|
|
Post by mnholdem on Mar 1, 2020 15:54:17 GMT -5
At the 2015 ASM Sanofi's big excuse for not selling afrezza was the spirometer requirement. Al brought with him a handheld device which was about $400. We got into a discussion about Jones marketing the afrezza spirometer. Soon after Al's health got bad so I don't think he ever put a deal together. Jone's is still selling the afrezza spirometer www.jonesmedical.com/spirometry-for-afrezza/I wonder why no spirometry testing for tobacco, weed, even asthma meds, why just Mannkinds Afrezza. I'd suggest the simplest reason: because there are unknowns with Afrezza. Look at the response to the coronavirus. Seasonal flu infections and deaths dwarfs COVID-19 and yet some are panicky because there are still so many unknowns about the new virus. The FDA (like the CDC) has to assume the worst-case scenario with Afrezza until enough data is gathered about insulin and the inert FDKP particles' side-effects to the lungs. |
|
|
|
Post by seanismorris on Mar 1, 2020 16:17:10 GMT -5
I don’t there is great concern by docs about the lung test...
I’m looking at the poor retention of people having tried Afrezza.
Unless you’ve had a hospital visit previously taking something else, and no visit with Afrezza, it’s difficult to quality the benefit.
So, I paid more for Afrezza and the results are the same? Most people will probably take the risk and save the money, and tell themselves they’ll just eat healthier.
It’s a marketing and sales problem. Somehow we’ve been duped into spending $35+ billion on vitamins and supplements that haven’t shown a clinical benefit, but we won’t spend extra to treat a disease.
|
|
|
|
Post by Charlie on Mar 1, 2020 16:17:14 GMT -5
Charlie, on the contrary, the fact your doc used Cough as a diagnosis code probably helped you out w/out you knowing it. In that way, your insurance would pay for it. If it were some sort of screening code, chances are you’d foot the bill for it as insurance won’t cover it. As to why the endo does not buy their own simple spiro and bill for it, I don’t know. Perhaps they don’t do it often enough to recover the expense of obtaining one. If that 400$ spiro really exists, no reason not to buy one. usually they’re much more but still, if done often enough, ROI should be attainable. Curious reply. I can't concur. The issue with a "cough" is associate with intolerance to the inhalation of a new drug. I would think it has to do with the doctor's concerns about Liability if he continue to prescribe something that could be a pulmonary negative response. I passed the test within the guidelines @ 85% within acceptance. My cough has to to with sinus issues. I went to a new ENT the same week. In fact I saw 8 different medical specialists and all but the General Physician and the Endocrinologist didn't Know and have Not heard about Afrezza. Point being that even in the medical community this drug is unknown. To me this is a double edge sword. On one hand the word (commercialization) hasn't occurred which is a negative; and on the other hand, because it isn't known, The Market is still New and ripe for those educated to recognize the positive appeal for an inhaled insulin. I was under dosing for the longest time. This morning I woke up with a blood reading of 100. One has to ask oneself how much was the cost at the hospital for the spirometry test? @ 400.00 to buy one the price would be recovered with 4 or 5 patients is my guess. This makes owning one and administering the test in office a money maker for the physician. As was pointed out by our administrator/Physician the doctor can't do this if the testing device is rented or leased (as I understand her). Please don't take this as confrontive; your participation is appreciated. Best to you. |
|
|
|
Post by Charlie on Mar 1, 2020 16:21:38 GMT -5
I don’t there is great concern by docs about the lung test... I’m looking at the poor retention of people having tried Afrezza. Unless you’ve had a hospital visit previously taking something else, and no visit with Afrezza, it’s difficult to quality the benefit. So, I paid more for Afrezza and the results are the same? Most people will probably take the risk and save the money, and tell themselves they’ll just eat healthier. It’s a marketing and sales problem. Somehow we’ve been duped into spending $35+ billion on vitamins and supplements that haven’t shown a clinical benefit, but we won’t spend extra to treat a disease. I have to disagree. My interpretation is that it isn't about the "unknowns" of Afrezza's perceived negative affect but rather that the drug itself is "unknown". |
|
|
|
Post by liane on Mar 1, 2020 16:47:30 GMT -5
Curious reply. I can't concur. The issue with a "cough" is associate with intolerance to the inhalation of a new drug. I would think it has to do with the doctor's concerns about Liability if he continue to prescribe something that could be a pulmonary negative response. I passed the test within the guidelines @ 85% within acceptance. My cough has to to with sinus issues. I went to a new ENT the same week. In fact I saw 8 different medical specialists and all but the General Physician and the Endocrinologist didn't Know and have Not heard about Afrezza. Point being that even in the medical community this drug is unknown. To me this is a double edge sword. On one hand the word (commercialization) hasn't occurred which is a negative; and on the other hand, because it isn't known, The Market is still New and ripe for those educated to recognize the positive appeal for an inhaled insulin. I was under dosing for the longest time. This morning I woke up with a blood reading of 100. One has to ask oneself how much was the cost at the hospital for the spirometry test? @ 400.00 to buy one the price would be recovered with 4 or 5 patients is my guess. This makes owning one and administering the test in office a money maker for the physician. As was pointed out by our administrator/Physician the doctor can't do this if the testing device is rented or leased (as I understand her).Please don't take this as confrontive; your participation is appreciated. Best to you. The physician can do the spiro in office, and bill for it. It's just that MNKD can have nothing to do with giving or leasing the spirometer to the physician. |
