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Post by Charlie on Mar 3, 2020 13:05:32 GMT -5
Peppy.
You are great in providing your thoughts and graphics to help the rest of us understand. I do hope that the sales people use your contributions in their education to reluctant physicians. These two graphics that you regularly present are essential tools.
thank you!
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Post by Deleted on Mar 3, 2020 14:04:08 GMT -5
I don't know how Peds will go... I pray that Mnkd markets it in a way that the kids will want it.. However, we do NOT have Endos on board.. nor do we have a lot of money to advertise so we are always at a disadvantage.. It is possible BP will want to partner for the peds population... But I don't know enough about it to say.. how large is that population? It's all about $$$$$!!!! Regarding our current marketing plan.. it isn't working.. it's been how many years now? Time is money.. our retention rate is dismal.. I for one don't want to be diluted into Oblivion.. or wake up one morning and find our company has filed BK.. sticking our heads into the sand isn't a good investment strategy IMO.. All of the problems have been spelled out to us and it's obvious our management has no plan to address any of it. My money is on Vdex.. and because I know how good Afrezza is. Mnkd needs to team up with Vdex.. and work together.. that is how we will see hockey stick growth!!!! I see what the problem is. You guys like to talk about the HERE AND NOW. I am talking about the the next 3-5 years. Where will the insurers be when PEDS is approved in 2021 and ramping starts in mid-2021? Insurers will be onboard by then. Also Diabetics are not stupid. If they see they are dosing too early and need a follow up dose....Maybe they will delay there dosing and wait until they are half way through their meal. Everyone is different and every meal is different. They need to figure out on their own and now with CGMs they can actually see in realtime the impact foods have on their BG levels. I got the Libre for my 90 year old Type 2 Mom and for the first time in her life she realizes how certain foods increase her levels. This is evolving and you have to look at the big picture. VDEX is DEAD. Come on people....Let that HORSE DIE.....Did I hear they closed one of their locations? |
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Post by prcgorman2 on Mar 3, 2020 14:21:31 GMT -5
I hope VDEX is alive and well and would stop trash talking Mannkind management and focus on the outstanding success I wish them.
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Post by agedhippie on Mar 3, 2020 15:55:13 GMT -5
I see what the problem is. You guys like to talk about the HERE AND NOW. I am talking about the the next 3-5 years. Where will the insurers be when PEDS is approved in 2021 and ramping starts in mid-2021? Insurers will be onboard by then. Also Diabetics are not stupid. If they see they are dosing too early and need a follow up dose....Maybe they will delay there dosing and wait until they are half way through their meal. Everyone is different and every meal is different. They need to figure out on their own and now with CGMs they can actually see in realtime the impact foods have on their BG levels. I got the Libre for my 90 year old Type 2 Mom and for the first time in her life she realizes how certain foods increase her levels. This is evolving and you have to look at the big picture. VDEX is DEAD. Come on people....Let that HORSE DIE.....Did I hear they closed one of their locations? Why will the insurers be onboard next year? The pediatrics trials are not going to change the insurers landscape, it will simply mean that doctors can legally prescribe Afrezza for kids. Why will weak Rx rate for adults not will translate to a weak Rx rate for kids? Granted it will result in a rise, even a weak Rx rate is an increase over nil! In diabetes the insurers have historically had to be dragged screaming and shouting to any position that involves them in increased expenditure in the short term. The issue I see is not going to be titration with Type 1, we all do that every day, it is going to be anything that increases the workload. One of the biggest killers in Type 1 is burn out although it is seldom talked about. It is something people are acutely aware of and the more you interact with your diabetes the worse that gets. I know if I prebolus by 10 minutes I will get a better outcome, but I still bolus immediately before the meal because it is less effort. My expectation would be that people will bolus before or after a meal, but not during in real life. However as you very correctly say everyone and every meal is different. What I do know is that Type 1 meetups everyone boluses as the food arrives, and nobody pre-boluses! A CGM is only any use if the person acts on the data. Your 90 year old Type 2 mom sees certain foods spike her blood sugar. What action does she take as a result of that (genuinely curious on this)? I can tell people until I am blue in the face that certain foods will spike them (mashed potato for example) but mostly they just nod and eat it anyway. There is this idea that the problem is sugar rather than carbs and that things like bread are ok whereas cake isn't. Seeing that spike might drive the idea home. |
