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Post by kc on Feb 28, 2020 9:48:58 GMT -5
The reason why this product has never gained any traction it’s too costly for the type one and type two diabetics. insurance companies our unwilling to pay the high price for such a good product.
If the company is to survive the market the product it will have to be a total paradigm shift in the way that Afrezza is marketed.
While none of us know what the cost of goods to produce Afrezza might be. We know it’s priced very high equal to the best selling insulin drugs on the market.
If you want to get on a better schedule you need to cut the price 50% and hope that you don’t go out of business while you try to build a new base of users. show the pharmaceutical industry that you’re prepared to take it directly to the consumer with good pricing.
The Board of Directors needs to look carefully how to change this dynamic. with our current pricing we will never make the right schedules to be an every day non-boutique drug for Medicare, Tricare,even Medicaid.
Formularies are chosen by the insurance companies based on prices and Afrezza is priced too high to make the cut. Evidenced by the fact that we keep hearing the complaint that we get new initiations but people cannot stay on Afrezza.
Time for the drastic paradigm shift and make this a product Affordable for all.
Selling in other markets like Brazil and India may prove this case.
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Post by uvula on Feb 28, 2020 10:23:15 GMT -5
A CEO can never do something risky and "hope they don't go out of business".
We probably all agree that price is a problem. But I disagree that all of BP is working together with the intent of killing MNKD. I think each BP company is just trying to maximize their profits. And they all have a bunch of smart people.
If MNKD can prove that Afrezza will be competitive if the volume were high enough to get the cost down,
Then a BP company might be interested in partnering with (or buying) mnkd with the intent of increasing their profits while hurting other BP companies.
I'm not sure how mnkd accomplishes this.
I'm not claiming that price is the biggest issue. I'm just saying that if price is the biggest issue it can be resolved by getting a large partner.
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Post by ktim on Feb 28, 2020 10:28:12 GMT -5
The reason why this product has never gained any traction it’s too costly for the type one and type two diabetics. insurance companies our unwilling to pay the high price for such a good product.If the company is to survive the market the product it will have to be a total paradigm shift in the way that Afrezza is marketed. While none of us know what the cost of goods to produce Afrezza might be. We know it’s priced very high equal to the best selling insulin drugs on the market. If you want to get on a better schedule you need to cut the price 50% and hope that you don’t go out of business while you try to build a new base of users. show the pharmaceutical industry that you’re prepared to take it directly to the consumer with good pricing. The Board of Directors needs to look carefully how to change this dynamic. with our current pricing we will never make the right schedules to be an every day non-boutique drug for Medicare, Tricare,even Medicaid. Formularies are chosen by the insurance companies based on prices and Afrezza is priced too high to make the cut. Evidenced by the fact that we keep hearing the complaint that we get new initiations but people cannot stay on Afrezza. Time for the drastic paradigm shift and make this a product Affordable for all. Selling in other markets like Brazil and India may prove this case. Management has stated they are fairly successful in getting prior auths approved. They also are negotiating with insurers, just like every other pharma, to get better placement in exchange for price breaks. What info do you have on their pricing with insurers that are willing to move to better tiers? Ordinarily that is a very tightly held secret. How does their negotiated pricing compare to RAA? From what I know of the way these rebates work, I wouldn't be surprised by it being 30% or more, potentially even 50%. In the past I remember hearing from some source that the horrible aspect of the way the current rebate system works is that MNKD could give away Afrezza and it still wouldn't pay for PBMs to put it on even footing with their preferred RAA. If it were strictly pricing, as you imply, then all plans would carry the same RAA (whichever of Novolog or Humalog is cheaper) or both if they had the same pricing. Hopefully this dysfunctional rebate system will be reigned in. By the way, as I remember from formularylookup.com Medicaid coverage was very high... and Medicare almost non existent. |
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Post by Deleted on Feb 28, 2020 11:28:39 GMT -5
A CEO can never do something risky and "hope they don't go out of business". We probably all agree that price is a problem. But I disagree that all of BP is working together with the intent of killing MNKD. I think each BP company is just trying to maximize their profits. And they all have a bunch of smart people. If MNKD can prove that Afrezza will be competitive if the volume were high enough to get the cost down, Then a BP company might be interested in partnering with (or buying) mnkd with the intent of increasing their profits while hurting other BP companies. I'm not sure how mnkd accomplishes this. I'm not claiming that price is the biggest issue. I'm just saying that if price is the biggest issue it can be resolved by getting a large partner. I think Afrezza is priced correctly. As CEO you have to make a decision...do you go after market share or margins. MNKD is going after margins because that will keep the lights on. Once Type 1's realize the benefits they will come and payors will jump onboard. And patients on Afrezza will tell other PWDs and the word will spread. We all know PWD only listen to other PWD. Let me ask you....If you buy a new model car during the first week of the new model year...do you get a discount?? NO...... You can buy an older model and get a deal but not a brand new model year car. Afrezza is that brand new model year drug. There is a premium but you also have to look at the medical benefits. Mike said 70% of PWD are not within range.....Why is that? Insulin has been on the market for 90 years and PWD are not in a safe place. With Afrezza that number will drop dramatically. |
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Post by uvula on Feb 28, 2020 12:38:43 GMT -5
When all electric cars first came out (paradigm shift) ike the Leaf, the car companies offered rebates and other incentives to entice people to try something new that had an unknown track record and required drivers to modify their refueling behavior.
