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Post by Thundersnow on Nov 8, 2022 16:34:47 GMT -5
Mike said today....“We also believe we'll start to see V-Go as a platform. I think that's something I don't want to talk about now, but as we get ready for next year, that's probably where some of that capital can go, which is how do you repurpose V-Go outside of diabetes. And we think it's a platform device that can be leveraged for other products. So that's an area that we're looking at.”
What other possibilities could MNKD use V-Go Delivery System for?
1. Could UTHR use it for one of their drugs??
Comments??
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Post by sayhey24 on Nov 8, 2022 18:27:36 GMT -5
Why would UTHR ever want to use V-Go when they have had such shockingly great results with Technosphere???
The problem Mike has is he spent $15M on this and now realizes V-Go and afrezza are like oil and water.
Mike said "So I think as we go into the end of this year going into '23, we're just starting to talk about how do we best maximize that impact, how do we best support the sales force so they can maximize their effect. And I think we'll see always a dedicated V-Go sales force because these are the top accounts, top reps, top experienced at V-Go. And I think the question is on the Afrezza side, when and how do we integrate, what does that look like? And do we have overlapping accounts or separate accounts? All that work is just starting. So I wouldn't give you much guidance until we probably get to the next quarter."
The bottom line is - He has to find a use for this thing. In a digital world he has a mechanical device. If you believe in Tyvaso DPI then you see the power of Technosphere and the potential of afrezza. afrezza and V-Go are competing for the same doctors with a vastly different approach to diabetes. V-Go is the traditional treat to fail approach and afrezza is the stop the progression so you don't fail approach. The same sales rep can't say two very different things at the same time to the same doctor. This mis-match then forces "overlapping accounts" and competing sales reps.
So, Mike needs to find another use for this boat anchor. Maybe there is some government program he can sell them into like a prep kit for iodine release during a nuclear war where we can't have electrical devices.
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Post by Thundersnow on Nov 8, 2022 19:45:10 GMT -5
Why would UTHR ever want to use V-Go when they have had such shockingly great results with Technosphere??? The problem Mike has is he spent $15M on this and now realizes V-Go and afrezza are like oil and water. Mike said "So I think as we go into the end of this year going into '23, we're just starting to talk about how do we best maximize that impact, how do we best support the sales force so they can maximize their effect. And I think we'll see always a dedicated V-Go sales force because these are the top accounts, top reps, top experienced at V-Go. And I think the question is on the Afrezza side, when and how do we integrate, what does that look like? And do we have overlapping accounts or separate accounts? All that work is just starting. So I wouldn't give you much guidance until we probably get to the next quarter." The bottom line is - He has to find a use for this thing. In a digital world he has a mechanical device. If you believe in Tyvaso DPI then you see the power of Technosphere and the potential of afrezza. afrezza and V-Go are competing for the same doctors with a vastly different approach to diabetes. V-Go is the traditional treat to fail approach and afrezza is the stop the progression so you don't fail approach. The same sales rep can't say two very different things at the same time to the same doctor. This mis-match then forces "overlapping accounts" and competing sales reps. So, Mike needs to find another use for this boat anchor. Maybe there is some government program he can sell them into like a prep kit for iodine release during a nuclear war where we can't have electrical devices. There are times when you display brilliance and then there are times when it's the TOTAL OPPOSITE. The V-Go Profile is totally different from the Afrezza profile. I'm not even going to waste my time explaining. Just look at Mike's slides. And for the record MNKD is getting 44% profit margins on V-GO and they just stabilized the turnaround. Add in the other 60+ sales people and what do you get?  BOOM |
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Post by cedafuntennis on Nov 8, 2022 22:41:09 GMT -5
Why would UTHR ever want to use V-Go when they have had such shockingly great results with Technosphere??? The problem Mike has is he spent $15M on this and now realizes V-Go and afrezza are like oil and water. Mike said "So I think as we go into the end of this year going into '23, we're just starting to talk about how do we best maximize that impact, how do we best support the sales force so they can maximize their effect. And I think we'll see always a dedicated V-Go sales force because these are the top accounts, top reps, top experienced at V-Go. And I think the question is on the Afrezza side, when and how do we integrate, what does that look like? And do we have overlapping accounts or separate accounts? All that work is just starting. So I wouldn't give you much guidance until we probably get to the next quarter." The bottom line is - He has to find a use for this thing. In a digital world he has a mechanical device. If you believe in Tyvaso DPI then you see the power of Technosphere and the potential of afrezza. afrezza and V-Go are competing for the same doctors with a vastly different approach to diabetes. V-Go is the traditional treat to fail approach and afrezza is the stop the progression so you don't fail approach. The same sales rep can't say two very different things at the same time to the same doctor. This mis-match then forces "overlapping accounts" and competing sales reps. So, Mike needs to find another use for this boat anchor. Maybe there is some government program he can sell them into like a prep kit for iodine release during a nuclear war where we can't have electrical devices. There are times when you display brilliance and then there are times when it's the TOTAL OPPOSITE. The V-Go Profile is totally different from the Afrezza profile. I'm not even going to waste my time explaining. Just look at Mike's slides. And for the record MNKD is getting 44% profit margins on V-GO and they just stabilized the turnaround. Add in the other 60+ sales people and what do you get? BOOM Agree with almost everything except there are not additional 60 sales people. They are going to give V-go to the total of 60 they have and have them sell both. Would be great if the existing top v-go people they have also get Afrezza and compare. There may be lessons to learn... |
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Post by Thundersnow on Nov 8, 2022 23:44:35 GMT -5
I was referring to their EXISTING SALESFORCE. Now they will have 2 products to sell/educate doctors on.
