.

Hope this help...

scottmnkd Your post caused me to ponder the following. I wonder if the Sales team could be very successful in what they do, but not have it reflected in prescriptions. For example, suppose they are phenomenally successful in getting doctors to prescribe Afrezza, only for them to find out that their patient's insurance doesn't cover the script. After a few failures the physicians may stop prescribing Afrezza. It seems clear that you have to get physicians, patients, and insurance all lined up to get a sale. When scripts are lagging it's not easy to know exactly where in that chain things failed--lack of patient interest, a physician that's not willing to prescribe, or an insurance company that won't cover some of the costs.

[jonny80s]

Apr 18, 2019 10:17:51 GMT -5 @chuckbass said:

Apr 18, 2019 9:42:48 GMT -5 jonny80s said:

Since my previous thread was removed before I could follow up with more info....

Previously holding strong for the last 6 years with cutting/adding to reduce average SPP.... Finally have my average ASPP below $2 after cutting all of my major losses and adding when appropriate to avoid WASH.



If Mike doesn't start supporting SP with some news ramp going into the ASM I'm done.



6 years and 80% loss with no positive outlook for 2 years.



Let us call UTHR what it is... A lifeline from an old friend to help kick the can down the road for another year. If it was serious the 2nd product would have been formally announced to further the momentum of the last run-up. Nothing, crickets.

And Mike contradicting himself from year to year isn't helping.  Mike, "potential users need to see advertising multiple times over a period of time to become motivated to compound that with the time to get an appointment, spirommetry test, fighting with insurance company.. etc.  6-12 months to start Afrezza."  Most recently....  "we expect a ramp up of prescriptions within 6-8 weeks of the add campaign."   

What gives?

Someone change my mind, May 14 approaches ever so slowly....

I'm not trying to change your mind but there's no basis for your UTHR synopsis.  Martine has stated publicly that TreT will replace Tyvaso as a treatment for PAH.  So there is no LIFELINE to accommodate Mannkind.   Because this is a new technology UTHR wants to see progress with TreT before they fully commit additional resources for a 2nd molecule.   Also since Martine has stated Technosphere is the platform of the future which means she has great confidence in Mannkind. 

Regarding their current marketing strategy - Mike will have to account for it.  From the beginning I said their TV Ad was not great but then again I am not an expert with marketing.  Maybe this is a strategy to introduce and now with their 2nd Ad will highlight the benefits of Afrezza.  I'm sure there will be a lot of discussion at the ASM this year. 

Then why did Arena get $800mil upfront and $400mill in milestones???  Granted Ralinpeg is already at phase 3.

Technosphere with treprostinil (fda approved delivery system combined with an fda approved drug) is the way of the future, but $45million upfront, $50mill in milestones and low double digit royalties.... with a $40mill, potential, for a second unnamed molecule.

If they believed technosphere is the way of the future, the money scenarios would be reversed, yes/no?

[jonny80s]

One scenario for Arena would be that $1bill seems to be the going price to bag and tag a competitor.

[longliner]

Apr 18, 2019 12:17:09 GMT -5 jonny80s said:

Apr 18, 2019 10:17:51 GMT -5 @chuckbass said:

I'm not trying to change your mind but there's no basis for your UTHR synopsis.  Martine has stated publicly that TreT will replace Tyvaso as a treatment for PAH.  So there is no LIFELINE to accommodate Mannkind.   Because this is a new technology UTHR wants to see progress with TreT before they fully commit additional resources for a 2nd molecule.   Also since Martine has stated Technosphere is the platform of the future which means she has great confidence in Mannkind. 

Regarding their current marketing strategy - Mike will have to account for it.  From the beginning I said their TV Ad was not great but then again I am not an expert with marketing.  Maybe this is a strategy to introduce and now with their 2nd Ad will highlight the benefits of Afrezza.  I'm sure there will be a lot of discussion at the ASM this year. 

Then why did Arena get $800mil upfront and $400mill in milestones???  Granted Ralinpeg is already at phase 3.

Technosphere with treprostinil (fda approved delivery system combined with an fda approved drug) is the way of the future, but $45million upfront, $50mill in milestones and low double digit royalties.... with a $40mill, potential, for a second unnamed molecule.

