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Post by awesomo on May 20, 2022 15:43:17 GMT -5
How can these medicare patients afford paying for Afrezza? Trippling the customer base doesn't help if we subsidize a majority of them. (Yes I'm being negative again but please explain why I'm wrong.) Do you think the V-GO Device plus Insulin is cheaper than Afrezza?? We don't know but I'm sure it's comparable. When you are getting 77% Profit Margins I'd say Medicare Patients will be able to afford it. There's elasticity in the price. The key is that MNKD paid $1,000 per patient which is a very low number to get a patient for life. So you're assuming 100% conversion to a competing product AND all of them lifetime customers? Realistically, that's just not even in the ballpark. |
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Post by peppy on May 20, 2022 15:52:51 GMT -5
I keep coming back to the idea that i must be missing something because on the surface buying V-Go makes no sense. This is really a mechanical syringe rather than a pump as there is no variability in the device. It's sole benefit over a standard basal like Tresiba is that you can use it to handle meal time insulin by squiting extra insulin in, you don't need to inject separately. Once you use Afrezza that advantage goes away and there is only down side. Possibly more useful than the device or patients may be access to the list of doctors prepared to prescribe this, and may be prepared to prescribe Afrezza. You are not missing anything. This seems to be a bonehead asset acquisition costing $10M. This device competes head to head with afrezza in the SoC step 4 insulin space. If I was a sales rep I have no idea how I would sell this. I would think Tresiba or the Omnipod would be better. I also know that if I believed in the real benefits of afrezza as a sales rep I would be replacing V-Go with afrezza not coexisting. Everybody know this is true, even Mike C. That is why we are trying to figure it out. |
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Post by porkini on May 20, 2022 16:08:56 GMT -5
I keep coming back to the idea that i must be missing something because on the surface buying V-Go makes no sense. This is really a mechanical syringe rather than a pump as there is no variability in the device. It's sole benefit over a standard basal like Tresiba is that you can use it to handle meal time insulin by squiting extra insulin in, you don't need to inject separately. Once you use Afrezza that advantage goes away and there is only down side. Possibly more useful than the device or patients may be access to the list of doctors prepared to prescribe this, and may be prepared to prescribe Afrezza. Mike and the team, have their name on a patent. mango do you recall the patent Mike C and was it Kendall have their name on? Found this mnkd.proboards.com/post/190746/thread |
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Post by akemp3000 on May 20, 2022 16:10:09 GMT -5
Interesting speculation that the purchase may have been for the two databases of prescribing doctors and patients to target them for Afrezza. Good posts.
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Post by peppy on May 20, 2022 16:18:07 GMT -5
In an attempt to make sense of something that makes no sense, the patent Mike C and Kendall have their name on. I recall there used to be a drug on their pipeline list for obesity. I'll go find it. 3) METHOD AND COMPOSITION FOR TREATING OBESITY Application Date: Publication Date: 31.10.2019 Applicants: MANNKIND CORPORATION Inventors: CASTAGNA, Michael KENDALL, David KRAFT, Kelly SMUTNEY, Chad, C. GRANT, Marshall Abstract: A method for treating obesity associated to Prader Willi Syndrome and/or binge eating is disclosed. The method utilizes a rapid drug delivery system which delivers small molecules and peptides to the lungs by oral inhalation. patentscope.wipo.int/search/en/detail.jsf?docId=WO2019210083&_cid=P11-K2EZ3G-20049-1 |
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Post by tarheelblue004 on May 20, 2022 16:40:40 GMT -5
People this is about business, not science.
Cost: MannKind paid $10M, if the product sells well they will pay more
Benefits:
- MannKind bought ~$20M in annual revenue
- Existing MannKind infrastructure will reduce incremental V-Go costs
- MannKind bought access to 10,000 new patients
- MannKind bought access to many (hundreds?) new doctors
- MannKind’s bought another product for sales reps to sell (helping them to earn more / making the company more attractive to them)
- MannKind bought 16 sales reps to fill open positions
- MannKind further diversified approved revenue streams
MannKind paid ONLY $10M, 5% of their cash, to get all of this. V-Go profits will probably return the purchase price in 3-5 years, not counting all of the benefits to Afrezza and MannKind in the points above.