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Post by sportsrancho on Mar 3, 2020 16:28:55 GMT -5
Please tell me how someone can get away with coming on here and saying “VDEX is a sham”. “They don’t use Medicare”, ( get proven wrong ) and then say, “VDEX is dead” ..clearly misinformation! It’s comical unless someone is paying him to do it. They did just hired me so I know for a fact they are alive and well:-)
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Post by sportsrancho on Mar 3, 2020 16:34:03 GMT -5
I hope VDEX is alive and well and would stop trash talking Mannkind management and focus on the outstanding success I wish them. Trash talking? Isn’t it you guys, or some of you, that have always wanted transparency!? Steve told you exactly what really happened. How many deals have to be buried for you guys to care about this company. |
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Post by sayhey24 on Mar 3, 2020 18:44:08 GMT -5
Please tell me how someone can get away with coming on here and saying “VDEX is a sham”. “They don’t use Medicare”, ( get proven wrong ) and then say, “VDEX is dead” ..clearly misinformation! It’s comical unless someone is paying him to do it. They did just hired me so I know for a fact they are alive and well:-) Sports - what are you doing for VDEX? |
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Post by ktim on Mar 3, 2020 19:29:56 GMT -5
I believe this is the path for the larger trials and better penetration. Once the Pediatric trials are completed and approved MNKD will partner with a larger pharma company to market Afrezza. The larger company have the resources to design and commence a large scale trial to prove the superiority of Afrezza. This will probably happen in late 2021 or 2022.... It's difficult to see who would want to partner. Lilly and Novo Nordisk both have their new insulins which they need to recover the development costs on, and Sanofi has their Humalog clone. Sanofi don't seem to have heard that it takes years to launch an insulin - Admelog has been on the market for two years and last year's net revenue was $278M which was 155% up on the previous year. I don't know what people's expectation of the pediatric trials is, but the insurance barrier remains. Then there is the whole question on how you get endos to prescribe it because if you are having a 75% drop out rate with adults then they are going to expect at least that with kids. For what it's worth (I take at face value), Mike just said that drop out rate (2 month) is only 50% for T2 and less for T1. |
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Post by ktim on Mar 3, 2020 19:34:26 GMT -5
I don't know how Peds will go... I pray that Mnkd markets it in a way that the kids will want it.. However, we do NOT have Endos on board.. nor do we have a lot of money to advertise so we are always at a disadvantage.. It is possible BP will want to partner for the peds population... But I don't know enough about it to say.. how large is that population? It's all about $$$$$!!!! Regarding our current marketing plan.. it isn't working.. it's been how many years now? Time is money.. our retention rate is dismal.. I for one don't want to be diluted into Oblivion.. or wake up one morning and find our company has filed BK.. sticking our heads into the sand isn't a good investment strategy IMO.. All of the problems have been spelled out to us and it's obvious our management has no plan to address any of it. My money is on Vdex.. and because I know how good Afrezza is. Mnkd needs to team up with Vdex.. and work together.. that is how we will see hockey stick growth!!!! I see what the problem is. You guys like to talk about the HERE AND NOW. I am talking about the the next 3-5 years. Where will the insurers be when PEDS is approved in 2021 and ramping starts in mid-2021? Insurers will be onboard by then.
Also Diabetics are not stupid. If they see they are dosing too early and need a follow up dose....Maybe they will delay there dosing and wait until they are half way through their meal. Everyone is different and every meal is different. They need to figure out on their own and now with CGMs they can actually see in realtime the impact foods have on their BG levels. I got the Libre for my 90 year old Type 2 Mom and for the first time in her life she realizes how certain foods increase her levels. This is evolving and you have to look at the big picture. VDEX is DEAD. Come on people....Let that HORSE DIE.....Did I hear they closed one of their locations? Many insurers are already "onboard" just at higher tiers and with the associated hoops to jump through as a non-preferred branded solution. Are you speculating/expecting that Afrezza will be the preferred prandial insulin on some meaningful fraction of formularies by end of 2021. I would say that isn't a reasonable expectation. |
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Post by prcgorman2 on Mar 3, 2020 20:50:23 GMT -5
I agree. I think good tier placement won’t be until 2022 or 2023. I do expect it’s coming though. Afrezza is the shiznits and it won’t be denied forever.