With MNKD’s cash hoard maybe they will buy another distressed diabetes product and build their portfolio of products to market.
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Post by sayhey24 on Nov 9, 2022 13:45:55 GMT -5
Why would UTHR ever want to use V-Go when they have had such shockingly great results with Technosphere??? The problem Mike has is he spent $15M on this and now realizes V-Go and afrezza are like oil and water. Mike said "So I think as we go into the end of this year going into '23, we're just starting to talk about how do we best maximize that impact, how do we best support the sales force so they can maximize their effect. And I think we'll see always a dedicated V-Go sales force because these are the top accounts, top reps, top experienced at V-Go. And I think the question is on the Afrezza side, when and how do we integrate, what does that look like? And do we have overlapping accounts or separate accounts? All that work is just starting. So I wouldn't give you much guidance until we probably get to the next quarter." The bottom line is - He has to find a use for this thing. In a digital world he has a mechanical device. If you believe in Tyvaso DPI then you see the power of Technosphere and the potential of afrezza. afrezza and V-Go are competing for the same doctors with a vastly different approach to diabetes. V-Go is the traditional treat to fail approach and afrezza is the stop the progression so you don't fail approach. The same sales rep can't say two very different things at the same time to the same doctor. This mis-match then forces "overlapping accounts" and competing sales reps. So, Mike needs to find another use for this boat anchor. Maybe there is some government program he can sell them into like a prep kit for iodine release during a nuclear war where we can't have electrical devices. There are times when you display brilliance and then there are times when it's the TOTAL OPPOSITE. The V-Go Profile is totally different from the Afrezza profile. I'm not even going to waste my time explaining. Just look at Mike's slides. And for the record MNKD is getting 44% profit margins on V-GO and they just stabilized the turnaround. Add in the other 60+ sales people and what do you get? BOOM I am not sure I am displaying any brilliance. I am more like a broken record. I just keep repeating what I heard from Al Mann and to be honest, I did not fully understand at the time. I also know what is being seen in real world use. A valid question is "Was Al Mann wrong? Is afrezza not as good as he thought?" I recently asked this question and I was prepared for the worst. The response I got was "No, Al was right". Personally I think afrezza is exceeding everyone's expectation except may Al's. I think we all understand the V-Go profile is totally different from the Afrezza profile. Now answer me this - what is the market potential of V-Go and what is it competing against? What makes V-Go better than other pumps like Omnipod? How much of that market potential could V-Go capture? Knowing MNKD is a small company with limited resources and knowing afrezza and V-Go are diametrically opposed in the philosophy of how a T2 should be treated, if you could only pick V-Go or afrezza which are you picking? Assume each V-Go sales rep is costing $500k per year and take Mike at his word that at this time he is not sure how to integrate his V-Go reps with afrezza reps. |
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Post by radgray68 on Nov 9, 2022 13:48:38 GMT -5
I gotta say, I never even considered a repurposing. But why not?
Right away I'm thinking V-GO might be repurposed for antiemetic meds for cancer patients, especially in the palliative care environment. Watched firsthand the bother with pumps. Tube always crimping, setting off alarms, batteries run low, setting off alarms, etc.
Then I go to fertility drugs. Instead of being a pincushion several times a day, just slap on a V-GO for all day consistency. Technosphere might be of use here as well.
Then, I'm thinking that UTHR might need anti-rejection drugs delivered consistently to xenotransplantation patients.
That's just my knee jerk reaction. It's FDA approved and we own it outright.