This is a fantastic move! It has nothing to do with being a blockbuster in diabetes and everything to do with expanding our diabetes franchise for ONLY $10M. What am I missing?!
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Post by cretin11 on May 20, 2022 16:52:34 GMT -5
How can these medicare patients afford paying for Afrezza? Trippling the customer base doesn't help if we subsidize a majority of them. (Yes I'm being negative again but please explain why I'm wrong.) The key is that MNKD paid $1,000 per patient which is a very low number to get a patient for life. That would be great if all those V-go customers would shift to Afrezza. However, we know only a tiny fraction of them would, if it were even our strategy to “convert” them. It’s not clear if that’s our strategy, and hopefully it’s not because as sayhey said, $10M is way too steep a price for a list of potential customers. It remains a head scratcher decision on its face. If the smart folks on this board are struggling with it, then hopefully there’s much more to it than meets the eye. |
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Post by mymann on May 20, 2022 17:10:14 GMT -5
Wear a patch for glucose monitoring, wear a patch for insulin delivery just to avoid pricking your skin. How many sells of Afrezza to make 10 million to cover the cost of fancy syringe?
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Post by tarheelblue004 on May 20, 2022 17:17:46 GMT -5
The key is that MNKD paid $1,000 per patient which is a very low number to get a patient for life. That would be great if all those V-go customers would shift to Afrezza. However, we know only a tiny fraction of them would, if it were even our strategy to “convert” them. It’s not clear if that’s our strategy, and hopefully it’s not because as sayhey said, $10M is way too steep a price for a list of potential customers. It remains a head scratcher decision on its face. If the smart folks on this board are struggling with it, then hopefully there’s much more to it than meets the eye. Hmm, am I not smart?! 😉 I’d like your smartness’ thoughts on the business case I laid out in the post right above yours please. Unless it’s the smart people who understand it’s a low-cost purchase with lots of value, and the others are scratching their heads? |
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Post by awesomo on May 20, 2022 17:58:20 GMT -5
People this is about business, not science. Cost: MannKind paid $10M, if the product sells well they will pay more Benefits: - MannKind bought ~$20M in annual revenue - Existing MannKind infrastructure will reduce incremental V-Go costs - MannKind bought access to 10,000 new patients - MannKind bought access to many (hundreds?) new doctors - MannKind’s bought another product for sales reps to sell (helping them to earn more / making the company more attractive to them) - MannKind bought 16 sales reps to fill open positions - MannKind further diversified approved revenue streams MannKind paid ONLY $10M, 5% of their cash, to get all of this. V-Go profits will probably return the purchase price in 3-5 years, not counting all of the benefits to Afrezza and MannKind in the points above. This is a fantastic move! It has nothing to do with being a blockbuster in diabetes and everything to do with expanding our diabetes franchise for ONLY $10M. What am I missing?! You're ignoring the costs beyond the purchase price. Zealand spent $44M in 2020 and $53M in 2021 on sales and marketing, so V-Go was still a major loss to them. Revenue of V-Go were down in 2021 on a per month basis (9 months of V-Go revenue in 2020 vs 12 in 2021). One company went bankrupt trying to sell this product, and the other cut ties after two years. You can argue that MannKind's existing sales/marketing force can offset some of this, but it's not like they have been killing it in these areas since Afrezza was approved. |
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Post by sayhey24 on May 20, 2022 19:13:07 GMT -5
People this is about business, not science. Cost: MannKind paid $10M, if the product sells well they will pay more Benefits: - MannKind bought ~$20M in annual revenue - Existing MannKind infrastructure will reduce incremental V-Go costs - MannKind bought access to 10,000 new patients - MannKind bought access to many (hundreds?) new doctors - MannKind’s bought another product for sales reps to sell (helping them to earn more / making the company more attractive to them) - MannKind bought 16 sales reps to fill open positions - MannKind further diversified approved revenue streams MannKind paid ONLY $10M, 5% of their cash, to get all of this. V-Go profits will probably return the purchase price in 3-5 years, not counting all of the benefits to Afrezza and MannKind in the points above. This is a fantastic move! It has nothing to do