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Post by ktim on Aug 5, 2019 22:31:23 GMT -5
Aged - I think you are absolutely correct and we are in violent agreement. They make the rules. If MNKD continues to play by the rules afrezza script growth will be a slow slog. I am hoping today's announcement with One Drop is a step forward in changing the paradigm in how afrezza will be sold going forward. Direct to PWD clinics with 24/7 connected care is the fastest way to increase sales and by-pass the rules which are holding back afrezza sales. Hopefully they will announce a clinic partner soon and get 'er done. If by playing by the rules you mean that Afrezza has to prove itself in the same way everyone else does, you are correct. Science is science. Hypotheses are just theory until you can prove them with reproducible data. Like it or not, these rules are rules for a reason. The board has hashed, rehashed, and then hashed again over a thousand times. It is the way it is and is the way it should be. Good medicine is not guesswork. As long as and until MC decides to make Afrezza more affordable, this will continue to be an issue. I'm not him, so I won't pretend to understand the rationale behind why he has set the price as high as he has. I'm sure he has good reason for it. But if you have to take twice as many doses as other prandial insulins, it will be cost-prohibitive for Afrezza to become the SOC. Cost is a real determining factor in the practice of medicine. The gold standard isn't always the standard of care if it is too expensive for all to have. There are other examples where cheaper tests/medications are given that are not as good of quality because it would help a broader amount of people to give the cheaper alternative vs the minuscule benefit of the best given to the few. He pretty much indicated that giving insurers price breaks ahead of getting tier placement improvement is counterproductive. Implying that a lower price would not have any meaningful effect on probability of getting prior auths and thus the strategy is to charge a high price and gradually eat away at insurers with prior authorizations until such time that the insurers are willing to concede and place at low tiers. That and then try to help cash paying customers out with the Eagle program. One might well argue scripts would be higher and better for patients overall if MNKD simply adopted the Eagle pricing for everyone, but presumably the current approach is deemed to be the appropriate one for making a profit for shareholders eventually. |
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Post by mnholdem on Aug 6, 2019 7:39:04 GMT -5
I recall a few years ago how the AACE took quite a bit of flack for setting its upper limit to 180 because lowering it would place undue burden on patients, particularly older the older PWD. The ADA has its own set of guidelines of what constitutes “in range” yet it appears to have considered the logic behind the AACE recommendations.
The difference goes to show that the top two KOLs may have initially used slightly different criteria but now are in alignment.
Regardless, defining a range at least provides drug companies the means by which they can provide the data needed to lobby the medical industry as to why their drug should be preferred.
MannKind is no exception.
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