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Post by Chris-C on Nov 9, 2022 13:49:06 GMT -5
Why would UTHR ever want to use V-Go when they have had such shockingly great results with Technosphere??? The problem Mike has is he spent $15M on this and now realizes V-Go and afrezza are like oil and water. Mike said "So I think as we go into the end of this year going into '23, we're just starting to talk about how do we best maximize that impact, how do we best support the sales force so they can maximize their effect. And I think we'll see always a dedicated V-Go sales force because these are the top accounts, top reps, top experienced at V-Go. And I think the question is on the Afrezza side, when and how do we integrate, what does that look like? And do we have overlapping accounts or separate accounts? All that work is just starting. So I wouldn't give you much guidance until we probably get to the next quarter." The bottom line is - He has to find a use for this thing. In a digital world he has a mechanical device. If you believe in Tyvaso DPI then you see the power of Technosphere and the potential of afrezza. afrezza and V-Go are competing for the same doctors with a vastly different approach to diabetes. V-Go is the traditional treat to fail approach and afrezza is the stop the progression so you don't fail approach. The same sales rep can't say two very different things at the same time to the same doctor. This mis-match then forces "overlapping accounts" and competing sales reps. So, Mike needs to find another use for this boat anchor. Maybe there is some government program he can sell them into like a prep kit for iodine release during a nuclear war where we can't have electrical devices. |
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Post by anderson on Nov 9, 2022 16:53:37 GMT -5
I gotta say, I never even considered a repurposing. But why not?Right away I'm thinking V-GO might be repurposed for antiemetic meds for cancer patients, especially in the palliative care environment. Watched firsthand the bother with pumps. Tube always crimping, setting off alarms, batteries run low, setting off alarms, etc. Then I go to fertility drugs. Instead of being a pincushion several times a day, just slap on a V-GO for all day consistency. Technosphere might be of use here as well. Then, I'm thinking that UTHR might need anti-rejection drugs delivered consistently to xenotransplantation patients. That's just my knee jerk reaction. It's FDA approved and we own it outright. Hmm, got to say that this post from back in May seems more relevant now. Note that I used the word suspensions when I really meant solutions.
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Post by Thundersnow on Nov 9, 2022 18:50:08 GMT -5
There are times when you display brilliance and then there are times when it's the TOTAL OPPOSITE. The V-Go Profile is totally different from the Afrezza profile. I'm not even going to waste my time explaining. Just look at Mike's slides. And for the record MNKD is getting 44% profit margins on V-GO and they just stabilized the turnaround. Add in the other 60+ sales people and what do you get? BOOM I am not sure I am displaying any brilliance. I am more like a broken record. I just keep repeating what I heard from Al Mann and to be honest, I did not fully understand at the time. I also know what is being seen in real world use. A valid question is "Was Al Mann wrong? Is afrezza not as good as he thought?" I recently asked this question and I was prepared for the worst. The response I got was "No, Al was right". Personally I think afrezza is exceeding everyone's expectation except may Al's. I think we all understand the V-Go profile is totally different from the Afrezza profile. Now answer me this - what is the market potential of V-Go and what is it competing against? What makes V-Go better than other pumps like Omnipod? How much of that market potential could V-Go capture? Knowing MNKD is a small company with limited resources and knowing afrezza and V-Go are diametrically opposed in the philosophy of how a T2 should be treated, if you could only pick V-Go or afrezza which are you picking? Assume each V-Go sales rep is costing $500k per year and take Mike at his word that at this time he is not sure how to integrate his V-Go reps with afrezza reps. You have valid questions SAYHEY (OBTW HBO has a documentary on Willie Mays (Say Hey, Willie Mays!) - Its amazing) but you are acting like Afrezza has a SUPERIOR LABEL and should compete with the other Superior Drugs. It DOESN'T and that's the Number 1 problem and yes MNKD can blame AL MANN for it. We all know the story and yes he got a raw deal but none the less MNKD/MIKE has to improve the label which will take time and resources. Until then Afrezza will suffer. We don't know the market potential of V-GO but what we do know is that it will generate CASH/INCOME for MNKD and will be accretive NEXT YEAR. Mike got a BARGAIN for V-Go and based upon his comment this week they are exploring new ways to utilize the device. RADGRAY has some excellent suggestions. So I would say the potential for V-GO is endless. We know the insurance companies cover it via Medicare so that's one hurdle out of the way. Apparently diabetics love it because SALES are RISING. In 2023 Afrezzas salesforce will be selling it along with the 15 NZ sales folks and the 15 will be selling Afrezza. |
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Post by sayhey24 on Nov 9, 2022 19:55:14 GMT -5
What do you mean SUPERIOR LABEL? The label will never say SUPERIOR. Compare the afrezza label to the Ozempic label and tell me you see??? How much is Ozempic doing in sales? Do you think Ozempic's label is better than afrezza's? There are 2 problems with the label today; it under doses; the packaging says units. Calling the cartridges "units" was a huge mistake. They should have just been small/med/large. Do we need the FET test, probably not but every GP has one sitting in their office. Does it need the warning for the risk of acute bronchospasm in individuals with chronic lung disease, probably not but if they have chronic lung disease don't prescribe.
