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Post by sayhey24 on Feb 5, 2024 7:55:35 GMT -5
... Costplusdrugs typical model is the manufacturer adds 15% and Mark adds 15%. If afrezza total cost is $30, MNKD would get $4.50 profit which is not much but what is the goal over the next 2 years? While getting $750 a box sounds great, if you are only selling 800 boxes and not expanding the user base is this really working? Right now we need to get to the 25-50k base which Bill from VDex suggested. I do think that Mark Cuban running around on a bunch of business and TV talk shows with his hair on fire pumping afrezza would sure not hurt. How many boxes of afrezza could be sold at $39? I would think a lot more than 800, especially if you have Cuban as the pitch boy explaining he has a near cure for T2 diabetes. While this is a nice idea it is not commercially viable and Mike would be finally be fired by even this BoD if he tried it. The BoD want the endocrine division to breakeven, not make an epic loss. My feeling is that the BoD have moved on from Afrezza and have it in care and maintenance mode. Are you suggesting selling 800 scripts a week is viable and this is a plan we should be sticking with? If the BoD wants the endocrine division to be profitable what I would suggest is closing down V-Go instead of limiting the damage which was done to key accounts last year and take the 15% profit on afrezza to grow the base. A year over year 20% growth of 800 scripts a week is not going to do much. As far as Cuban, he understands a little about afrezza. You may remember a few years back when he was running around telling people how he was going to make insulin available for $35 and then found out he could go to Walmart and get it for $30. Thats when he started to learn that there is a big difference between insulins and a huge difference with afrezza. I am actually thinking if the BoD sees Cuban really embrace afrezza and pitch it like he was costplusdrugs a few years ago, Mike might actually be able to save his job. If the BoD has moved on from afrezza, even more the reason to break even and grow the base. I think the board has not only not moved on from afrezza but sees the power afrezza holds and understands the $3.5B invested in it. What I do think is Mike is very gun shy of Big Pharma. There is a reason we are no longer selling direct at $99 but will sell at $100 if and only if you have jumped through a zillion hoops and failed to get any kind of insurance coverage. Whats up with that? I would say someone put the screws to him. |
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Post by prcgorman2 on Feb 5, 2024 8:03:25 GMT -5
Jumping through hoops to get heavily discounted drugs is not a new thing or singular to MannKind’s Afrezza.
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Post by rickf on Feb 5, 2024 12:04:28 GMT -5
At 35.00 .. sure would take a long time to get a couple of billion back 🤔 I am no financial wizard but - to the folks that are - if Afrezza became the SOC - and it was sold at $35.00 -- would the (hopeful) massive volume compensate for the lower price and provide huge profits for Mnkd? |
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Post by lennymnkd on Feb 5, 2024 14:43:50 GMT -5
Rick there are so many moving parts I’m learning.. I would need a lot more fact to know
If 35.00 could be the volume number ..hopefully someone can answer that for us.
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Post by sayhey24 on Feb 5, 2024 15:05:55 GMT -5
At 35.00 .. sure would take a long time to get a couple of billion back 🤔 I am no financial wizard but - to the folks that are - if Afrezza became the SOC - and it was sold at $35.00 -- would the (hopeful) massive volume compensate for the lower price and provide huge profits for Mnkd? If afrezza became the SoC and it got insurance coverage, I would expect yearly price increases. However, if it became the SoC it would totally disrupt the market. There are 40 million diabetics in the U.S. Thats not including "pre-diabetics" and since Covid things have sky rocketed. Apple is suppose to release their non-invasive BG watch in 2 years and BG will become the new craze just like weight-loss is now. Every diabetic and many pre-diabetics should be taking. Lets assume 10M scripts weekly and a $5 profit on each sale. Thats $50M weekly or about $2.5B yearly. Thats a little more profit than MNKD is seeing today. Even at 1M scripts weekly $260M yearly profit is a lot more than our current 800 weekly scripts. |
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Post by lennymnkd on Feb 5, 2024 15:15:39 GMT -5
Now we’re at 5.00 profit / imagine how long that would take to get the original two billion back
What kind of business plan was this… there are plenty of pharma seasoned veterans over the years putting
This together. You would have thought they had a better plan .
