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Post by morfu on Aug 9, 2020 8:31:38 GMT -5
“Do you recommend to go against FDA and their medical advice? It seems there are studies showing that hydroxychloroquine is "unlikely to kill or inhibit the virus that causes COVID-19"...” When I see the letters FDA, I cringe. I only have to look back at the MNKD/Afrezza ADCOM to realize how misguided they can be, and to the same effect what tail wags that dog! I also don’t believe anyone has claimed Hydroxychloroquine kills the COVID virus. I believe it is meant to act as a prophylactic, much like zinc, to help keep the virus from attaching and spreading in the body. Late stage disease is a very unlikely place to test this concept, but it doesn’t surprise me that the nay sayers would use such a study to completely rule out its use. Considering there is no money in such a solution for big pharma only strengthens my opinion that there are conflicts of interest throughout the medical establishment as to what solution(s) should be promoted and when. If you search for a reason that "nay-sayers" exist for this particular drug, look at the 2nd part of my sentence, which you conveniently shorted:
"but can have side effects that kill the patient,"
(which is a huge difference to Zinc by the way at least at the doses we seem to talk about)
However, my question was, if you would advise Mannkind to go against the FDA on this? They did not do so on any other topic I am aware of.
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Post by jasper27 on Aug 9, 2020 9:11:49 GMT -5
Nice outside the box Covid ideas -- even if Matt and Aged reject (like always) insert smiley face.
The focus of this thread is to share ideas to sell Afrezza.
I don't know how Mike C. can sit idle with such low weekly scripts and not radically change things. (Note to Mike: It's time for some Hail Mary passes -- even if some fall flat and Indy cars don't count)
What is the weakest part of MNKD? -- it's Legal Department (if they have one)
1. Never could understand why MNKD didn't sue the FDA for Martin Shikel (pharma bro) involvement in second FDA rejection in 2011 ? 2. On the day of FDA approval -- Wall street players published messages that Afrezza was rejected again and killed our stock rally. But, MNKD legal dept. did nothing. 3. Afrezza was approved with Black Box warning --- this is where MNKD legal dept should have bargained "Drop the Black Box or we sue for offenses 1 and 2 above"
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Post by sportsrancho on Aug 9, 2020 10:36:44 GMT -5
About Spencer‘s post, first you need to read the article.
Then think about the ideas. The guy had 20 thumbs up on Stocktwits and it was very interesting discussion although I cannot copy and paste all that.
People asked him to send it to Mike but he didn’t feel that was appropriate but he doesn’t mind it being posted and used or part of it, if Mannkind so wishes.
It’s nice he’s showing an interest.
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Post by prcgorman2 on Aug 9, 2020 10:40:35 GMT -5
Nice outside the box Covid ideas -- even if Matt and Aged reject (like always) insert smiley face.
The focus of this thread is to share ideas to sell Afrezza.
I don't know how Mike C. can sit idle with such low weekly scripts and not radically change things. (Note to Mike: It's time for some Hail Mary passes -- even if some fall flat and Indy cars don't count)
What is the weakest part of MNKD? -- it's Legal Department (if they have one)
1. Never could understand why MNKD didn't sue the FDA for Martin Shikel (pharma bro) involvement in second FDA rejection in 2011 ? 2. On the day of FDA approval -- Wall street players published messages that Afrezza was rejected again and killed our stock rally. But, MNKD legal dept. did nothing. 3. Afrezza was approved with Black Box warning --- this is where MNKD legal dept should have bargained "Drop the Black Box or we sue for offenses 1 and 2 above"
Great spirit, but you shouldn’t assume Afrezza isn’t selling better than it is because of incompetence. If you want to judge the CEO, you need to look at everything he worked on since his arrival. Look at the sales charts since 2016 if you want to see his impact. Yes, the weekly Rx prescriptions are still too low to even be profitable, but the fact that we can even have the conversation about becoming profitable is due in no small part to the efforts of Dr. Castagna and Dr. Kendall (which I’m curious if it has ever been confirmed publicly that he’s moving on). And, you need to appreciate what it is that Dr. Castagna inherited and maybe that when he got here, he hadn’t yet earned the doctor title - how many folks with drug re-launch chops take on that job, CEO, and annex a doctorate? People can say what they want but it takes extraordinary effort and ability to achieve those accomplishments. It might also be remembered that he worked his way through college, and his MBA from Wharton. It just stuns me that people disregard this as though anybody could do that. That’s not reality. Now, back to what he inherited. A tiny pipeline drug development company with one horse, Afrezza, no marketing or sales capabilities to speak of, and large amounts of debt. Bleak doesn’t begin to describe the situation. I’ll skip over all of the mountains of work that have happened since then to this point in time where salespeople are largely unable to move the needle, even less than before when they were representing a single product, not a portfolio of products (meaning it’s more difficult for a salesperson to make sales and earn a living). It’s been mentioned here numerous times that the two biggest headwinds are insurers are unwilling to cover Afrezza for the most part except as part of a STEP program and/or Prior Authorization, and doctors are largely unwilling to prescribe Afrezza. These issues are a big deal. Doctors don’t like to go rogue. Afrezza is not the standard of care (SoC) and most doctors consider it a niche product. For sure, the majority of the 200,000+ general practitioners do not like prescribing insulin of any kind because it must be self-administered by the patient, and it can and does kill them occassionally. There are less than 5,000 endocrinologists (think about it less than 100 per US state), and many of them are working as reasearchers for corporations and do not practice medicine