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Post by dh4mizzou on Apr 16, 2024 10:57:49 GMT -5
Following SOC is one thing. Outright lying to a patient SHOULD allow for such a lawsuit.
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Post by prcgorman2 on Apr 16, 2024 11:01:22 GMT -5
"....multiple Endos lied to this patient about Afrezza...." I'm thinking a medical malpractice lawsuit or two would clear this up. Unfortunately there’s no viable medical malpractice theory for such a lawsuit. As long as doctor follows SOC there’s no case. Another problem would be proving damages, even if one could show some negligence that resulted in injury. If in fact multiple endocrinologists knowingly misled a patient about a drug or treatment option, it could cause a stir at least. ChatGPT echoed your comment though. Arguing SOC not provided and prove harm are two tenets of a malpractice lawsuit. The SOC argument would be out the window.
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Post by sayhey24 on Apr 16, 2024 11:01:59 GMT -5
This is a huge issue. What is Mike doing about it? Why don't you ask him and tell us about it instead of posting the question here.... that would be more productive and not sound like you're whining I post it here because it gets visibility and it needs to be public. I will also ask a question at the AGM. When I ask him direct I have not really gotten a straight answer. The last time he whined about shareholders not appreciating the cost of studies. What I don't appreciate is the amount of money we spent on V-Go. Once we have some of the extra study and maybe show superiority with the kids maybe we can get SoC changes and then maybe get insurance without pre auths. Afrezza has a cost issue and the current approach is to get insurance to cover it, but they usually say no. Until its the standard of care this will continue which leaves MNKD not a lot of choices in the short term. Maybe a limited time price reduction to $35? To that Mike will say he needs to return the $3.5B invest to the shareholders.
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Post by prcgorman2 on Apr 16, 2024 11:09:05 GMT -5
Mike did say at the last earnings call that further studies for Afrezza will be based on measuring success of the pump/switch and Pediatric trials and I took it that was Board of Directors guidance. I don't know how you design a trial to prove superior safety of Afrezza, but that would be my vote for one of the next trials.
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Post by uvula on Apr 16, 2024 12:01:01 GMT -5
From mango:
"I imagine Mike has/is doing all he can. Health insurance is a corrupt man’s game. I really like what Mark Cuban has done with his online pharmacy store. He is 100% transparent with the drug pricing, and they mark up the cost 15% for profit, and they list the wholesale cost of each drug. They don’t have a lot available yet, but would be awesome if Mike could get Afrezza on there at an affordable price to bypass the insurance companies."
Doesn't this only work if Cuban is selling generic drugs? In our case, the high price is from mnkd because it costs a lot to make.
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Post by sayhey24 on Apr 16, 2024 12:19:21 GMT -5
Why don't you ask him and tell us about it instead of posting the question here.... that would be more productive and not sound like you're whining I imagine Mike has/is doing all he can. Health insurance is a corrupt man’s game. I really like what Mark Cuban has done with his online pharmacy store. He is 100% transparent with the drug pricing, and they mark up the cost 15% for profit, and they list the wholesale cost of each drug. They don’t have a lot available yet, but would be awesome if Mike could get Afrezza on there at an affordable price to bypass the insurance companies. There also appears to be a huge issues with endocrinologist, as the person pointed out. In this case, multiple Endos lied to this patient about Afrezza. How often is that happening?! Mike turned the offer down. He said Mark's model will not return shareholder value on the $3.5B investment. I guess Mike has a plan. I just hope he reveals it soon. One thing I am sure of and that this pre auth process which is limiting scripts will not return shareholder value either.
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Post by sayhey24 on Apr 16, 2024 12:30:17 GMT -5
From mango: "I imagine Mike has/is doing all he can. Health insurance is a corrupt man’s game. I really like what Mark Cuban has done with his online pharmacy store. He is 100% transparent with the drug pricing, and they mark up the cost 15% for profit, and they list the wholesale cost of each drug. They don’t have a lot available yet, but would be awesome if Mike could get Afrezza on there at an affordable price to bypass the insurance companies." Doesn't this only work if Cuban is selling generic drugs? In our case, the high price is from mnkd because it costs a lot to make. No. It does not cost a lot to make. One of the biggest costs is filling and packaging. Cuban was at one time really big on bringing $35 insulin to market - prior to the Inflation Reduction Act $35 insulin. I explained to him back then you can already get $25 insulin at Walmart and that not all insulins are the same. It seemed odd to me but the guy who started Costplusdrugs is a diabetic and should have explained this to him. Anyway Mark got really interested in afrezza once he understood why it was so different. Afrezza was priced the way it is because Al Mann thought it was so great the market will pay this and premium priced it. Could afrezza pricing be reduced, absolutely. Could it fit Cuban's model, IDK as it was never negotiated. If Cuban had it, could he make afrezza a household name? IDK but I do know I would like to give it a try since Tyvaso DPI is paying the bills.
