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Post by sayhey24 on Mar 5, 2024 18:22:08 GMT -5
... Having Hirsch present the data seems a bit of an anomaly in my opinion. I suspect these data that Hirsch is presenting will be ground breaking. You are absolutely right. Having Irl Hirsch presenting this gives it serious credibility. For the longest time since Dave Kendall left we had been complaining Mike needed to get some serious "thought leaders" telling the afrezza story. Mike listened and put Irl on the payroll awhile back and he is "study chair" for the Inhale-3 study. The bottom line is afrezza is the real deal and everyone knows it. The only thing stopping afrezza is the PWDs ability to get access to it and as long as the PBMs have the blockade in place, not even Al Mann himself would be able to sell it. Then again Al would figure out a way around or through the blockade. |
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Post by agedhippie on Mar 6, 2024 4:16:21 GMT -5
For the longest time since Dave Kendall left we had been complaining Mike needed to get some serious "thought leaders" telling the afrezza story. Mike listened and put Irl on the payroll awhile back and he is "study chair" for the Inhale-3 study. The bottom line is afrezza is the real deal and everyone knows it. The only thing stopping afrezza is the PWDs ability to get access to it and as long as the PBMs have the blockade in place, not even Al Mann himself would be able to sell it. Then again Al would figure out a way around or through the blockade. Everyone does not know it or you wouldn't still get endos confusing Exubera and Afrezza, or having forgotten about Afrezza entirely. Last year this same presentation was given by Kevin Kaiserman, an MNKD VP, and consequently sank without trace. This year pretty much the same topic is being given by Irl Hirsch who is a well known endo and as a result will get a lot more attention. Lack of adoption is not a "blockade", it is a consequence of expecting insurers to pick up the tab for a more expensive insulin with no trial data to show a clear outcome improvement. |
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Post by sayhey24 on Mar 6, 2024 11:42:09 GMT -5
For the longest time since Dave Kendall left we had been complaining Mike needed to get some serious "thought leaders" telling the afrezza story. Mike listened and put Irl on the payroll awhile back and he is "study chair" for the Inhale-3 study. The bottom line is afrezza is the real deal and everyone knows it. The only thing stopping afrezza is the PWDs ability to get access to it and as long as the PBMs have the blockade in place, not even Al Mann himself would be able to sell it. Then again Al would figure out a way around or through the blockade. Everyone does not know it or you wouldn't still get endos confusing Exubera and Afrezza, or having forgotten about Afrezza entirely. Last year this same presentation was given by Kevin Kaiserman, an MNKD VP, and consequently sank without trace. This year pretty much the same topic is being given by Irl Hirsch who is a well known endo and as a result will get a lot more attention. Lack of adoption is not a "blockade", it is a consequence of expecting insurers to pick up the tab for a more expensive insulin with no trial data to show a clear outcome improvement. You told us that PBMs negotiate for the insurers and PBMs can not cover afrezza because pharma manufacturers bundle their products and PBMs have to buy bundle products to get better pricing. As a result they will not have similar products such as humalog, novolog and/or afrezza on the same plan. You also said since MNKD has no other drugs to bundle the PBMs won't cover it but will offer humalog or novolog in its place which are part of some bundled deal. To me no matter how great afrezza is, if what you said is correct they will never cover it because of bundling. Did I get that right? You can't have adoption when people can't afford it. They can't afford it because insurance is not covering it. Insurance is not covering it because the PBMs can't carry it because of bundling. If I have that right then no matter how great the data is afrezza will not be a standard insurance offering and will always require an exception through the pre auth process. What this means is they will get denied unless they can show a specific medical need such as lipohypertrophy as was the case with Ginger V. Do I have this right? The PBMs are controlling insurance access and MNKD can not compete against this bundling process? If not please explain. |
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Post by radgray68 on Mar 6, 2024 12:41:49 GMT -5
The stranglehold PBM’s have is why I believe we will need to partner up with one of the larger insulin cartel companies for sales. I don’t like the idea of splitting the profits, especially after the Sanofi ordeal but if I’m selling drugs out of cartel territory, I have to work with the cartels and not against them. That’s seemingly the only way Afrezza can quickly become a blockbuster in my opinion.