with patients. That was the reason why Mannkind made an effort to make progress with T2 persons with diabetes who are often seen by primary care physicians (PCPs). There are far more doctors and far more patients engaged in Type 2 diabetes treatment. This is made extremely difficult without general support from endocrinologists who are the experts, and the endos aren’t yet persuaded generally that Afrezza should be a mainstream part of treatment options. Why the reluctance you might ask? Data. The large trials performed for the FDA approval were now over 6 years ago, and they were flawed in their design for establishing superiority of Afrezza as a prandial insulin treatment. You can thank the FDA for that. You mentioned suing people for wronging Mannkind. I’m inclined to agree but I work with attorneys on a regular basis and they’re great folks for the most part but they aren’t inexpensive and courts do not move quickly. I’m positive there’ve been many conversations about how/where to use litigation. For sure it was used with Sanofi to extract a reduction in debt and cash after the backstab by Oliver Brandicourt. Anyway, the main point to remember is doctors need data, and data comes from trials. And persuasive data comes from large trials which take time but more importantly take money. Money Mannkind has not had the luxury of having available. There have been complaints about that situation and some of them are probably reasonable, but whether they are or they aren’t doesn’t change the situation. So, what you should keep in mind is that it is an extremely difficult, expensive, and regulated sales and marketing environment compounded by lack of insurance coverage, lack of trial data, and oh yes, let’s not forget COVID-19. |
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Post by sportsrancho on Aug 9, 2020 10:45:23 GMT -5
Obviously you did not listen to the conference call. Mike announced he was leaving.
And you might give our reliable source a thumbs up for the heads up:-)
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Post by prcgorman2 on Aug 9, 2020 10:57:13 GMT -5
Correct, have not listened to the earnings CC yet. And yes, thumbs up to nylefty (I think) for breaking the news here first.
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Post by uvula on Aug 9, 2020 11:22:27 GMT -5
Back the original poster. It does get annoying for the old timers when new people show up and claim they have an easy fix that we would have already thought of if we or people at mnkd were as smart as the new person. That might not be how you actually feel but that is how you come across.
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Post by awesomo on Aug 9, 2020 11:43:22 GMT -5
Correct, have not listened to the earnings CC yet. And yes, thumbs up to nylefty (I think) for breaking the news here first. It was pguerrero, who also broke McCauley leaving. |
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Post by sportsrancho on Aug 9, 2020 12:06:09 GMT -5
Back the original poster. It does get annoying for the old timers when new people show up and claim they have an easy fix that we would have already thought of if we or people at mnkd were as smart as the new person. That might not be how you actually feel but that is how you come across. Well everybody might as well just stop posting then. |
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Post by sportsrancho on Aug 9, 2020 12:07:05 GMT -5
Correct, have not listened to the earnings CC yet. And yes, thumbs up to nylefty (I think) for breaking the news here first. It was pguerrero, who also broke McCauley leaving. He knows who it was. |
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Post by nylefty on Aug 9, 2020 12:26:04 GMT -5
Spencer backs up his claims by citing a pediatrician/minister who believes that medical conditions can be caused by people having sex in their dreams with demons and witches, alien DNA is used in medical treatments, a vaccine is being created to keep people from being religious, and the government is run, in part, by reptilians and other aliens.
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Post by jasper27 on Aug 9, 2020 13:21:53 GMT -5
Uvula -- I've been invested in MNKD for 12 years. Does that make me worthy to post? And thanks Sports for saying I (and others) are welcome here.
As for Afrezza's low sales: "It's a riddle, wrapped inside an enigma, but perhaps there is a key"
Look up that quote and Gordian Knot --- maybe I haven't solved Afrezza sales but I do bring intellect and humor  |
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Post by prcgorman2 on Aug 9, 2020 13:41:32 GMT -5
It was pguerrero, who also broke McCauley leaving. He knows who it was. Nope. Totally forgot and didn’t bother to search for it. Thank you to pguerrero (and awesomo). |
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Post by prcgorman2 on Aug 9, 2020 13:43:59 GMT -5
Uvula -- I've been invested in MNKD for 12 years. Does that make me worthy to post? And thanks Sports for saying I (and others) are welcome here.
As for Afrezza's low sales: "It's a riddle, wrapped inside an enigma, but perhaps there is a key"
Look up that quote and Gordian Knot --- maybe I haven't solved Afrezza sales but I do bring intellect and humor Of course you’re welcome to post! And to receive the same treatment everyone gets by investors and non-investors alike! And don’t feel bad, I made similar posts as yours (some years ago). Live and learn. |
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Post by ronw77077 on Aug 9, 2020 14:08:06 GMT -5
Interesting observation about the small number of people who comment. I have commented rarely, when I felt I had something meaningful to add. I do read the postings but find many are inane and/or reflect a lack of corporate experience or knowledge. I've been an investor in MNKD for about 6 years, roughly the same time I have been a subscriber to Nate's Notes (notwallstreet.com). Over the years I have made impressive returns following Nate's counsel. His newsletter is among the highest ranked newsletters by Hulbert Ratings for 5, 10 and 15 years (which you can check for yourselves). Nate advocates continued patience. While I, too, am impatient to see MNKD soar, I place much higher value in Nate's counsel than in the many ramblings on the board.
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