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Post by sportsrancho on Mar 3, 2020 22:08:14 GMT -5
Please tell me how someone can get away with coming on here and saying “VDEX is a sham”. “They don’t use Medicare”, ( get proven wrong ) and then say, “VDEX is dead” ..clearly misinformation! It’s comical unless someone is paying him to do it. They did just hired me so I know for a fact they are alive and well:-) Sports - what are you doing for VDEX? Page 13..... “Director of social media” mnkd.proboards.com/thread/11536/vdex-diabetes?page=13 |
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Post by brotherm1 on Mar 3, 2020 23:29:15 GMT -5
Sports, don’t let anyone push your buttons. “Why do some people constantly strive to "push your buttons"?” “There is a type of character for whom this is a common thing - I would encourage you to look up Narcissistic Personality Disorder. The Split Personality People with this disorder are Jekyll & Hyde characters – their sense of self is derived entirely from others. They need something called Narcissistic Supply, and for the most part this is in a positive form – think adulation, adoration, acclaim etc. To most people, they appear as thoroughly charming and confident. Sadly they also have a sadistic side that needs supply in a negative form – control, drama and the like – and will push buttons to get this. Invariably it is only their nearest and dearest who they seek this from – to everyone else they appear the most charming and charismatic types. The reality is that they are deeply self-loathing and have zero self-esteem. They are at war with themselves, and anyone that tangles with them is ultimately ends up as collateral damage...” www.quora.com/Why-do-some-people-constantly-strive-to-push-your-buttons |
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Post by agedhippie on Mar 3, 2020 23:31:38 GMT -5
I agree. I think good tier placement won’t be until 2022 or 2023. I do expect it’s coming though. Afrezza is the shiznits and it won’t be denied forever. It will be denied until it either gets competitive on the cost to treat (if you need twice the insulin it had better cost half the price), or there are large scale trials proving that it is better and how - TIR, HbA1c, and hypos (all three of which should be doable). Without those two, especially the first, expect the insurance cover to be exactly where it is today. |
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Post by brotherm1 on Mar 3, 2020 23:39:41 GMT -5
It's difficult to see who would want to partner. Lilly and Novo Nordisk both have their new insulins which they need to recover the development costs on, and Sanofi has their Humalog clone. Sanofi don't seem to have heard that it takes years to launch an insulin - Admelog has been on the market for two years and last year's net revenue was $278M which was 155% up on the previous year. I don't know what people's expectation of the pediatric trials is, but the insurance barrier remains. Then there is the whole question on how you get endos to prescribe it because if you are having a 75% drop out rate with adults then they are going to expect at least that with kids. For what it's worth (I take at face value), Mike just said that drop out rate (2 month) is only 50% for T2 and less for T1. Again, emphasis is on one to two months. He wisely did not say what the drop out rate is after that. |
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Post by porkini on Mar 3, 2020 23:51:15 GMT -5
I don't know how Peds will go... I pray that Mnkd markets it in a way that the kids will want it.. However, we do NOT have Endos on board.. nor do we have a lot of money to advertise so we are always at a disadvantage.. It is possible BP will want to partner for the peds population... But I don't know enough about it to say.. how large is that population? It's all about $$$$$!!!! Regarding our current marketing plan.. it isn't working.. it's been how many years now? Time is money.. our retention rate is dismal.. I for one don't want to be diluted into Oblivion.. or wake up one morning and find our company has filed BK.. sticking our heads into the sand isn't a good investment strategy IMO.. All of the problems have been spelled out to us and it's obvious our management has no plan to address any of it. My money is on Vdex.. and because I know how good Afrezza is. Mnkd needs to team up with Vdex.. and work together.. that is how we will see hockey stick growth!!!! I see what the problem is. You guys like to talk about the HERE AND NOW. I am talking about the the next 3-5 years. Where will the insurers be when PEDS is approved in 2021 and ramping starts in mid-2021? Insurers will be onboard by then. Also Diabetics are not stupid. If they see they are dosing too early and need a follow up dose....Maybe they will delay there dosing and wait until they are half way through their meal. Everyone is different and every meal is different. They need to figure out on their own and now with CGMs they can actually see in realtime the impact foods have on their BG levels. I got the Libre for my 90 year old Type 2 Mom and for the first time in her life she realizes how certain foods increase her levels. This is evolving and you have to look at the big picture. VDEX is DEAD. Come on people....Let that HORSE DIE.....Did I hear they closed one of their locations? No doubt some will understand why you think this way; however, Friends Uplift All Horses!      |
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