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Post by hellodolly on Mar 16, 2023 12:36:51 GMT -5
A few years ago the idea of selling off Afrezza would’ve been offensive to me. Not so anymore. If MNKD could negotiate favorable sales terms (questionable I realize), then do it and get Afrezza under the control of someone who can competently commercialize it. Good for PWDs, good for MNKD shareholders. But yes, a lot of “ifs” there, so that’s a long shot. MNKD could continue to collect royalties and/or manufacturing revenues on Afrezza and skip the whole marketing and sales but, at the JPM Conference MC mentioned that the focus of the team will be internal. Does that mean keeping AFREZZA? Or, can they simply become the "go to" manufacturer of new DPI products across the pharmaceutical industry by partnering, discovering and/or acquiring existing compounds. As for a partnership, if it's going to be as easy as conducting dose escalation studies to determine toxicity and move immediately to a PIII trial of an already FDA approved drug, like UTHRs Tyvaso, now is not a bad time. Of course, current economic uncertainty might make this a challenge. But, from what I've been reading, acquisitions could be pretty cheap right now and I think MC was more interested in doing their own thing by looking for new compounds to keep in house.
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Post by cretin11 on Mar 16, 2023 13:55:33 GMT -5
Hellodolly, what I like in your post is the notion that we “skip the whole marketing and sales” part of things. We have seen enough track record to know those are not our areas of competence. Developing product and collecting royalty, that is the ticket.
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Post by hellodolly on Mar 16, 2023 14:36:40 GMT -5
Hellodolly, what I like in your post is the notion that we “skip the whole marketing and sales” part of things. We have seen enough track record to know those are not our areas of competence. Developing product and collecting royalty, that is the ticket. Question is does MNKD think they have gotten Afrezza to a place where some BP can use their global marketing efforts to grow scripts, or...does MC lack the confidence to put it up for sale wondering (deep in the back of his mind) that it might just be taken and stuffed into the garbage resulting in zero royalties/manufacturing revenue and jeopardizing shareholders investments? There is a lot of meat on that bone. It's not so cut and dry as we like to think.
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Post by sayhey24 on Mar 16, 2023 14:53:11 GMT -5
By dropping the cost of its Humalog and Humulin insulins, Lilly could sidestep $430 million per year in new Medicaid rebates and make more than $85 million in new annual profit, according to an analysis by Spencer Perlman, the director of health-care research at Veda Partners.10 hours ago That's correct. A slightly longer explanation from the research paper ( here) is that a drug company has to rebate the greater of 23% or the difference between the list price and the best price a PBM pays, plus an addition for the amount the price rises above inflation to CMS on Medicaid revenue. Currently that is capped at 100% of the list price and the big three insulin manufacturers all hit that cap. As of the start of next year that cap is removed and so they will be rebating a fair bit more than the list price of the drug. The example the chose in the paper was Humalog. The list price is $274, and the best price is about $66 (all these numbers are approximate, but the reasoning is sound). That gives a rebate of 274-66 = $208 plus an inflation rebate of $234 for a total rebate of $442. The current cap limits that to 100% of the list price and so while Lilly make no profit they avoid the full $442, but that changes next year when their rebate cost would jump from $234 to $442. How can they avoid this? By reducing the price to $66 they now pay the 23% rebate, since that is the greater, which is $15 and the inflation rebate drops to $26 for a total rebate of $41 which gives a margin of $25, or 37%. After the price reduction the revenue next year will be $156M so they jump from a revenue after rebate of $0 to $56M. Novo Nordisk and Sanofi are in the same position which is why Novo Nordisk reduced their prices, and Sanofi will reduce their prices at some point before next year. How does this apply to MNKD? Your link is for MedicAID and not Medicare. Are they the same??? I would think MNKD has close to $0 sales for Medicaid. I don't know what Lilly and NVO MedicAID sales are. Medicare on the other hand I would think is significant. I also see Medicare as the place MNKD can make a foothold in the T2 world with Medicare and the CGM effort underway. I do know is on the last four public calls MNKDs CEO has mentioned afrezza and Medicare and this being a big deal.
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Post by agedhippie on Mar 16, 2023 17:06:27 GMT -5
How does this apply to MNKD? Your link is for MedicAID and not Medicare. Are they the same??? I would think MNKD has close to $0 sales for Medicaid. I don't know what Lilly and NVO MedicAID sales are. Medicare on the other hand I would think is significant. I also see Medicare as the place MNKD can make a foothold in the T2 world with Medicare and the CGM effort underway. I do know is on the last four public calls MNKDs CEO has mentioned afrezza and Medicare and this being a big deal. Medicaid and Medicare are different although both run by the CMS. The last available data was from 2021 which was $1.94M for Medicare Part D. For context Humalog was $594.5M.
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Post by peppy on Mar 16, 2023 17:16:07 GMT -5
How does this apply to MNKD? Your link is for MedicAID and not Medicare. Are they the same??? I would think MNKD has close to $0 sales for Medicaid. I don't know what Lilly and NVO MedicAID sales are. Medicare on the other hand I would think is significant. I also see Medicare as the place MNKD can make a foothold in the T2 world with Medicare and the CGM effort underway. I do know is on the last four public calls MNKDs CEO has mentioned afrezza and Medicare and this being a big deal. Medicaid and Medicare are different although both run by the CMS. The last available data was from 2021 which was $1.94M for Medicare Part D. For context Humalog was $594.5M. Aged, are the pharmacy purchasing managers going to care about script numbers for Humalog or Novalog any more? are there any incentives left?
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Post by agedhippie on Mar 16, 2023 17:31:00 GMT -5
Medicaid and Medicare are different although both run by the CMS. The last available data was from 2021 which was $1.94M for Medicare Part D. For context Humalog was $594.5M. Aged, are the pharmacy purchasing managers going to care about script numbers for Humalog or Novalog any more? Yes because they want the other drugs NVO or LLY make. Look at Ozempic which bounces between the the fifth and sixth highest revenue drug, or Trulicity which is a couple of positions lower. If you are not taking their insulin you aren't getting their best price on those juicy high value drugs. These things get negotiated as a basket, not individually.
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Post by sayhey24 on Mar 16, 2023 19:38:11 GMT -5
Aged, are the pharmacy purchasing managers going to care about script numbers for Humalog or Novalog any more? Yes because they want the other drugs NVO or LLY make. Look at Ozempic which bounces between the the fifth and sixth highest revenue drug, or Trulicity which is a couple of positions lower. If you are not taking their insulin you aren't getting their best price on those juicy high value drugs. These things get negotiated as a basket, not individually. Peppy - Didn't Mike say on Tuesday they would not care as much any more and this created a new opportunity for afrezza? I am going from memory so I could have this wrong.
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Post by agedhippie on Mar 17, 2023 17:02:35 GMT -5
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