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Post by sayhey24 on Feb 5, 2024 16:19:02 GMT -5
Now we’re at 5.00 profit / imagine how long that would take to get the original two billion back What kind of business plan was this… there are plenty of pharma seasoned veterans over the years putting This together. You would have thought they had a better plan . A better plan than what - sell 800 boxes a week? The reality is Al Mann was convinced he had developed the greatest advance in diabetes care since Banting and Best and he was right. However, he believed the world would immediately embrace afrezza and it did not for several reasons. Al was a giant in the diabetes industry and would have probably been able to strong arm some people. The reality is he got sick and passed. What he also did not anticipate was the pushback it would get from the industry. In hind-sight he should have after the 2 CRL's. He knew something was up when he demanded the ADCOMM. At the ASM in 2015 he finally understood Sanofi was BS'ing him when they told him the reason it was not selling was because doctors did not have spirometers. Every PCP has a spirometer and Sanofi licensed for the T2 market not T1. At the current rate and the current plan MNKD will never, ever see $1B in profit let alone the $3.5B invested. Mike's plan was to put V-Go in the reps bags. As predicted on Proboards that turned into a disaster and now they are doing damage control with the key accounts. |
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Post by daisyz on Feb 5, 2024 21:43:10 GMT -5
... Costplusdrugs typical model is the manufacturer adds 15% and Mark adds 15%. If afrezza total cost is $30, MNKD would get $4.50 profit which is not much but what is the goal over the next 2 years? While getting $750 a box sounds great, if you are only selling 800 boxes and not expanding the user base is this really working? Right now we need to get to the 25-50k base which Bill from VDex suggested. I do think that Mark Cuban running around on a bunch of business and TV talk shows with his hair on fire pumping afrezza would sure not hurt. How many boxes of afrezza could be sold at $39? I would think a lot more than 800, especially if you have Cuban as the pitch boy explaining he has a near cure for T2 diabetes. While this is a nice idea it is not commercially viable and Mike would be finally be fired by even this BoD if he tried it. The BoD want the endocrine division to breakeven, not make an epic loss. My feeling is that the BoD have moved on from Afrezza and have it in care and maintenance mode. That is hilarious. |
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Post by ktim on Feb 5, 2024 22:44:24 GMT -5
At 35.00 .. sure would take a long time to get a couple of billion back 🤔 I am no financial wizard but - to the folks that are - if Afrezza became the SOC - and it was sold at $35.00 -- would the (hopeful) massive volume compensate for the lower price and provide huge profits for Mnkd? If Afrezza were to somehow become the SOC, they could make a heck of a lot more by charging significantly more than $35 to insurance companies and since it would be on formulary patients would still pay only $35 out of pocket. In that unlikely scenario MNKD could rake in billions. From projections of Afrezza revenue growth offered by management it is clear they in no way expect Afrezza to become a SOC. |
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Post by bones1026 on Feb 5, 2024 22:57:35 GMT -5
While this is a nice idea it is not commercially viable and Mike would be finally be fired by even this BoD if he tried it. The BoD want the endocrine division to breakeven, not make an epic loss. My feeling is that the BoD have moved on from Afrezza and have it in care and maintenance mode. That is hilarious. Indeed. Give him a break though, he doesn’t have any skin in the game, he’s just here to help. |
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Post by sayhey24 on Feb 6, 2024 8:00:36 GMT -5
I am no financial wizard but - to the folks that are - if Afrezza became the SOC - and it was sold at $35.00 -- would the (hopeful) massive volume compensate for the lower price and provide huge profits for Mnkd? If Afrezza were to somehow become the SOC, they could make a heck of a lot more by charging significantly more than $35 to insurance companies and since it would be on formulary patients would still pay only $35 out of pocket. In that unlikely scenario MNKD could rake in billions. From projections of Afrezza revenue growth offered by management it is clear they in no way expect Afrezza to become a SOC. I think you are correct on both accounts 1. Afrezza as the SoC could charge significantly more than $35 to insurance companies 2. MNKD projections do not expect afrezza to become the SoC Why can't afrezza become the SoC? Is it not good enough? No, we know it is, It is the first thing which should be given to all T2s, afrezza and a CGM. After the kids trials and the Cipla trials we should have enough data for a good start. We should also be doing additional trials which MNKD is not currently doing. Why not? We have the money. Why is metformin the first step in the T2 SoC? Its expected to fail but its cheap and BP likes it failing. In fact if you put the CGM on the T2 day 1 you will see metformin fails day 1. I think Bill from VDex and Calley Means are both correct. Afrezza needs to get to the 25 - 50k user base to make it harder for BP to marginalize it and we need to understand what Al Mann did not and what Calley outlines which is that BP is rigging the game and the last thing they want is a disruption to this $100B market. The three issues afrezza has today are; 1- label; 2- SoC; 3- Cost. All three need to be fixed. Fixing one or two will not do it. Fixing the label requires trial data and FDA resubmission. A new label is 2 years away. Fixing the SoC requires two things; 1- trial data; and 2- BP allowing it. We will never be able to get any pressure on BP without a large enough user base Fixing the cost requires; 1- insurance coverage or 2- a cheap enough price. We are not getting insurance coverage until it is the SoC and we are not getting in the SoC without a large enough user base. The great news is Tyvaso DPI is paying the bills and we have the greatest advance in diabetes care in 100 years. For afrezza to be realized we can't just keep doing the same thing over and over. Mike's 20% afrezza growth chart sounds great but 20% of nothing is nothing. What did the pps close at yesterday $3.25. That decimal point can easily be moved to the right at least one position but probably two in a couple of years. |
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Post by sayhey24 on Feb 6, 2024 8:47:41 GMT -5
One last point and then I will stop sounding like the broken record on why afrezza's price needs to be reduced to around $35.