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Post by prcgorman2 on Apr 16, 2024 13:03:52 GMT -5
Does Mark Cuban have doctors working at his pharmacy to prescribe Afrezza? If his model requires volume, not sure how he can make that happen since the first thing doctors look at is the SOC and not the price.
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Post by ktim on Apr 16, 2024 14:56:12 GMT -5
I assumed stella was being sarcastic. I hope so. I sure laughed. I also agree with you. It would make a great study. How dysfunctional is the attitude of the average investor towards each of their investments? I think it's the very well known tendency for people to not want to recognize losses and hold out hope their investments will recover. Many times people look at what they originally paid, and wishfully assume there must be some way they can be made whole. Even if one intellectually recognizes something, be it losing faith in management or knowing that massive share dilution has occurred, emotionally they want to not lock in a loss. I would be incredibly hard pressed to think of anyone I know that hasn't made that mistake at least once. It is a real investment psychological flaw/dysfunction that most investors have to consciously deter themselves from. I remember years ago I was invested in a tech company where I steadily lost confidence in the management. I swore their performance and communication seemed designed to destroy shareholder confidence. The share price continued down. I held because I thought the inherent worth of the company was higher... and my tendency to want to believe in that without weighing the fact that I thought the management was horrible. After the share price hit an unbelievably low rock bottom, that management team orchestrated a private buyout of the company. Then 12 or 18 months later they came back to the IPO market making a huge profit for themselves. Somehow their performance as a management team had improved enormously over that year after toasting us shareholders. Note, I'm in no way saying I don't believe in current MNKD management, just saying it's very easy to believe why a long time holder of a company might stick with it even with serious misgivings. Lots of investors smoke the hopium pipe rather than bailing on losing positions in which they no longer have full faith.
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Post by sayhey24 on Apr 16, 2024 15:00:35 GMT -5
Does Mark Cuban have doctors working at his pharmacy to prescribe Afrezza? If his model requires volume, not sure how he can make that happen since the first thing doctors look at is the SOC and not the price. Why would he have doctors? Its an online pharmacy. They would not be prescribing afrezza they would be selling it like Amazon Pharmacy. The different is Amazon is selling it for $1200+ and probably does not have many buyers. The SoC is a separate issue from price. To solve the SoC issue you need trial data and lobbyists. To solve the cost issue you need insurance or an out of pocket price people can afford. Right now, with the exception of the pre auth process, afrezza has neither an affordable price nor insurance.
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Post by sayhey24 on Apr 16, 2024 15:11:32 GMT -5
Any idea which facebook page they complained about? If its the MNKD one that one is full of safety issue warnings. If its the non-MNKD one, thats too bad so sad. MNKD has no control over that. In either case I see this as good news. For some reason afrezza got someone's attention. Its been years since this has happened. I wonder why now. Maybe the kids trial is getting some people nervous. I have not checked the FDA adverse reaction database in a long time so I just did. In 10 years there are less than 1100 complaints. How in 10 years is that possible?
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Post by BD on Apr 16, 2024 15:19:13 GMT -5
ktim, good post. I keep thinking of the hackneyed phrase "Great product, bad company", but so far that's what MNKD's financials have pointed to. How long do you (not you personally, the collective you) hold on with putting your money into something like this? Would have to depend on your level of confidence. And there are probably as many different ones of those as there are shareholders (or shorts) of MNKD...