(I'm not sure what my point is but I'm proud of my clever analogy.)
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Post by agedhippie on Feb 28, 2020 12:53:05 GMT -5
A CEO can never do something risky and "hope they don't go out of business". We probably all agree that price is a problem. But I disagree that all of BP is working together with the intent of killing MNKD. I think each BP company is just trying to maximize their profits. And they all have a bunch of smart people. If MNKD can prove that Afrezza will be competitive if the volume were high enough to get the cost down, Then a BP company might be interested in partnering with (or buying) mnkd with the intent of increasing their profits while hurting other BP companies. I'm not sure how mnkd accomplishes this. I'm not claiming that price is the biggest issue. I'm just saying that if price is the biggest issue it can be resolved by getting a large partner. I think Afrezza is priced correctly. As CEO you have to make a decision...do you go after market share or margins. MNKD is going after margins because that will keep the lights on. Once Type 1's realize the benefits they will come and payors will jump onboard. And patients on Afrezza will tell other PWDs and the word will spread. We all know PWD only listen to other PWD. Let me ask you....If you buy a new model car during the first week of the new model year...do you get a discount?? NO...... You can buy an older model and get a deal but not a brand new model year car. Afrezza is that brand new model year drug. There is a premium but you also have to look at the medical benefits. Mike said 70% of PWD are not within range.....Why is that? Insulin has been on the market for 90 years and PWD are not in a safe place. With Afrezza that number will drop dramatically. This analogy is all very well, but we are five years down the line from launch now and if word of mouth was going to do the trick in the Type 1 community it would have caught on by now. You are correct about PWD only listening to other PWD (the assumption is that everyone else is trying to either sell them something or tell them how to run their lives - both sensitive topics), but the rider to that is that PWD do not expect that something that works for one PWD will necessarily work for them. Contrary to the idea that is often promoted here it is quite possible to get an A1c in the 5s on RAA with a high TIR (Shawn who posts here is an example), it's just that most people (me included) don't want to have that level of engagement with their diabetes and compromise. |
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Post by mnkdfann on Feb 28, 2020 13:38:09 GMT -5
When all electric cars first came out (paradigm shift) ike the Leaf, the car companies offered rebates and other incentives to entice people to try something new that had an unknown track record and required drivers to modify their refueling behavior. (I'm not sure what my point is but I'm proud of my clever analogy.) A lot (probably most, maybe even all) of those electric car rebates and incentives are paid for by the taxpayer. www.clippercreek.com/ev-incentives/Regarding Leaf in particular: www.nissanusa.com/vehicles/electric-cars/leaf/features/performance-and-benefits.html"Tax credits, rebates & incentives - Depending on where you live and your personal tax situation, you may qualify for potential Federal, state, and city tax incentives like the New Qualified Plug-In Electric Drive Motor Vehicle Credit of up to $7,500 just for driving fully electric." So, your analogy seems to suggest Mannkind just needs the gummint to step up.  |
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Post by akemp3000 on Feb 28, 2020 13:49:33 GMT -5
When all electric cars first came out (paradigm shift) ike the Leaf, the car companies offered rebates and other incentives to entice people to try something new that had an unknown track record and required drivers to modify their refueling behavior. (I'm not sure what my point is but I'm proud of my clever analogy.) Interesting analogy. Is the suggestion that everyone's taxes should be increased to fund the federal government subsidizing incentives to try Afrezza? If so, the shift needs to happen much faster and less costly than the on going glacial speed of moving toward electric cars, solar panels and wind turbines  |
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Post by wgreystone on Feb 28, 2020 14:12:19 GMT -5
A CEO can never do something risky and "hope they don't go out of business". We probably all agree that price is a problem. But I disagree that all of BP is working together with the intent of killing MNKD. I think each BP company is just trying to maximize their profits. And they all have a bunch of smart people. If MNKD can prove that Afrezza will be competitive if the volume were high enough to get the cost down, Then a BP company might be interested in partnering with (or buying) mnkd with the intent of increasing their profits while hurting other BP companies. I'm not sure how mnkd accomplishes this. I'm not claiming that price is the biggest issue. I'm just saying that if price is the biggest issue it can be resolved by getting a large partner. I think Afrezza is priced correctly. As CEO you have to make a decision...do you go after market share or margins. MNKD is going after margins because that will keep the lights on. Once Type 1's realize the benefits they will come and payors will jump onboard. And patients on Afrezza will tell other PWDs and the word will spread. We all know PWD only listen to other PWD. Let me ask you....If you buy a new model car during the first week of the new model year...do you get a discount?? NO...... You can buy an older model and get a deal but not a brand new model year car. Afrezza is that brand new model year drug. There is a premium but you also have to look at the medical benefits. Mike said 70% of PWD are not within range.....Why is that? Insulin has been on the market for 90 years and PWD are not in a safe place. With Afrezza that number will drop dramatically. An underdog charging higher price. Good luck with insurers. |