with being a blockbuster in diabetes and everything to do with expanding our diabetes franchise for ONLY $10M. What am I missing?! You're ignoring the costs beyond the purchase price. Zealand spent $44M in 2020 and $53M in 2021 on sales and marketing, so V-Go was still a major loss to them. Revenue of V-Go were down in 2021 on a per month basis (9 months of V-Go revenue in 2020 vs 12 in 2021). One company went bankrupt trying to sell this product, and the other cut ties after two years. You can argue that MannKind's existing sales/marketing force can offset some of this, but it's not like they have been killing it in these areas since Afrezza was approved. MannKind bought ~$20M in annual revenue - We don't need revenue we need profit. What is the profit? Existing MannKind infrastructure will reduce incremental V-Go costs - What existing infrastructure? The plant in Danbury? There is no room in that place to make V-Gos which are probably made in China anyway. Its a plastic box and spring. I haven't been there since Covid but I have to guess they had to bust out the back wall to make room for Tyvaso DPI. MannKind bought access to 10,000 new patients - OK, I doubt the MNKD Sales rep is going door to door to these PWD, so what are we doing now with this access? Are we replacing their V-Go with afrezza? We just paid $1000 per PWD. Thats one hell of an expensive mailing list MannKind bought access to many (hundreds?) new doctors - OK, now what? Are we going to these doctors to tell them not to prescribe V-Go's anymore? These doctors are going to tell us the SoC says to add basal before mealtime insulin and they are going to tell us the great advantage of the V-Go is you can deliver mealtime doses without any jabs, just push the button. Are we going to explain that with afrezza you don't need basal nor should you need the GLP1 or SGLT2. Are you going to ask them to deviate from the ADA SoC and ask them to develop their own SoC? That is what Mike is going to attempt with his "Seeing is Believing" Campaign but he is taking this to large corp GPs with many doctors. He is going to ask someone like a Geisinger or a Penn Medicine to adopt their own SoC for their corp GP staff. He may have some success but thats a tough row to hoe but he may have some success and success will build success. However, we know who these Corps are. We don't need to pay $10M to find out. MannKind’s bought another product for sales reps to sell - afrezza and V-Go are competing products - they are not complimentary. The skill set for an afrezza rep is significantly different than a pump or traditional insulin sales rep. The afrezza rep needs to understand why afrezza is a paradigm shift in diabetes care. If the rep understands this the last thing they are going to want to sell is a plastic contraption with a spring. If you want another product take Technosphere Insulin and submit a new drug application based on a trial run against Mounjaro. The new drug is a GLP1/GIP replacement. its a new ADA class drug. The cartridges are no longer insulin units but small, medium and large and the dosing directions are for use for a T2 not taking other T2 meds or basal insulin. Its prescribed before these other meds. Thats a another product that can sell $$$BBBs if they get that new product in step 2 of the SoC. MannKind bought 16 sales reps to fill open positions - OK, how is this good? These guys are bringing in how much revenue? We have already tried this and its always an epic fail and we always lay these guys off. How many times do you want to do the same thing over and over? Until there are SoC changes these guys are setup for failure. We are better to leave the positions open and not incur the cost. MannKind further diversified approved revenue streams - Why is this good? All my McKinsey training says to focus. Can't we focus on figuring out how to position Technosphere Insulin so it can be sold in the T2 market? Why in the world do we want to be hawking a plastic contraption whose sales could never ever come close to what a Technosphere Insulin product will do once we start to properly market it to the T2 step 2 market. The more I think back the more I think the VP from Sanofi who was in charge of the afrezza deal was 100% spot on. Maybe Mike can find that guy and hire him. Now that Dave Kendall is back in the picture and Mounjaro is approved maybe we can get him back too and he can restart his SoC efforts. The $10M would be much better spent hiring those two guys rather than the 16 sales reps. |
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Post by cedafuntennis on May 20, 2022 19:59:46 GMT -5
...Now that Dave Kendall is back in the picture and Mounjaro is approved maybe we can get him back too and he can restart his SoC efforts. The $10M would be much better spent hiring those two guys rather than the 16 sales reps.
