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Post by lennymnkd on May 13, 2024 23:47:23 GMT -5
By “proper coverage “ I meant health insurance.
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Post by prcgorman2 on May 14, 2024 6:40:58 GMT -5
By “proper coverage “ I meant health insurance. Good point. I’ve taken insurance for granted, but I shouldn’t. It is not clear to me how insurance providers decide to support a given drug or form of drug. If current prices are what MannKind used to base their estimates of revenue, and the Clofazimine DPI is more effective and less side effects, it should be covered. Easy to say, but that is assuming too much. It would be good to hear MannKind’s thoughts on coverage for Clofazimine.
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Post by olebob1 on May 14, 2024 8:17:52 GMT -5
Seeing 373k shares traded after-hours mostly at $4.41. Thoughts? Looks like 199,500 shares traded @ 4.32 time 16:13
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Post by runner on May 14, 2024 15:08:57 GMT -5
First close at $4.50 or above in five weeks.
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Post by runner on May 15, 2024 14:48:53 GMT -5
The share price was $4.61 this morning right before the ASM started. Now it looks like we’re gonna close at about $4.45 a share.
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Post by prcgorman2 on May 19, 2024 11:18:19 GMT -5
Some great posts in the “T-DPI Manufacturing Capacity” thread. I especially like ronw77077 most recent post in that thread. mnkd.proboards.com/post/265153/threadI’d love to see the logic and math behind those predictions but am fine with what I think may be a good back-o-the-napkin musing. Something I’ve been concerned about lately and I think it was lennymnkd that brought it up is insurance coverage on clofazimine. The more I’ve thought about it the more concerned I’ve become so I wanted to invite folks who can’t know less than I do about such things to give their views such as castlerockchris, agedhippie, @clement, and others. The most recent earnings call had forward-looking slides at the end that highlighted both Clofazimine and Nintedanib. Earlier slides in the deck indicated Clofazimine is estimated to bring in $100M annually per 1,000 patients being treated for NTM. (I had earlier posted on this and misread it as $100M per 10,000, but nope, $100M per 1K.). That represents ~$8,300/month for a year’s worth of prescriptions although I think the treatment isn’t anticipated to last an entire year so the costst could actually be much higher per month and per perscription. Those cost per perscription and per patient blow my mind. I have to wonder what is the insurance coverage like in that situation? And, how many of the 122,000 NTM patients are going to be treated using MannKind’s nebulized formulation of Clofazimine? 1%? 2%? 20%? And how much is prescription cost a barrier where lower per perscription pricing could be recovered and exceeded by larger volumes of market penetration? ronw77077 also included an estimate of revenue for 2026. Going from memory, I thought Mike’s comments on the progression of the Ph3 trial were that it would be fully enrolled by the time of the interim readout maybe in 1Q 2025. That would imply that the Ph3 trial would likely complete mid-year and I’ll speculate Q3. I’m not sure how long it takes to compile results and present them for FDA approval, but will guess by EOY 2025 (and invite correction). For ronw77077’s prediction to be correct, MannKind will have successfuly sold to more than 1% of NTM patients by the EOY 2026. Given the FDA Fast Track program implies a no-longer-than 6 month review, I assume ronw77077’s EOY 2026 revenue prediction for Clofazimine isn’t impossible, but also I have very little idea what is possible or likely, which is why I’m writing this post. Thanks for whatever (useful) feedback anyone can offer.
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Post by agedhippie on May 19, 2024 15:36:14 GMT -5
... Those cost per perscription and per patient blow my mind. I have to wonder what is the insurance coverage like in that situation? And, how many of the 122,000 NTM patients are going to be treated using MannKind’s nebulized formulation of Clofazimine? 1%? 2%? 20%? And how much is prescription cost a barrier where lower per perscription pricing could be recovered and exceeded by larger volumes of market penetration? ... The question is where it is classed as a pharmacy or hospital benefit. Pharmacy benefits are tightly controlled by the PBM, hospital benefits are medical benefits rather than pharmacy and pretty much most things go. My suspicion is that this will be a hospital benefit since I suspect the patient will be treated in hospital. But to be clear, that is a guess. An example of this is DME such as pumps. With the exception of the Omnipod these are covered under medical insurance. Omnipod can be either and so depends on who you can get the best deal from.
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Post by ktim on May 19, 2024 17:16:58 GMT -5
prcgorman2Certainly that 2026 $150M Clofazimine projection by ronw runs well ahead of MNKD management's own projections. Looking at the graph format slide on "Non-risk Adjusted Outlook" presented by MNKD late last year, it appears Clofazimine might be at $10M to $20M in 2026 and then ~$100M 2027. Hopefully those are conservative "under promise, over deliver" estimates (though still subject to FDA delays as one of the risks not adjusted for), but it still would be hard to square ronw optimistic 2026 estimate.
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Post by cretin11 on May 19, 2024 18:17:12 GMT -5
“Under promise over deliver” is not how MNKD management has rolled. Would love that to change one day.
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Post by prcgorman2 on May 19, 2024 20:09:11 GMT -5
Even without under promise and over deliver, the results have been good (IMHO) and seem primed to be better. I don’t get too excited about a certain amount of optimism that doesn’t pan out because stuff happens. e.g., FDA decided to blow off UTHR’s $150M early delivery voucher, COVID global pandemic delayed the pediatric trial for Afrezza, or another example being the mfr of Clofazmine had a fire. There’s been other examples that are more back on MNKD management, but the big picture continues to look promising however its delivered.
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Post by ktim on May 20, 2024 3:37:40 GMT -5
Even without under promise and over deliver, the results have been good (IMHO) and seem primed to be better. I don’t get too excited about a certain amount of optimism that doesn’t pan out because stuff happens. e.g., FDA decided to blow off UTHR’s $150M early delivery voucher, COVID global pandemic delayed the pediatric trial for Afrezza, or another example being the mfr of Clofazmine had a fire. There’s been other examples that are more back on MNKD management, but the big picture continues to look promising however its delivered. I could tell you the things that happen with the best laid plans of mice and men when it comes to business... survival counts for a lot. Slow and steady growth beyond that is very nice.
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Post by prcgorman2 on May 20, 2024 9:50:20 GMT -5
I couldn't take it any longer. I bought back the shares I sold back in March plus some and scooped up a minor amount of free shares into the bargain. I finally did it! I traded around a "core". Woohoo! OK, it wasn't much and I should have been doing this starting years ago, but what can I say? I have not trusted my ability to guess share price movement. Too many positive indicators are lining up to stay down. C'mon shorts! Orderly exit time (I hope).
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Post by BD on May 20, 2024 9:57:00 GMT -5
Funny, I had bought some more as well but last week I decided I'd gone too far and sold half of the ones I'd purchased over the previous month. At least I didn't lose money on them. So I began with MNKD representing 4% of my trading portfolio, it went up to 9%, now back to 6%.
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Post by radgray68 on May 20, 2024 12:32:50 GMT -5
Be sure to select LIFO (last in first out) when selling those trading shares if you want to protect your average cost on the core holdings.
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Post by BD on May 20, 2024 14:40:10 GMT -5
I believe I have LIFO as the default, but I haven't checked since the switchover from TDA to Schwab so thanks for the heads-up.
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