The $35 price is what MNKD is already selling it on Medicare for so this is not something new. If I remember correctly Mike was so excited about the script increase from Medicare but it requires that crazy pre auth process. How much MNKD is making from this and who is getting paid with this PBM scheme maybe Aged can explain.
MNKD is also already selling for $100 commercially but you need 3 denials from insurance to get it. This is crazy too and few doctors want to do the paperwork. I have no idea what happened to the $99 deal but I would sure like Mike to explain this one.
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Post by cretin11 on Feb 6, 2024 9:15:00 GMT -5
If Afrezza were to somehow become the SOC, they could make a heck of a lot more by charging significantly more than $35 to insurance companies and since it would be on formulary patients would still pay only $35 out of pocket. In that unlikely scenario MNKD could rake in billions. From projections of Afrezza revenue growth offered by management it is clear they in no way expect Afrezza to become a SOC. For afrezza to be realized we can't just keep doing the same thing over and over. Mike's 20% afrezza growth chart sounds great but 20% of nothing is nothing. What did the pps close at yesterday $3.25. That decimal point can easily be moved to the right at least one position but probably two in a couple of years. Good post until that last sentence. We would need drastic changes at MNKD to dream of that. Even if we got such changes, your decimal point projection is fantasy even beyond the MTOI level (never thought I’d miss his fantastic predictions but kinda do). |
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Post by agedhippie on Feb 6, 2024 9:38:53 GMT -5
One last point and then I will stop sounding like the broken record on why afrezza's price needs to be reduced to around $35. The $35 price is what MNKD is already selling it on Medicare for so this is not something new. If I remember correctly Mike was so excited about the script increase from Medicare but it requires that crazy pre auth process. How much MNKD is making from this and who is getting paid with this PBM scheme maybe Aged can explain. MNKD is also already selling for $100 commercially but you need 3 denials from insurance to get it. This is crazy too and few doctors want to do the paperwork. I have no idea what happened to the $99 deal but I would sure like Mike to explain this one. The Afrezza co-pay (not per box) is $35 on Medicare where it is in the Plan D formulary. The actual amount MNKD gets is far higher though and is negotiated between the Part D insurer and MNKD. There is a rather weird rebate system between the Plan provider and CMS. My guess would be that the cost to CMS is about the same as to a commercial insurer. Unfortunately I cannot explain exactly how this works since I have never found a full breakdown. There are to many possibilities for me to guess why the $99 offer was withdrawn, but I would love to know for curiosity sake. |
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Post by sayhey24 on Feb 6, 2024 9:52:07 GMT -5
One last point and then I will stop sounding like the broken record on why afrezza's price needs to be reduced to around $35. The $35 price is what MNKD is already selling it on Medicare for so this is not something new. If I remember correctly Mike was so excited about the script increase from Medicare but it requires that crazy pre auth process. How much MNKD is making from this and who is getting paid with this PBM scheme maybe Aged can explain. MNKD is also already selling for $100 commercially but you need 3 denials from insurance to get it. This is crazy too and few doctors want to do the paperwork. I have no idea what happened to the $99 deal but I would sure like Mike to explain this one. The Afrezza co-pay (not per box) is $35 on Medicare where it is in the Plan D formulary. The actual amount MNKD gets is far higher though and is negotiated between the Part D insurer and MNKD. There is a rather weird rebate system between the Plan provider and CMS. My guess would be that the cost to CMS is about the same as to a commercial insurer. Unfortunately I cannot explain exactly how this works since I have never found a full breakdown. There are to many possibilities for me to guess why the $99 offer was withdrawn, but I would love to know for curiosity sake. Is CMS not footing some of the bill? If we can sell commercial for $100 I would think MNKD could offer it for $100 to Medicare but I am sure there is some scheme preventing this. The Part D cost on Medicare.gov is usually around $1200. |
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