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So with all these negatives and critiques and predictions of failure, last weeks revenues were at an all week high and the tend is clearly in a steep up ramp and income streams are multiplying. Go figure.,
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Post by Deleted on May 20, 2022 21:29:29 GMT -5
Do you think the V-GO Device plus Insulin is cheaper than Afrezza?? We don't know but I'm sure it's comparable. When you are getting 77% Profit Margins I'd say Medicare Patients will be able to afford it. There's elasticity in the price. The key is that MNKD paid $1,000 per patient which is a very low number to get a patient for life. So you're assuming 100% conversion to a competing product AND all of them lifetime customers? Realistically, that's just not even in the ballpark. What I am saying is MNKD now has a larger embedded base to which they can market/convert to Afrezza and it only costs them $1,000 per patient. Will a convert spend more than $1K on Afrezza over their lifetime??? YES MNKD will now have a list of the prescribing doctors and I'm sure there will be very little overlap so you have 2 ways to strategic advantages. Will he convert 100% maybe not but he now has a target rich environment. Someone doubted the V-Go's salesforce - I think they will love to market Afrezza and they are Diabetes Salespeople so the learning curve will be small. This is a golden opportunity for MNKD and it only cost $10M. Now this will take time like 6-12 months but in the meantime they are getting sweet Revenues from V-GO. When you think about V-GO......it's not a bad device. It's discrete and give precise boluses which is ideal. |
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Post by letitride on May 21, 2022 3:20:29 GMT -5
I see opportunity in the diabetes space by expanding our footprint. Im liking it opens doors that are currently closed.
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Post by peppy on May 21, 2022 4:14:31 GMT -5
I see opportunity in the diabetes space by expanding our footprint. Im liking it opens doors that are currently closed. Did shawnonafrezza tell us he takes human insulin and afrezza? Shawnflynn, may I ask you to pop up in this conversation? I can go dig, I know you told us.  agedhippie , any chance, a closed loop system? am I off the rocker, totally misunderstanding? shawnonafrezza , to read your posts like a book, they are informative. "Read aged post, he explains it better. If the Afrezza got the PWD to 90 then the HCL will just take them back to 120. That is how it works so 120 at 3 hours is your baseline best. You could just take Afrezza every 30 minutes and the basal in the HCL would just shut off in an attempt to get to 120. Period. You could tell it you took Afrezza and it'll just say, "ok, but now I'm below 120 so I must give **less** basal insulin. Here, let's take the food out of it. Let's say your blood glucose is at 120 mg/dl. The pump will have your basal at 100%. You take Afrezza and drop to 80, cool. The pump will take your basal to 20% or some fraction in an attempt to get you to 120 mg/dl because it only accepts that number as the goal. It does not care that you're at 80 and stable, it cares that you are under 120. It **WILL** get you to 120 given a long enough timeline so if you're follow up is 3 hours it will be pushing you to 120 that ENTIRE time. Once again, it does not at all care about the Afrezza, it doesn't even have to know it was taken. You could take Afrezza and then start the system below 120 and it will STILL shut off basal to get you back up. This is not a problem with Afrezza FFS, it's just how the pumps work right now." Side note from reading Shawns posts. Look at the name of the accelerant.  |
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