If they believed technosphere is the way of the future, the money scenarios would be reversed, yes/no?

I think you hit the nail on the head, royalties and the second unnamed molecule.  Ralinpeg is a one and done, technosphere goes on as long as licensing agreements continue.

[boca1girl]

Apr 18, 2019 12:02:06 GMT -5 bill said:

Apr 18, 2019 11:22:52 GMT -5 scottmnkd said:

Afrezza has been a huge disappointment thus far but still has potential. The agreements with UTHR and Receptor Life Sciences can possibly turn things around.

Having said that... I believe the low price per share is reflective of two things: 1) dilution, which is obvious, and 2) management which is not so obvious. I think Mike C is a very lucid and good speaker, but after his Christmas present last year, I've lost all confidence in his leadership as CEO. He's been "very" wrong about Afrezza sales thus far. Remember "guidance" and the recent TV add sales projections? I also heard that Mannkind had a great Hawaiian sales meeting last year while investors like me were saying WTF? Mike has had plenty of time to show improvement in sales and bolster Mannkind's image, but the company is still struggling on most fronts. The good news is that Mannkind is still in business. Do we have the CEO or CFO to thank for that? I don't know...

So, I believe in the products Mannkind is developing, but IMHO, I believe Mike C needs to be replaced due to credibility issues (gasp). If Mike C is replaced by someone well connected, I believe things will turn around. If Mike C isn't replaced, the company will grow, but at a much slower pace with investors always in doubt of what's next.

Looking at MNKD simply from a risk/reward standpoint, I'm in it to win it, so I'll stick around and see what happens. After about 6 years It's been an interesting story thus far and I've enjoyed following this board, which is part of my daily routine.

Hope this help...

scottmnkd Your post caused me to ponder the following. I wonder if the Sales team could be very successful in what they do, but not have it reflected in prescriptions. For example, suppose they are phenomenally successful in getting doctors to prescribe Afrezza, only for them to find out that their patient's insurance doesn't cover the script. After a few failures the physicians may stop prescribing Afrezza. It seems clear that you have to get physicians, patients, and insurance all lined up to get a sale. When scripts are lagging it's not easy to know exactly where in that chain things failed--lack of patient interest, a physician that's not willing to prescribe, or an insurance company that won't cover some of the costs.

Mike keeps telling us that insurance isn’t that much of a problem anymore because of Mannkind Cares, the $15 copay card and the direct purchase plan.  So if you take insurance coverage out of the equation, the answer lies with the doctors unwillingness to prescribe.  Some may not believe or understand the benefits and others may just not want to make changes to what they know and others may take a go slow approach by following one new Afrezza user for 6 months or more before adding other patients.

In another thread, I told a story about a T1 who had a group meeting with her doctor and other T1 pump users and they talked about Afrezza but we’re told by their doctor that they had more precise dosing and control with their pumps and had the “lung cancer concern” with Afrezza.  Up to that meeting, my T1 friend was really interested in Afrezza.  Since she told me politely that she was happy with her current treatment and I should not send her anything more about Afrezza.  So who is to blame in this case?

[mannmade]

Unfortunately that explains in a nutshell how little many doctors understand Afrezza as its forgiving nature from fast in and fast out allows for less precision and a better quality of life with better results.

[mcbone]

Apr 18, 2019 12:17:09 GMT -5 jonny80s said:

Apr 18, 2019 10:17:51 GMT -5 @chuckbass said:

I'm not trying to change your mind but there's no basis for your UTHR synopsis.  Martine has stated publicly that TreT will replace Tyvaso as a treatment for PAH.  So there is no LIFELINE to accommodate Mannkind.   Because this is a new technology UTHR wants to see progress with TreT before they fully commit additional resources for a 2nd molecule.   Also since Martine has stated Technosphere is the platform of the future which means she has great confidence in Mannkind. 

Regarding their current marketing strategy - Mike will have to account for it.  From the beginning I said their TV Ad was not great but then again I am not an expert with marketing.  Maybe this is a strategy to introduce and now with their 2nd Ad will highlight the benefits of Afrezza.  I'm sure there will be a lot of discussion at the ASM this year. 

