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Post by cretin11 on Jan 26, 2022 9:05:42 GMT -5
They absolutely did! Where have you guys been? The whole thing was public, there’s many posts about it. Don’t you remember when Bill and I went to headquarters and I told you I came out of there in tears because it was so sad! Well I’m not sad anymore :-) but for goodness sake‘s stop questioning my credibility!Credibility is one thing. Inside information is another. Consider the words? Was this years ago with the HFM (or what ever it was called) thingy? I am going to stop this now. Cmon peppy, this all happened a long time ago, nobody claimed it was inside info then. Folks here having severe memory issues this morning. sports, thank you for being about the most credible poster we have here. Period. Afrezza commercialization: dramatic failure, epic failure, whatever adjective we choose, it’s not being mean spirited it’s just an accurate assessment. Go back and review original projections for Afrezza revenues and then decide. Anybody doing that and yet claiming we’ve done a heroic and miraculous job (“but Sanofi! and Covid!”) is simply grading on a weirdly easy curve. Revisionist history is fine if it makes you feel better. All some of us care about is what we do now and going forward, let’s not give up on this thing. Afrezza is still amazing, we just need the right strategy to get it to PWDs, with proper support and instruction. |
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Post by mytakeonit on Jan 26, 2022 13:28:19 GMT -5
And after all this ... MNKD pps is shooting up again !!!
But, that's mytakeonit
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Post by prcgorman2 on Jan 26, 2022 21:12:23 GMT -5
Credibility is one thing. Inside information is another. Consider the words? Was this years ago with the HFM (or what ever it was called) thingy? I am going to stop this now. Cmon peppy, this all happened a long time ago, nobody claimed it was inside info then. Folks here having severe memory issues this morning. sports, thank you for being about the most credible poster we have here. Period. Afrezza commercialization: dramatic failure, epic failure, whatever adjective we choose, it’s not being mean spirited it’s just an accurate assessment. Go back and review original projections for Afrezza revenues and then decide. Anybody doing that and yet claiming we’ve done a heroic and miraculous job (“but Sanofi! and Covid!”) is simply grading on a weirdly easy curve. Revisionist history is fine if it makes you feel better. All some of us care about is what we do now and going forward, let’s not give up on this thing. Afrezza is still amazing, we just need the right strategy to get it to PWDs, with proper support and instruction. I think the difference in our views is context. People who’ve been waiting a long time (9 years for me) are undertandably frustrated if for no other reason than that it’s been a very long time. And, taken out of context, that is reason enough to blame whoever is the CEO regardless of whether it is Dr. Castagna or any other individual put in the position of trying to rescue a company and market the company’s only FDA-approved drug into a blockbuster success. But, is it fair to ignore all that happened prior to Dr. Castagna being promoted to CEO? How could it be fair? That’s like assuming there were no challenges whatsoever and any idiot could be successful. If that were the case, Mannkind wouldn’t have needed to hire Mike Castagna (who became Dr. Castagna after going to work for Mannkind). Dr. Castagna was hired from Amgen as an executive with a track record of successfully re-launching drugs. That is precisely the skillset Mannkind should have been looking for. One of the things Mike said early on that both dismayed me but also earned credit with me was that re-launching drugs was difficult and that most drugs don’t successfully re-launch. I assumed it was difficult. I didn’t know it was that difficult. So he set expectations at the beginning, this would be an uphill effort. I assume the conversation with Bill and Sports went something like, “We tried everything we could... with the resources we had available, and the results have been dissappointing.” I worried that “veins of gold” would be hyperbole, just like “embarrassment of riches” and “epic” (although I still hope those come true of course). I don’t like blustering execu-speak. Mike was down to earth but he didn’t paint a rosy picture. Still, even with that, he also said in an interview early on that the reason he lobbied for the job was because he 100% believed Dr. Al Mann was right. That Afrezza was the most important development in device and insulin for managing diabetes ever invented. And, since Dr. Mann is credited for having commercialized insulin pumps, his opinion and committing $1B+ of his own money to establishing Mannkind and developing Afrezza and getting it FDA approved, was and is understandably persuasive. You and I both agree Afrezza is the shiznits. Unfortunately, it doesn’t matter what we think, it matters what prescribers and insurers and PWDs think, and what they think is they’re not sold on Afrezza which is not a failure of Dr. Castagna anymore than it is yours or mine. There hasn’t been the money needed to conquer the clinical study hurdle (the reason for this thread started by Mango) or to purchase Tier 1 insurance coverage. It was only last year after managing the company out of crushing toxic debt on the brink of bankruptcy to a position of usable Future Cash Flow, from Afrezza, and then an assumption Tyvaso would be approved and provide another source of substantial revenue that Dr. Castagna and Mannkind managed to improve the company’s cash position to a point where they could start talking seriously about large scale clinical trials. So, has the company failed to make Afrezza a success? I guess it depends on your definition of success. They were nearly bankrupt and now they have more than $200M of cash, debt on reasonable terms (especialy in light of the current situation with rising interest rates) and if Tyvaso gets approved, things will be looking bright indeed. But, if instead you think it is reasonable to assume we should already be swimming in profit and enjoying substantial EPS and a great PPS based on a fat P/E, than no. But if you think that, you’re an optimist at best and delusional at worst. |
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Post by sportsrancho on Jan 26, 2022 22:14:56 GMT -5
People are pigeonholing people….
Nevertheless Mannkind acknowledges that Afrezza has a bad reputation. Improper dosing, insurance etc. people badmouth it. Somebody on the private FB page yesterday was insisting it causes shortness of breath. Of course I got on there as Vdex and straightened her out.