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Post by ktim on Feb 28, 2020 14:34:21 GMT -5
This analogy is all very well, but we are five years down the line from launch now and if word of mouth was going to do the trick in the Type 1 community it would have caught on by now. You are correct about PWD only listening to other PWD (the assumption is that everyone else is trying to either sell them something or tell them how to run their lives - both sensitive topics), but the rider to that is that PWD do not expect that something that works for one PWD will necessarily work for them. Contrary to the idea that is often promoted here it is quite possible to get an A1c in the 5s on RAA with a high TIR (Shawn who posts here is an example), it's just that most people (me included) don't want to have that level of engagement with their diabetes and compromise. Most PWD totally ignore their physician's opinions? Call me an oddity but I primarily rely on my doctor's opinion and authoritative sources such as Mayo... or rarely dig into scientific publications myself. Hardly ever put much weight on what lay people say... though I nod and thank them for their kind advice. |
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Post by ktim on Feb 28, 2020 14:41:14 GMT -5
When all electric cars first came out (paradigm shift) ike the Leaf, the car companies offered rebates and other incentives to entice people to try something new that had an unknown track record and required drivers to modify their refueling behavior. (I'm not sure what my point is but I'm proud of my clever analogy.) Interesting analogy. Is the suggestion that everyone's taxes should be increased to fund the federal government subsidizing incentives to try Afrezza? If so, the shift needs to happen much faster and less costly than the on going glacial speed of moving toward electric cars, solar panels and wind turbines Solar and wind has actually been a success (assuming one believes getting off fossil fuels is needed). They are now reaching pricing parity even without subsidies in many locations. Roughly three quarters of new capacity this year will be solar and wind. Electric cars certainly not reached that sort of inflection point yet. |
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Post by agedhippie on Feb 28, 2020 14:56:15 GMT -5
This analogy is all very well, but we are five years down the line from launch now and if word of mouth was going to do the trick in the Type 1 community it would have caught on by now. You are correct about PWD only listening to other PWD (the assumption is that everyone else is trying to either sell them something or tell them how to run their lives - both sensitive topics), but the rider to that is that PWD do not expect that something that works for one PWD will necessarily work ... Most PWD totally ignore their physician's opinions? Call me an oddity but I primarily rely on my doctor's opinion and authoritative sources such as Mayo... or rarely dig into scientific publications myself. Hardly ever put much weight on what lay people say... though I nod and thank them for their kind advice. It wasn't what I was talking about (we were discussing word of mouth campaigns), but it's a fair comment and worth looking at. There is the whole spectrum and we have seen examples here of people being told no by their doctor and just excepting it through to people fighting. Personally I am happy to have the fight or even change endos if I don't think our views align. I have quite enough to do with my diabetes not to want to add fighting the endo - better just to swap them. |
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Post by Deleted on Feb 28, 2020 15:00:20 GMT -5
When all electric cars first came out (paradigm shift) ike the Leaf, the car companies offered rebates and other incentives to entice people to try something new that had an unknown track record and required drivers to modify their refueling behavior. (I'm not sure what my point is but I'm proud of my clever analogy.) The Gov't offered REBATES and TAX CREDITS not the car companies. |
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Post by matt on Feb 28, 2020 15:53:30 GMT -5
Pricing is an issue that will never go away. It simply costs more to make Afrezza than other insulins, partly due to the fact that they purchase insulin from a third-party that needs to make a profit, and partly because the FDKP particles used in the Technosphere delivery system add to the cost. Even if MNKD were to lower prices to the point where they were selling Afrezza simply to recoup the variable cost of production, Lilly and Novo could price their RAA products at the same level and they would still be making money due to their greater economies of scale and their lower cost for recombinant insulin. That is an impossible competitive position.
Until and unless MNKD can demonstrate conclusively the long-term economic benefits of Afrezza over the competing RAA products, they will be at a serious competitive disadvantage. A superior product can garner a premium price, but the medical world is not convinced by the evidence offered to date. It is going to take a large and medium to long-term head-to-head trial of Afrezza vs the other insulins to prove the value, and I am not sure MNKD can afford to do such a trial.
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Post by mytakeonit on Feb 28, 2020 15:56:45 GMT -5
And so we go international ... then return to the U.S.
But, that always was mytakeonit
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