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Post by ktim on Apr 16, 2024 15:23:17 GMT -5
Response To: "Anyway, this is mostly idle chatter to pass the time. The fortunes of MannKind are no longer hanging by a single thread. Afrezza is now a valuable asset (say those of us who still believe it is the best mealtime insulin, bar none), which is finally returning shareholder value, and still holds the provably elusive promise of being a blockbuster, but not so much that we have to obsess about it (or V-Go)." Wouldn't it be refreshing if the focus was on the pipeline and its potential and not Afrezza? When I have time and it's not going to be this week, I will share my research on why Afrezza is not being supported by the endocrinologists and why so many that tried Afrezza have decided to switch. Furthermore, I actually contacted a number of people in the VC community and Hedge Funds located in New York (past associates), and after many discussions and preliminary research on their part, the feedback was that there was no indication that Afrezza was ever going to be profitable enough for anyone to dump a boatload of money to try and make it successful. However, the general consensus was by all involved, that the technology (Technosphere) and inhaled medications was viable and would generate a lot of revenue if directed into the correct marketplace. Suffice it to say, they all said Al Mann had options, but unfortunately picked the wrong one. They were not interested in making a play for the company - to many obstacles and hurdles. I would like to see your research. If its not cost or the label driving the people to switch we may have a fourth issue. I would like to know what that is. We know the label is wrong and as a result people are misusing it and under dosing and not follow-up dosing as needed and not getting the results they should. I have seen a few people who build up a resistance to human insulin and switch to an analog but thats not many. I really don't put much stock in the VC and Hedge Fund opinions. I also don't think as long as the Mann foundation is still backing the company its for sale. I think Al Mann knew what he was doing and picked the right option. Things happen and he did not plan on getting sick. For MNKD those who followed could not fill his shoes. I also think we are going to agree to disagree on the potential of afrezza vs. MNKD-101 and MNKD-201 combined. IMO they are small potatoes compared to what should be the greatest selling drug of all time. Saxenda DPI might get me excited but Mike does not want to take on BP and wants to stay out of their lane. I have questioned whether afrezza is really as good as Al Mann said. We know Bill from VDex thinks so and he has a lot of hands on experience. I posed the same question to Mike not that long ago and got a surprising answer or at least one I was not expecting. He told me its probably better and as we know Mike is an afrezza user himself. When you have the time, please post your research. Have you considered that patients may not like needing to follow-up dose? That could be a problem that is unfixable.
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Post by prcgorman2 on Apr 16, 2024 15:30:54 GMT -5
I assumed stella was being sarcastic. I hope so. I sure laughed. I also agree with you. It would make a great study. How dysfunctional is the attitude of the average investor towards each of their investments? I think it's the very well known tendency for people to not want to recognize losses and hold out hope their investments will recover. Many times people look at what they originally paid, and wishfully assume there must be some way they can be made whole. Even if one intellectually recognizes something, be it losing faith in management or knowing that massive share dilution has occurred, emotionally they want to not lock in a loss. I would be incredibly hard pressed to think of anyone I know that hasn't made that mistake at least once. It is a real investment psychological flaw/dysfunction that most investors have to consciously deter themselves from. I remember years ago I was invested in a tech company where I steadily lost confidence in the management. I swore their performance and communication seemed designed to destroy shareholder confidence. The share price continued down. I held because I thought the inherent worth of the company was higher... and my tendency to want to believe in that without weighing the fact that I thought the management was horrible. After the share price hit an unbelievably low rock bottom, that management team orchestrated a private buyout of the company. Then 12 or 18 months later they came back to the IPO market making a huge profit for themselves. Somehow their performance as a management team had improved enormously over that year after toasting us shareholders. Note, I'm in no way saying I don't believe in current MNKD management, just saying it's very easy to believe why a long time holder of a company might stick with it even with serious misgivings. Lots of investors smoke the hopium pipe rather than bailing on losing positions in which they no longer have full faith. Yup, agree. I had a similar experience, only the company whose management I kept hoping would pull their head out was the one I was working for. I finally took a big fat loss on the shares I'd been accumulating on the ESPP, options, etc. and reinvested them elsewhere. The company never did recover and now no longer exists. It was probably my front row view that helped me dump the stock sooner than I might have if I'd simply been an open market investor. That reinvestment didn't work out perfectly (never, right?) but it certainly has done better than going into non-existence. (I kicked myself the other day because I'd bought GE around $15 and dumped it about the time they came roaring back. Figures.)
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Post by cretin11 on Apr 16, 2024 15:31:46 GMT -5
In either case I see this as good news. For some reason afrezza got someone's attention. It’s been years since this has happened. I wonder why now. Maybe the kids trial is getting some people nervous. sayhey the article I’m seeing is over five years old. Are you looking at something more recent?
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