I admit I thought when Laura K endorse it to her thousands of followers all the diabetic people that know and follow her would get on it. But you know what, I hear people say all the time, “oh I can’t do anything that my Endo doesn’t want me to do.” We don’t have their support which makes everything so much harder. We do that with papers, with studies. We prove to them that not prescribing it is not ethical.
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Post by sportsrancho on Jan 26, 2022 22:29:34 GMT -5
Also everyone or most need to be monitored until they “get it” …the light goes on and they understand what it’s capable of. That IMO is the way to retain them.
Bill on shortness of breath….
“High blood sugar causes heart disease kidney disease cancer retinopathy and on and on… and even in the end stage, shortness of breath. I would bet her fear of insulin causes more shortness of breath than Afrezza. With hundreds of patients we have not heard this in any significant way. A few patients may report that but it’s more likely how they inhale not due to Afrezza.”
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Post by cretin11 on Jan 26, 2022 23:05:41 GMT -5
Cmon peppy, this all happened a long time ago, nobody claimed it was inside info then. Folks here having severe memory issues this morning. sports, thank you for being about the most credible poster we have here. Period. Afrezza commercialization: dramatic failure, epic failure, whatever adjective we choose, it’s not being mean spirited it’s just an accurate assessment. Go back and review original projections for Afrezza revenues and then decide. Anybody doing that and yet claiming we’ve done a heroic and miraculous job (“but Sanofi! and Covid!”) is simply grading on a weirdly easy curve. Revisionist history is fine if it makes you feel better. All some of us care about is what we do now and going forward, let’s not give up on this thing. Afrezza is still amazing, we just need the right strategy to get it to PWDs, with proper support and instruction. So, has the company failed to make Afrezza a success? I guess it depends on your definition of success. Agreed, it is subjective and credit to you for presenting an impassioned plea that the answer is no. Respect for your opinion, and I wish I could agree. As hard as I try, the evidence is incontrovertible, the company has failed to make Afrezza the success we all believe it should be. I’m not saying it was an easy mission, but sadly it has not been accomplished in all these years. However, there is still time, the story has not ended. Learn from all the mistakes and get it right asap (but a serious player partner might be needed, let’s be real). |
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Post by prcgorman2 on Jan 27, 2022 8:02:48 GMT -5
So, has the company failed to make Afrezza a success? I guess it depends on your definition of success. Agreed, it is subjective and credit to you for presenting an impassioned plea that the answer is no. Respect for your opinion, and I wish I could agree. As hard as I try, the evidence is incontrovertible, the company has failed to make Afrezza the success we all believe it should be. I’m not saying it was an easy mission, but sadly it has not been accomplished in all these years. However, there is still time, the story has not ended. Learn from all the mistakes and get it right asap (but a serious player partner might be needed, let’s be real). Correct. My view is Dr. Castagna & team have not failed to make Afrezza as successful as it could be given the limited resources available to them. It is a relative success, not an absolute success. And meager as the success has been, because it is not sufficient yet to get the company to break-even and profitability, the improvement in sales and which have remained steady during COVID and the refinancing (which was positively impacted by the improvement in sales) is what has provided the spring board which is the situation Mannkind is in now. If Tyvaso gets approved and the manufacturing and royalties come in as predicted by UTHR, Mannkind investors should enjoy their first positive EPS and an improved PPS. I can’t say if the dosing recommendations have been mistakes or are driven by caution and influence from prescribers and the FDA. I can’t judge because I’m not an insulin user (yet). I find the arguments that they should have been more generous in their recommendations, and even saying, “small”, “medium”, “large” on the cartridge sizes are persuasive, but I don’t know what held them back or holds them back. I agree the TV DTC failed, but even there I can’t say it was a mistake. Many here, including me, thought PWDs might drive the prescribers to prescribe and insurers to cover, if only the PWDs knew an inhalable human insulin was available (and in the case of the prescribers, that Mannkind was not bankrupt). I know I completely overestimated the impact of TV ads. In hindsight, it is obvious, and I should have known going in, insulin-taking PWDs are not inclined to mess with their routine, and who can blame them? And if they aren’t persuaded, they’re not going to persuade prescribers and insurers. I still hold hope there is a “critical mass” where Afrezza gets recognized in the PWD community (especially those with CGMs) as providing exquisite control never before available with RAAs. An “Aha!” moment where Afrezza builds a fan base, an “Afrezza Army”. Ever since the failure of TV DTC, it appears to me the only way to move “the needle” is with expensive and time-consuming but apparently tried-and-true methods of studies, and discounts to PBMs. So be it. I’m ambivalent about whether a partner is needed, but I’m not against it. My view is if Tyvaso gets approved next month, the clock gets reset for Mannkind on marketing Afrezza to an absolute success. Assuming COVID or other natural disasters don’t impair progress, I expect measurable improvement within 3 years. That may sound like a generous amount of time, but it really isn’t. Setting up, conducting, and reporting on large scale studies is time-consuming. And then more time is needed for the presumably-influential information to permeate and move “the needle”. And, there needs to be a cash flow sufficient to assist with larger discounts to the PBMs to buy better insurance coverage. Persuade, and pay-to-play appears to be the path forward. It is not an easy or quick path, but the rewards should be very substantial. |
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Post by sportsrancho on Jan 27, 2022 9:38:23 GMT -5
“My view is if Tyvaso gets approved next month, the clock gets reset for Mannkind on marketing Afrezza to an absolute success.”
This is vitally important, agree.
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