I don't blame Al Mann. He made a deal with Sanofi who was 100% focused on the T2 market. They were going to do follow-on studies and make afrezza Step 1 or 2 in the SoC and that was before CGMs. Then their CEO got the axe and Brandicourt immediately killed the deal. At that point Al was in bad health. Did Brandicourt take advantage of that for some reason - IDK. In the end it was hard to tell what Brandicourt was thinking. He was co-launching Toujeo at the time but that was for the T1 market. IDK - in the end Brandicourt made a big mess and got axed too. What I do know is Pfizer went out of their way to sabotage afrezza prior to approval with the Exubera cancer scare. IDK, maybe more recently too before launching Mounjaro but thats speculation. What we do know is if Al Mann and Sanofi succeeded they would have blown-up the $40B antiglycemic market and there would be no need for Mounjaro.
You say we don't we know the market potential for V-GO? We plunked down 10% of our free cash and don't know the market potential and are now feeding 15 sales reps which is growing to what, 15 more? Why did Mike not include this market potential in his slides? OK, Mike went dumpster diving and got a bargain. You know what they say about "getting what you paid for". They were closing that business - why??? Maybe Mike could have picked it up nothing but even if he did - its at odds with the afrezza philosophy.
You say we don't have medicare coverage. The onset of type 2 diabetes is most common in people aged 45–64. Thats before medicare. Thats the afrezza target market. However Ozempic is covered by medicare, why??? Do you think afrezza would get coverage if it was step 2 or 3 like Ozempic??? Of course it would. V-Go is the very last step. This means you have failed on the orals and the GLP1s and basal alone. You need basal and mealtime. If you had gotten the afrezza years prior you would never need the V-Go.
Do you see the problem? Afrezza obsoletes V-Go, if afrezza really works. Does afrezza really work? If it does, what was Mike thinking? BTW - Mike says afrezza really works. Bill from VDex says it really works too and so do a bunch of people on social media.
Thanks for the tip on the HBO special. IMO - the greatest player of all time and thats not because I am from NY.
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Post by Thundersnow on Nov 10, 2022 7:52:43 GMT -5
What do you mean SUPERIOR LABEL? The label will never say SUPERIOR. Compare the afrezza label to the Ozempic label and tell me you see??? How much is Ozempic doing in sales? Do you think Ozempic's label is better than afrezza's? There are 2 problems with the label today; it under doses; the packaging says units. Calling the cartridges "units" was a huge mistake. They should have just been small/med/large. Do we need the FET test, probably not but every GP has one sitting in their office. Does it need the warning for the risk of acute bronchospasm in individuals with chronic lung disease, probably not but if they have chronic lung disease don't prescribe. I don't blame Al Mann. He made a deal with Sanofi who was 100% focused on the T2 market. They were going to do follow-on studies and make afrezza Step 1 or 2 in the SoC and that was before CGMs. Then their CEO got the axe and Brandicourt immediately killed the deal. At that point Al was in bad health. Did Brandicourt take advantage of that for some reason - IDK. In the end it was hard to tell what Brandicourt was thinking. He was co-launching Toujeo at the time but that was for the T1 market. IDK - in the end Brandicourt made a big mess and got axed too. What I do know is Pfizer went out of their way to sabotage afrezza prior to approval with the Exubera cancer scare. IDK, maybe more recently too before launching Mounjaro but thats speculation. What we do know is if Al Mann and Sanofi succeeded they would have blown-up the $40B antiglycemic market and there would be no need for Mounjaro. You say we don't we know the market potential for V-GO? We plunked down 10% of our free cash and don't know the market potential and are now feeding 15 sales reps which is growing to what, 15 more? Why did Mike not include this market potential in his slides? OK, Mike went dumpster diving and got a bargain. You know what they say about "getting what you paid for". They were closing that business - why??? Maybe Mike could have picked it up nothing but even if he did - its at odds with the afrezza philosophy. You say we don't have medicare coverage. The onset of type 2 diabetes is most common in people aged 45–64. Thats before medicare. Thats the afrezza target market. However Ozempic is covered by medicare, why??? Do you think afrezza would get coverage if it was step 2 or 3 like Ozempic??? Of course it would. V-Go is the very last step. This means you have failed on the orals and the GLP1s and basal alone. You need basal and mealtime. If you had gotten the afrezza years prior you would never need the V-Go. Do you see the problem? Afrezza obsoletes V-Go, if afrezza really works. Does afrezza really work? If it does, what was Mike thinking? BTW - Mike says afrezza really works. Bill from VDex says it really works too and so do a bunch of people on social media. Thanks for the tip on the HBO special. IMO - the greatest player of all time and thats not because I am from NY. I remember the day he retired from the Mets, I was balling my eyes out. I was young and he has always been my IDOL. He's the reason I played baseball and got all the way to Division 1 Collegiate. It will be a very sad day for the world when he leaves us. |
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BOOM 