|
|
|
Post by seanismorris on Mar 1, 2020 16:48:46 GMT -5
I don’t there is great concern by docs about the lung test... I’m looking at the poor retention of people having tried Afrezza. Unless you’ve had a hospital visit previously taking something else, and no visit with Afrezza, it’s difficult to quality the benefit. So, I paid more for Afrezza and the results are the same? Most people will probably take the risk and save the money, and tell themselves they’ll just eat healthier. It’s a marketing and sales problem. Somehow we’ve been duped into spending $35+ billion on vitamins and supplements that haven’t shown a clinical benefit, but we won’t spend extra to treat a disease. I have to disagree. My interpretation is that it isn't about the "unknowns" of Afrezza's perceived negative affect but rather that the drug itself is "unknown". If you are correct... the Afrezza sales team is garbage. They should have the docs fully educated by now... I guess the question is: Should MannKind spend more resources on educating the doctors or the diabetics? Focusing on the doctors might be working on T1 patients, but is failing with T2 patients. I don’t think the cough or ‘lung risk’ should be a deterrent. I don’t think most doctors bother to explain Afrezza, and set expectations. they don’t want to bother fighting the insurance companies, unless the T2 patients insist... If doctors aren’t doing their part, online ads directing people to the right information is the only solution. MannKind says they’ll higher more sales people... |
|
|
|
Post by seanismorris on Mar 1, 2020 16:53:47 GMT -5
Curious reply. I can't concur. The issue with a "cough" is associate with intolerance to the inhalation of a new drug. I would think it has to do with the doctor's concerns about Liability if he continue to prescribe something that could be a pulmonary negative response. I passed the test within the guidelines @ 85% within acceptance. My cough has to to with sinus issues. I went to a new ENT the same week. In fact I saw 8 different medical specialists and all but the General Physician and the Endocrinologist didn't Know and have Not heard about Afrezza. Point being that even in the medical community this drug is unknown. To me this is a double edge sword. On one hand the word (commercialization) hasn't occurred which is a negative; and on the other hand, because it isn't known, The Market is still New and ripe for those educated to recognize the positive appeal for an inhaled insulin. I was under dosing for the longest time. This morning I woke up with a blood reading of 100. One has to ask oneself how much was the cost at the hospital for the spirometry test? @ 400.00 to buy one the price would be recovered with 4 or 5 patients is my guess. This makes owning one and administering the test in office a money maker for the physician. As was pointed out by our administrator/Physician the doctor can't do this if the testing device is rented or leased (as I understand her).Please don't take this as confrontive; your participation is appreciated. Best to you. The physician can do the spiro in office, and bill for it. It's just that MNKD can have nothing to do with giving or leasing the spirometer to the physician. I wonder what’s the percentage that don’t have the ability (equipment) to do the spiro. Seems like basic equipment that they all should have (at least the inexpensive version). |
|
|
|
Post by Charlie on Mar 1, 2020 16:56:49 GMT -5
Thanks for that Mannmade. 6 doses is an interesting thing as in what is a dose. Given that the medicine is of equal strength and I take 4 3 unit cartridges; I'd guess that this is a "dose". But, if the glucose # is too high in 90 minutes because I miscalculated then I would take another cartridge as a corrective measure. Would you consider this a 2nd dose? I think that Mannkind is yielding information on the conservative side.
Someone else mention why there isn't the retention that we would like to see. My answer to this is that is a learning curve which requires confidence and the chance to personally confirm Afrezza's positive affects. For me, there was an adjustment (described by others as a tickle in the back of the throat). I got use to it. The real challenge for me which made me feel like a moron was that I was under dosing for too long trying to associate certain foods with how much insulin I needed to neutralize the blood sugar. So now I'm not just taking a 12 unit for a bagel. Yes, I shouldn't be eating bagels; however I like them and consider the carb content in them so I now adjust with 16 units for just the bread. It's all individual based on the Body Mass Index.
Bloggers have posted that they eat up to 5 or 6 times a day with smaller portions and asking that 2 unit cartridges be made available. @ 6 times a day that would be more than 6 doses a day which is the guideline.