Then why did Arena get $800mil upfront and $400mill in milestones???  Granted Ralinpeg is already at phase 3.

Technosphere with treprostinil (fda approved delivery system combined with an fda approved drug) is the way of the future, but $45million upfront, $50mill in milestones and low double digit royalties.... with a $40mill, potential, for a second unnamed molecule.

If they believed technosphere is the way of the future, the money scenarios would be reversed, yes/no?

Leverage. MNKD's desperate cash situation left it with very little leverage to get a better deal with UTHR.

[scottmnkd]

Apr 18, 2019 12:02:06 GMT -5 bill said:

Apr 18, 2019 11:22:52 GMT -5 scottmnkd said:

Afrezza has been a huge disappointment thus far but still has potential. The agreements with UTHR and Receptor Life Sciences can possibly turn things around.

Having said that... I believe the low price per share is reflective of two things: 1) dilution, which is obvious, and 2) management which is not so obvious. I think Mike C is a very lucid and good speaker, but after his Christmas present last year, I've lost all confidence in his leadership as CEO. He's been "very" wrong about Afrezza sales thus far. Remember "guidance" and the recent TV add sales projections? I also heard that Mannkind had a great Hawaiian sales meeting last year while investors like me were saying WTF? Mike has had plenty of time to show improvement in sales and bolster Mannkind's image, but the company is still struggling on most fronts. The good news is that Mannkind is still in business. Do we have the CEO or CFO to thank for that? I don't know...

So, I believe in the products Mannkind is developing, but IMHO, I believe Mike C needs to be replaced due to credibility issues (gasp). If Mike C is replaced by someone well connected, I believe things will turn around. If Mike C isn't replaced, the company will grow, but at a much slower pace with investors always in doubt of what's next.

Looking at MNKD simply from a risk/reward standpoint, I'm in it to win it, so I'll stick around and see what happens. After about 6 years It's been an interesting story thus far and I've enjoyed following this board, which is part of my daily routine.

Hope this help...

scottmnkd Your post caused me to ponder the following. I wonder if the Sales team could be very successful in what they do, but not have it reflected in prescriptions. For example, suppose they are phenomenally successful in getting doctors to prescribe Afrezza, only for them to find out that their patient's insurance doesn't cover the script. After a few failures the physicians may stop prescribing Afrezza. It seems clear that you have to get physicians, patients, and insurance all lined up to get a sale. When scripts are lagging it's not easy to know exactly where in that chain things failed--lack of patient interest, a physician that's not willing to prescribe, or an insurance company that won't cover some of the costs.

Bill, thanks for your reply! I could arm-chair CEO Mannkind decisions all day long, but here's my take on your preponderance.

Yes. The sales team could be doing exactly what was asked of them by management. And, because of hurdles like insurance, a prospect might be turned away by insurance whoas. I remember way back when Sanofi had Afrezza and wondered why scripts seemed to stagnate. I was perplexed by the slow growth. Since then, the split between new and recurring prescriptions has been roughly 50/50, so most people who have tried Afrezza do not stick with Afrezza. Why? Based on what I've read, insurance is the primary blocker. And, lack of preparation and education by Mannkind has a lot to do with lack of motivation, for if a doctor and insurance company doesn't understand the benefits, why is it worth the fight to keep a patient on Afrezza?

I'm in the software business and my impression is that the initial rollout of Afrezza was like creating a software program and throwing it over the fence for someone else to figure out (Sanofi in this case). This is evidenced by number of SKU changes (repackaging) that have occurred since Mannkind took full control over Afrezza a few years ago. So, in some instances, I can understand Sanofi's and a doctor's reluctance to continue with Afrezza. I think in the long run, however, Sanofi will regret that decision. After all, they had a pretty good deal!

In any event, two positive things are happening to mitigate the aforementioned problems: 1) Direct to Consumer Sales, and 2) focused regional sales support.

Back to being an arm-chair CEO, I've always thought that the sales force was too large and unfocused. I would have thought that instead of going national, Mannkind would have targeted LA, NY, and other large metro areas prior to trying a large-scale rollout.