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Post by sportsrancho on Nov 22, 2023 14:20:07 GMT -5
When Bill and Stevil mention cost being a major factor in discontinuation of Afrezza, I am just curious if these people did not qualify for the Afrezza Savings Card copay can be as low as $15-$35. Or Eagle Pharmacy savings program that is $99 for 1 month of 90 carts or $199 for 1 months of 180 carts. Did both VDex and Stevil use these services? If not, why not? If so, what went wrong? stevil sportsrancho Bill will get back to you in a bit. I see Nate a little troubled by all this🤷‍♀️ Bill doesn’t know what’s going on on social media. He does know what’s going on with Afrezza. That’s the info he is trying to provide. |
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Post by cretin11 on Nov 22, 2023 14:47:08 GMT -5
Nate is troubled by anything that threatens his narrative to his subscribers that he has “never been wrong” about MNKD.
Meanwhile, Bill simply tells it like it is and understands the issues and nuances of Afrezza as well as anyone (and yes that includes anyone at MNKD in charge of commercializing it). Thankful we have him on our side.
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Post by sportsrancho on Nov 22, 2023 14:48:48 GMT -5
From Bill…
“In answer to Mango, we used the various discount programs that were available. Ultimately it led us to Eagle and the $99-$199 monthly cost. We were in regular conversation with MannKind Cares and they helped but still patients eventually found the cheapest route was the specialty pharma like Eagle. And that was still too high for many patients, especially when the alternatives were essentially free.”
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Post by agedhippie on Nov 22, 2023 14:55:13 GMT -5
Stevil - are you breaking major news here? Did you just say your patients were seeing a 0.4-0.5% lower A1c when using afrezza than using what - Mounjaro? I am not sure what you are comparing afrezza to but if its GLP1s that is HUGE news. Can you clarify, please. ... Reread the section more slowly. Here it is: The biggest issue was it was too much work to babysit their CGM with Afrezza. They got excellent results- they admitted as much. They just got tired of having to dose so many times a day when they could get 0.4-0.5% higher A1c with less than half the effort.No mention of GLP-1 anywhere. This is entirely around what I frequently comment on, and both Bill and Stevil have raised as well. People (including me) don't want to put the level of effort into managing their diabetes that you expect them to. They would rather just dose once, ignore their CGM, and live with the slightly worse results. There is no other drug involved. |
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Post by mango on Nov 22, 2023 15:02:40 GMT -5
From Bill… “In answer to Mango, we used the various discount programs that were available. Ultimately it led us to Eagle and the $99-$199 monthly cost. We were in regular conversation with MannKind Cares and they helped but still patients eventually found the cheapest route was the specialty pharma like Eagle. And that was still too high for many patients, especially when the alternatives were essentially free.” Great info. So the $99 a month is still too high for many patients. I wonder if MannKind could renegotiate to say, $50 a month or even $25 a month through Eagle if that would help. I’m assuming many of these patients are low income/poverty and that $99 a month is a lot for them. We have to do better! |
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Post by mango on Nov 22, 2023 15:11:50 GMT -5
Al always meant for Afrezza to treat T2D, not just T1D. T2D have a diminished or lose of the first phase insulin secretion, which Afrezza mimics, thus restoring post prandial glucose homeostasis.
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Post by mpg54 on Nov 22, 2023 15:14:06 GMT -5
Stevil - are you breaking major news here? Did you just say your patients were seeing a 0.4-0.5% lower A1c when using afrezza than using what - Mounjaro? I am not sure what you are comparing afrezza to but if its GLP1s that is HUGE news. Can you clarify, please. ... Reread the section more slowly. Here it is: The biggest issue was it was too much work to babysit their CGM with Afrezza. They got excellent results- they admitted as much. They just got tired of having to dose so many times a day when they could get 0.4-0.5% higher A1c with less than half the effort.No mention of GLP-1 anywhere. This is entirely around what I frequently comment on, and both Bill and Stevil have raised as well. People (including me) don't want to put the level of effort into managing their diabetes that you expect them to. They would rather just dose once, ignore their CGM, and live with the slightly worse results. There is no other drug involved. I don't have diabetes, but I can't imagine having a pump to wear all day being less of a hassle then a quick inhale when needed. The pump seems like a much bigger management issue. If I did have diabetes I know I would much prefer a CGM and Afrezza as it seems so much less burdensome. I can't speak from actual experience, but I know what would be my choice if I did have to make it. There might be times when I'd inhale in the mens room rather than in public, but if I had to inhale in public that wouldn't be an issue for me personally. |
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Post by agedhippie on Nov 22, 2023 15:16:19 GMT -5
