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Post by sugarland on Mar 20, 2020 19:15:20 GMT -5
Regretfully, the only people controlling doctors protocols are insurance companies. And yes a free market indicates any and all docs can and should prescribe. Hell I hope everyone of them starts tomorrow. Again the more the better in my opinion. I’m simply saying that VDex seems to have a more organized, detailed, and according to them, successful way of doing so. Looking forward to learning more. I like most wanna see the numbers grow with consistently sound results. Who ever and how ever the magic bullet is found is fine by me. But it will take a unified approach to get there. We are small, and further fragmentation will make us smaller in the equation. So I agree with your point about not limiting script writers. But zeroing in on the approach to successfully prescribe. That’s the message here in my opinion.
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Post by ktim on Mar 20, 2020 19:37:26 GMT -5
Regretfully, the only people controlling doctors protocols are insurance companies. And yes a free market indicates any and all docs can and should prescribe. Hell I hope everyone of them starts tomorrow. Again the more the better in my opinion. I’m simply saying that VDex seems to have a more organized, detailed, and according to them, successful way of doing so. Looking forward to learning more. I like most wanna see the numbers grow with consistently sound results. Who ever and how ever the magic bullet is found is fine by me. But it will take a unified approach to get there. We are small, and further fragmentation will make us smaller in the equation. So I agree with your point about not limiting script writers. But zeroing in on the approach to successfully prescribe. That’s the message here in my opinion. To be fair, you aren't hearing from the other early adopter doctors/clinics. Some of them participated in the trials, so have been using Afrezza even longer than VDex. Some are T1 themselves and use Afrezza (Dr. Pettus for instance). Not sure if VDex is really claiming they are better than the other clinics that have been prescribing Afrezza regularly and for a long time, they are just saying they are better than the overall numbers for Afrezza, which is undoubtedly true. Since MNKD can't control doctors there will be doctors using it that don't understand it and don't support their patients properly. Sadly, there may be no magic bullet... there is nothing that guarantees every problem has one. Of course there is doing a large clinical trial to prove superiority but that's an unaffordable bullet rather than a magic one. At one point Bill offered to share the VDex protocol publicly, but I think that was never done... presumably he changed his mind. MNKD can't force VDex to share, so really no way for MNKD to unify protocols on VDex's even if VDex had something unique beyond what other successful frequent prescribing doctors are doing. Actually MNKD isn't in a role to unify clinical use of Afrezza. Even if VDex had made their protocol public MNKD could no more force Dr. Pettus to use it than they could force VDex to switch to Dr. Pettus' protocol. Perhaps MNKD could help facilitate putting frequent prescribing docs in touch with each other so they could share best practices. I would imagine the docs themselves would have more leeway to share info, since they aren't constrained by FDA as MNKD is. Maybe a monthly teleconference. Probably someone other than MNKD would need to lead it to avoid the FDA constraints. Wonder if VDex would be interested in participating or would consider it giving away their trade secrets. |
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Post by sugarland on Mar 20, 2020 20:31:40 GMT -5
Agree. Let’s see if the next couple videos present actual detailed information on applied techniques and results, or just generalizations. I agree it’s time they back it up. I think once things settle behind the scenes this should become more evident hopefully. And if Vdex is legit and ends up successfully expanding across the county promoting afrezza, they gotta be a team player. I do not support exclusive rights to just vdex in any capacity at present. As I said before it’s mnkd company and that’s my investment. But on the surface I see potential with Vdex philosophy and it’s time to put it out on the table.
I also mentioned a few years ago about networking amongst your most successful prescribers with other nonprescribing friends at annual, regional or local meeting in some capacity. Science and protocols are one thing, but it’s also about developing relationships. Case presentation, lunch and learn, continuing education,......Again I’m sure a lot of this is going on with drug reps, speakers who have actually prescribed, and offices. With technology today it’s easy to reach target groups with emails on 1 hour ceu course presentations on line. Vdex guys can be involved on MNKD behalf in this capacity as well I hope. That’s called a united front. Great idea. Many things to throw around on this topic. But since this is vdex section I’ll keave it at that.
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Post by ktim on Mar 20, 2020 22:00:58 GMT -5
I don't think Bill necessarily should reveal anything about VDex, that was simply his own assertion that they would publicly release the protocol. I personally wouldn't vote for him for the BoD because I think it is a conflict of interest being a founder of VDex. Nothing to do with whether I believe his claims about success... I would have no reason to question them. Certainly hope they are true and hope he expands VDex much more aggressively. Actually wish he'd focus on that rather than trying to gain a board seat for himself.
There have been doctors such as Dr. Pettus that speak about Afrezza, both to medical gatherings and in a video aimed at PWD. Bill could have one of his doctors do that as well. Just like Dr. Pettus, that doesn't require any permission or participation from MNKD.