Lastly, because food is no longer just categorized as "what is delicious"; my new interpretation is seeing food much differently broken into Carbs, Fat, Protein, & Sugar. I can't say that Afrezza has made me lose weight; but I can say that for 10 years I weighed 220 lbs. This morning I am at 190. I think the weight loss is do to thinking about and motivated by controlling my diabetes.
thank you for your contribution.
|
|
|
|
Post by Charlie on Mar 1, 2020 16:59:14 GMT -5
I agree. Perhaps just like the insecurity of dealing with something new; both patients and physicians have similar learning curves.
thank you
|
|
|
|
Post by nylefty on Mar 1, 2020 18:15:10 GMT -5
I have to disagree. My interpretation is that it isn't about the "unknowns" of Afrezza's perceived negative affect but rather that the drug itself is "unknown".
(snip) Many, if not most, docs refuse to see sales reps, especially reps from tiny companies with only one drug to peddle. |
|
|
|
Post by rockstarrick on Mar 1, 2020 20:45:33 GMT -5
I wonder why no spirometry testing for tobacco, weed, even asthma meds, why just Mannkinds Afrezza. I'd suggest the simplest reason: because there are unknowns with Afrezza. Look at the response to the coronavirus. Seasonal flu infections and deaths dwarfs COVID-19 and yet some are panicky because there are still so many unknowns about the new virus. The FDA (like the CDC) has to assume the worst-case scenario with Afrezza until enough data is gathered about insulin and the inert FDKP particles' side-effects to the lungs. It just seems that how anything you put in your lungs would work, they didn’t know how the lungs would handle everything I suggested when new. I guess with tobacco and weed it may be the surgeon general,(I don’t know anything about this), and they may require or recommend, but I’ve never seen it. |
|
|
|
Post by rockstarrick on Mar 1, 2020 21:43:38 GMT -5
I wonder why no spirometry testing for tobacco, weed, even asthma meds, why just Mannkinds Afrezza. IMHO, likley because of the frequency of use, eg: up to six doses a day if use for three meals and require a follow up. Others are much less frequent I beleive, except perhaps weed...  GLTAL's Is there other new respiratory drugs that require monitoring, I have no idea. |
|
|
|
Post by agedhippie on Mar 1, 2020 23:15:45 GMT -5
Thanks for that Mannmade. 6 doses is an interesting thing as in what is a dose. Given that the medicine is of equal strength and I take 4 3 unit cartridges; I'd guess that this is a "dose". But, if the glucose # is too high in 90 minutes because I miscalculated then I would take another cartridge as a corrective measure. Would you consider this a 2nd dose? I think that Mannkind is yielding information on the conservative side. ... That dose at 90 minutes is the second dose. Less because you miscalculate as that Afrezza clears fast so you may have uncovered carbs when it clears. This depends on your carb absorption rate, the number of carbs (although I think less so), and the speed at which it is digested (refined v. unrefined carbs, and fat content having impact here). |
|
|
|
Post by Charlie on Mar 1, 2020 23:16:30 GMT -5
If you are correct... the Afrezza sales team is garbage. They should have the docs fully educated by now...
(snip) Many, if not most, docs refuse to see sales reps, especially reps from tiny companies with only one drug to peddle. I think that's a blanket statement seanismorris. Have you ever waited in a doctors office for your appointment along with a sales rep waiting to have a moment with a doctor. I have, many times. With regard to the sales reps being garbage; I think it's more about the advertising which I consider non personal and ineffectual. For a sales rep this is a hard sell. Again, if most or many in the medical community what is their basis of promoting the last failure of an inhalation drug: Exubra? I think nylefty makes a good point. If it were up too me I'd be collecting tributes by Youtube Afrezza users along with proven data for the sales reps to hand out. The insulin / outsilin was a silly and childish investment which may still be affective for younger children in the pediatric promotion; but for adults, who can relate to that. It's not personal. Another promotion using the concept of eat when you want to without planning had a good premise but wasn't personal it was more psychedelic than relatable. However the kid drinking a coke and monitoring his glucose was genuine, personal and factual. Those are the kind of messages that will make an impact. The most impressive one was the child with a million needles in her; it would be great if Mannkind would purchase that image and use it for its realistic shock value. Any new drug like Afrezza in the age of injectables needs to make it's message in advertising personal otherwise it's just more of the same to a busy physician and the diabetics who have never heard of Afrezza. Advertising is the Key needed for the sales reps to be heard. |
|
|
|
Post by sportsrancho on Mar 2, 2020 8:28:50 GMT -5
I eat once a day, so if I were a PWD I would try and take 24 units with no follow up.
|
|
GLTAL's