From Bill… “In answer to Mango, we used the various discount programs that were available. Ultimately it led us to Eagle and the $99-$199 monthly cost. We were in regular conversation with MannKind Cares and they helped but still patients eventually found the cheapest route was the specialty pharma like Eagle. And that was still too high for many patients, especially when the alternatives were essentially free.” Great info. So the $99 a month is still too high for many patients. I wonder if MannKind could renegotiate to say, $50 a month or even $25 a month through Eagle if that would help. I’m assuming many of these patients are low income/poverty and that $99 a month is a lot for them. We have to do better! For context; with commercial insurance I pay a flat $100 per quarter for Humalog pens regardless of quantity. I would need at least two boxes of Afrezza per month which, I suspect, is not atypical - so $100 vs. $600 with Eagle per quarter or an extra $2,000 per year to use Afrezza. |
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Post by sayhey24 on Nov 22, 2023 15:21:29 GMT -5
Stevil - are you breaking major news here? Did you just say your patients were seeing a 0.4-0.5% lower A1c when using afrezza than using what - Mounjaro? I am not sure what you are comparing afrezza to but if its GLP1s that is HUGE news. Can you clarify, please. ... Reread the section more slowly. Here it is: The biggest issue was it was too much work to babysit their CGM with Afrezza. They got excellent results- they admitted as much. They just got tired of having to dose so many times a day when they could get 0.4-0.5% higher A1c with less than half the effort.No mention of GLP-1 anywhere. This is entirely around what I frequently comment on, and both Bill and Stevil have raised as well. People (including me) don't want to put the level of effort into managing their diabetes that you expect them to. They would rather just dose once, ignore their CGM, and live with the slightly worse results. There is no other drug involved. Aged - as I framed my question to Stevil "our patients were seeing a 0.4-0.5% lower A1c when using afrezza than using what - Mounjaro?" Immediately after this he starts talking about Mounjaro and how he has many patients using it. Lets let Stevil answer what he is comparing afrezza to. My experience with afrezza is different than what Stevil describes and if I remember correctly you have never used it. I dosed "large" at meals and seldom second dosed. I agree with Bill that the CGM is only needed when dialing in how big to go on the dosing. Then again I was getting mine on Ebay. When Al said its near impossible to get a hypo I went with this. 3 puffs a day was never an issue then again I watched my Dad try and take care of his ever progressing diabetes and he never had the right tools. The best he had was test tape and orinase until he went to porcine insulin. If people don't want to take care of themselves then they will end up like my Grandmother and it was not pretty. It was a lot worse than "slightly worse results". |
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Post by mango on Nov 22, 2023 15:25:37 GMT -5
WTF is going on. So many people are missing out on Afrezza because of cost. We need good insurance coverage. We need Medicare coverage. We need affordable out of pocket costs without insurance-instead of $99 a month it should be $25 a month. No patient should be left behind because of cost. MannKind must do better. michaelcastagna |
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Post by agedhippie on Nov 22, 2023 15:34:18 GMT -5
I don't have diabetes, but I can't imagine having a pump to wear all day being less of a hassle then a quick inhale when needed. The pump seems like a much bigger management issue. If I did have diabetes I know I would much prefer a CGM and Afrezza as it seems so much less burdensome. I can't speak from actual experience, but I know what would be my choice if I did have to make it. There might be times when I'd inhale in the mens room rather than in public, but if I had to inhale in public that wouldn't be an issue for me personally. I don't like saying this, but that's because you haven't been a diabetic for decades. My experience was that in the early days I was all over it - I checked a lot, I watched what I ate, I always prebolused, and I did corrections. A couple of decades later I only check at meal times, I don't pre-bolus, and corrections never happen except for bed time. Most of that has happened over the last 10 years (strangely, almost parallel to my time on this board  ). I did this because I wanted to have less to do with my diabetes and if the price was higher numbers I could live with that if it meant avoiding diabetic burnout. If I used an AID pump my numbers would be way better than they are at the moment, but although I have used a pump in the past it's not something I am keen on. That said I am seriously considering the Omnipod 5 if I can just slap it on and more or less forget about diabetes between meals. The plus to an omnipod is that the running cost is high, but the upfront cost is zero so I can drop it if I can't get on with it with a clear conscience (tubed pumps cost in the thousands). I never criticize a diabetic's choice provided it was a considered decision. I have seen people make choices I strongly disagree with, but it's their decision to make and not mine - we all make our own deal with this particular devil reflecting what we can and cannot live with. Taking insulin in public very rapidly becomes something you see as other peoples' problem  |
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Post by agedhippie on Nov 22, 2023 15:40:32 GMT -5