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Post by nylefty on Mar 20, 2020 22:26:07 GMT -5
I don't think Bill necessarily should reveal anything about VDex, that was simply his own assertion that they would publicly release the protocol. I personally wouldn't vote for him for the BoD because I think it is a conflict of interest being a founder of VDex. How is it a conflict of interest? The two companies aren't competing with each other and both want Afrezza to be a success. |
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Post by ktim on Mar 20, 2020 23:17:34 GMT -5
I don't think Bill necessarily should reveal anything about VDex, that was simply his own assertion that they would publicly release the protocol. I personally wouldn't vote for him for the BoD because I think it is a conflict of interest being a founder of VDex. How is it a conflict of interest? The two companies aren't competing with each other and both want Afrezza to be a success. He was the one that has made it clear that VDex (and perhaps him as an individual) has been seeking business relationships with MNKD... i.e. wanting to be a distributor, wanting to be involved in deals internationally. For those he had business interests separate from ours as MNKD shareholders. He was, would be, negotiating those on behalf of himself, VDex and whoever his international partners were. Yes, potentially there could be some business win-win, but those are still business relationships where it would create conflict of interest if voting on something and having financial stake in both sides of the business relationship. He would have fiduciary duties to both sides... i.e. conflict. Additionally, VDex competes with other medical practices using Afrezza, and VDex appears to be saying they are wanting to compete by using proprietary insight into Afrezza use. Having access to Afrezza proprietary information to then use it to compete with other clinics would also be a conflict. VDex is a very unique situation since it is a company whose clinical practice and business model seems to be solely built around Afrezza. If it were Dr. Jeremy Pettus, just to pick a name I know that has been using Afrezza a long time, seeking a seat on board I wouldn't see the same conflict since despite using Afrezza in his practice he doesn't have a business interest like Bill does, he's just a salaried doctor in the Univ CA system. Granted sometimes BoD members have conflicts and they simply recuse themselves in those issues, but it seems exactly what Bill is saying he would contribute to the board are the areas where he has conflicting interests. If he's proposing a strategy to work with more limited number of clinics, he'd be doing it while having a fiduciary duty to any other investors in VDex to do what is in their best interest and a fiduciary duty to do what is best for MNKD shareholders. It doesn't fly from business ethics to merely speculate that those two different fiduciary duties would be coincident. |
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Post by sportsrancho on Mar 20, 2020 23:40:28 GMT -5
Interesting ...my question is what is it that you guys think are exclusive rights? Just curious.. there is no deal on the table for exclusive anything.
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Post by ktim on Mar 21, 2020 1:32:38 GMT -5
Interesting ...my question is what is it that you guys think are exclusive rights? Just curious.. there is no deal on the table for exclusive anything. I didn't say anything about exclusive, if that was directed at me as one of "you guys". But you probably didn't mean me, right? |
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Post by sportsrancho on Mar 21, 2020 3:58:06 GMT -5
Interesting ...my question is what is it that you guys think are exclusive rights? Just curious.. there is no deal on the table for exclusive anything. I didn't say anything about exclusive, if that was directed at me as one of "you guys". But you probably didn't mean me, right? The interesting was directed at you all and the exclusive was directed at sugar. Or the many other people that have mentioned it in the past. I never thought it was completely understood. I didn’t want to assume what people were thinking. |
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Post by falconquest on Mar 21, 2020 5:58:27 GMT -5
I agree with sports. I think there was/is a lot of misconception about the "exclusivity" issue.
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Post by sugarland on Mar 21, 2020 7:53:48 GMT -5
Wasn’t there discussion at one time of bill wanting exclusive rights to prescribe in select areas ? I thought that was thrown out there at sometime on the forum. If true I am not in support. If I misunderstood - my mistake. But That’s what I was referring too. Lots of ideas , opinions, and facts get thrown around here.
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Post by sportsrancho on Mar 21, 2020 9:52:37 GMT -5
This is what I think... that was an idea that Vdex could go into the states that Mannkind had abandoned. With a distributor contract. But that would not stop Mannkind from going back into those states ...it was only so that another clinic couldn’t set up shop within a certain mile radius and also sell Afrezza with the same kind of agreement. Nevertheless the whole thing is void as far as I know.
The word abandon is probably not correct either...there are just some states that there are no reps and they aren’t getting covered because there are areas with a lot of white out. Too far for the reps to drive between Endo’s.
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Post by sugarland on Mar 21, 2020 9:59:38 GMT -5
Thanks for the clarification Sporty!! Keep doing what your doing, you do it well!
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Post by morfu on Mar 22, 2020 11:38:31 GMT -5
This is what I think... that was an idea that Vdex could go into the states that Mannkind had abandoned. With a distributor contract. But that would not stop Mannkind from going back into those states ...it was only so that another clinic couldn’t set up shop within a certain mile radius and also sell Afrezza with the same kind of agreement. Nevertheless the whole thing is void as far as I know. The word abandon is probably not correct either...there are just some states that there are no reps and they aren’t getting covered because there are areas with a lot of white out. Too far for the reps to drive between Endo’s.
Well, last week Mannkind made about $1.4mil with 830 scripts and about 45% earning rate. They are also 50% up from last year on a solid trend which went on for several years now.
There is no immediate need for cash (and hopefully some more milestone payments)
So I hope for this company to show green numbers potentially within two years (they only have roughly double the scripts provided they make a little more bucks through other channels).
To restrict their business with an exclusive contract with Vdex in not in the interest of Mannkind, they would love to have many clinics right next to each other competing to sell Afrezza! So, my guess is such an exclusive is only interesting for Mannkind, if it provides a massive incentive. If Vdex would offer $50mil for a 10year contract or something like that, it would help Mannkind in it current position, but only in a sense, that it provides additional security for unforeseen things (an unexpected and expensive lawsuit for example).
Vdex needs Mannkind a lot more than the other way around!
(You have access to their number, but my guess is, that they are not doing too well.. all this fancy Voodoo might slightly increase the patient compliance, but in the end is just much more expensive than a conventional doctor)
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Post by ktim on Mar 22, 2020 12:51:56 GMT -5
It's weird that somehow VDex is perceived by some as an enemy.
These are difficult times. VDex is helping people.
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