Reread the section more slowly. Here it is: The biggest issue was it was too much work to babysit their CGM with Afrezza. They got excellent results- they admitted as much. They just got tired of having to dose so many times a day when they could get 0.4-0.5% higher A1c with less than half the effort.No mention of GLP-1 anywhere. This is entirely around what I frequently comment on, and both Bill and Stevil have raised as well. People (including me) don't want to put the level of effort into managing their diabetes that you expect them to. They would rather just dose once, ignore their CGM, and live with the slightly worse results. There is no other drug involved. Aged - as I framed my question to Stevil "our patients were seeing a 0.4-0.5% lower A1c when using afrezza than using what - Mounjaro?" Immediately after this he starts talking about Mounjaro and how he has many patients using it. Lets let Stevil answer what he is comparing afrezza to. ... Read the passage like an English comprehension test. It's crystal clear. |
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Post by porkini on Nov 22, 2023 15:43:37 GMT -5
Source, reference? Thank you. The sources are scattered on my posts on other threads but here’s some to wet your appetite: ... Thanks, my ask was for anyone who wanted to look into your post further and, of course, give credit where due to authors/researchers.  |
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Post by peppy on Nov 22, 2023 15:52:19 GMT -5
Reread the section more slowly. Here it is: The biggest issue was it was too much work to babysit their CGM with Afrezza. They got excellent results- they admitted as much. They just got tired of having to dose so many times a day when they could get 0.4-0.5% higher A1c with less than half the effort.No mention of GLP-1 anywhere. This is entirely around what I frequently comment on, and both Bill and Stevil have raised as well. People (including me) don't want to put the level of effort into managing their diabetes that you expect them to. They would rather just dose once, ignore their CGM, and live with the slightly worse results. There is no other drug involved. I don't have diabetes, but I can't imagine having a pump to wear all day being less of a hassle then a quick inhale when needed. The pump seems like a much bigger management issue. If I did have diabetes I know I would much prefer a CGM and Afrezza as it seems so much less burdensome. I can't speak from actual experience, but I know what would be my choice if I did have to make it. There might be times when I'd inhale in the mens room rather than in public, but if I had to inhale in public that wouldn't be an issue for me personally. Aged is an expert on diabetes and treatment options. The Omnipod 5. www.omnipod.com/what-is-omnipod/omnipod-5Aged pointed out to me years ago, it is a miniature auto syringe that can be digitally programed. Computerized now with a Continuous glucose monitor as the feed back system. mpg54 , the real upside in Afrezza is the delivery system, into the left atrium, left ventricle and systemic blood stream allows for 35 min peak time and 90 min out of the system for a 4 unit cartridge. *if blood glucose level is over 100 at 60 mins a second dose of afrezza may be necessary. the omnipod because the delivery is subcutaneous, Peak is two hours and it takes 5 hours to get out of the system as the delivery is through the capillaries to the blood stream a slow go. . . |
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Post by mpg54 on Nov 22, 2023 16:07:15 GMT -5
I don't have diabetes, but I can't imagine having a pump to wear all day being less of a hassle then a quick inhale when needed. The pump seems like a much bigger management issue. If I did have diabetes I know I would much prefer a CGM and Afrezza as it seems so much less burdensome. I can't speak from actual experience, but I know what would be my choice if I did have to make it. There might be times when I'd inhale in the mens room rather than in public, but if I had to inhale in public that wouldn't be an issue for me personally. I don't like saying this, but that's because you haven't been a diabetic for decades. My experience was that in the early days I was all over it - I checked a lot, I watched what I ate, I always prebolused, and I did corrections. A couple of decades later I only check at meal times, I don't pre-bolus, and corrections never happen except for bed time. Most of that has happened over the last 10 years (strangely, almost parallel to my time on this board ). I did this because I wanted to have less to do with my diabetes and if the price was higher numbers I could live with that if it meant avoiding diabetic burnout. If I used an AID pump my numbers would be way better than they are at the moment, but although I have used a pump in the past it's not something I am keen on. That said I am seriously considering the Omnipod 5 if I can just slap it on and more or less forget about diabetes between meals. The plus to an omnipod is that the running cost is high, but the upfront cost is zero so I can drop it if I can't get on with it with a clear conscience (tubed pumps cost in the thousands). I never criticize a diabetic's choice provided it was a considered decision. I have seen people make choices I strongly disagree with, but it's their decision to make and not mine - we all make our own deal with this particular devil reflecting what we can and cannot live with. Taking insulin in public very rapidly becomes something you see as other peoples' problem I get it, like I said I can't speak from any experience. My point of view was simply if I had it, what would I think I'd prefer. I don't doubt experience might change my thinking overtime. I'm fairly active, can't imagine having to wear anything much more than a patch for a CMG. |
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). I did this because I wanted to have less to do with my diabetes and if the price was higher numbers I could live with that if it meant avoiding diabetic burnout.