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Post by sayhey24 on Mar 6, 2024 14:24:11 GMT -5
The stranglehold PBM’s have is why I believe we will need to partner up with one of the larger insulin cartel companies for sales. I don’t like the idea of splitting the profits, especially after the Sanofi ordeal but if I’m selling drugs out of cartel territory, I have to work with the cartels and not against them. That’s seemingly the only way Afrezza can quickly become a blockbuster in my opinion. Its bigger than that. Afrezza disrupts the entire industry not just the insulin business. At this point no BP wants to disrupt the industry. They are making way too much money selling junk into the T2 space. Afrezza would reduce their revenue and potentially reverse T2 diabetes. Afrezza's real power is in the T2 space and as TITR grows and Stelo grows with the non-insulin users seeing their metformin and Jardiance and the rest do nothing for PPG spikes the only answer besides a Richard Bernstein diet is afrezza. BP can not let this happen. They have to continue to blockade afrezza and tell people not to eat. Christopher Viebacher took the chance of disrupting the industry and soon after he lost his job. None of them will try that again. Right now Mike is committed to working through the PBMs. He seems OK to force T1s to go through the pre auth process and in many cases get denied. This is such the norm we have web pages dedicated to it and a help desk waiting for the call. He is OK pretty much writing off a 10x bigger market with the T2s to get a small slice of the pie with the T1s in "our niche space". Its safe and things like Inhale-3 will grow sales another 20% but 20% of not much is not much. I think the only alternative to going through the PBMs is selling direct. Hello Mark Cuban. If there was another option I would like to hear it. Maybe rebranding afrezza as "Newfrezza" for the T2s and getting FDA approval only as a T2 drug. Maybe rebrand the cartridges small, medium and large is a possibility so not to disrupt current afrezza sales and then calling Mark Cuban deserves serious discussion at the MNKD board level. Otherwise we can just accept our PBM Stockholm Syndrome and enjoy it. Atleast we know what the big issue is with afrezza adoption and sales and its not the Sales Reps so lets stop hiring and firing them. As I have said before afrezza has 3 issues; label; SoC; and cost. The label is easy it takes trial data. The SoC takes trial data and guys like Irl Hirsch on the payroll. That leaves cost and we can either take what the PBMs are offering and be happy or go in another direction. |
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Post by lennymnkd on Mar 6, 2024 15:04:04 GMT -5
Again I’ll say it / and with the good results Mike is expecting,, and sounding more open to marketing…a direct to consumer add campaign is
Probably “unfortunately “ is the only way to go . An add emphasizing simplicity of use first and foremost and looking like the miracle results
It can achieve .. using your imagination what will the STELO ADD LOOK LIKE? IM SURE THEY WILL NEED ONE AND HAVE ONE.
I don’t think it will cannibalize their other meters …they know what they are doing .. two different categories.
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Post by prcgorman2 on Mar 6, 2024 15:11:55 GMT -5
And as I and others have said, Afrezza's biggest hurdle is getting prescribed. Label, SoC, and even cost, do play into it, but the biggest issues are lack of awareness and even more so, lack of acceptance, and that is because of a lack of (queue Bill McCullough) "DATA DATA DATA". We'll see if the ATTD conference presentation this Friday by Dr. Irl Hirsch moves the needle. If, as agedhippie says, it's last year's presentation with this year's more respected presenter, I don't expect we'll see anything meaningful until 1Q EC, if then. But if it somehow is ground-breaking, then I would expect to see MNKD volume improve or continue. The big hitter for addressing the lack of "DATA DATA DATA" is the Pediatric trial and the "Primary Endpoint" analysis won't be until 4Q. We won't see those results "move the needle" until next year (assuming they do). It's the INHALE-1 pediatric trial DATA DATA DATA due next year which I assume will directly address the label and SoC. |
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Post by lennymnkd on Mar 6, 2024 15:18:05 GMT -5
Imagine a great pediatric advertisement… powerful
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Post by dh4mizzou on Mar 6, 2024 15:26:23 GMT -5
I said this a long while ago but you could make fashionable 'whistles' for the kids. Let them pick from a fixed set of designs and/or colors and give them a lanyard so they can proudly display it.
If the kids think it's COOL to have and use the device that will go a long way in acceptance and continued use.
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Post by letitride on Mar 9, 2024 15:06:06 GMT -5
Leerink conference Monday has Mannkind scheduled for a 1x1 meeting with no presentation. Followed by an Oppenheimer presentation scheduled for Wednesday maybe there will be more to talk about than the ATTD conference.
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Post by prcgorman2 on Mar 9, 2024 16:33:47 GMT -5
Leerink conference Monday has Mannkind scheduled for a 1x1 meeting with no presentation. Followed by an Oppenheimer presentation scheduled for Wednesday maybe there will be more to talk about than the ATTD conference. Good reminder about the upcoming conferences that were also mentioned in the most recent earnings call a couple of weeks ago. The best MNKD earnings call ever that apparently got the MNKD volume train going which then hauled ass with the share price. Can you imagine if the Leerink and Oppenheimer conferences add or keep the volume going? I can. It looks like the last two weeks and peppy’s charts. |
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Post by Clement on Mar 10, 2024 9:51:02 GMT -5
Leerink conference Monday has Mannkind scheduled for a 1x1 meeting with no presentation. Followed by an Oppenheimer presentation scheduled for Wednesday maybe there will be more to talk about than the ATTD conference. Good reminder about the upcoming conferences that were also mentioned in the most recent earnings call a couple of weeks ago. The best MNKD earnings call ever that apparently got the MNKD volume train going which then hauled ass with the share price. Can you imagine if the Leerink and Oppenheimer conferences add or keep the volume going? I can. It looks like the last two weeks and peppy’s charts. UTHR at Leerink on Tuesday. See post in UTHR thread. mnkd.proboards.com/post/262560/thread |
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Post by Thundersnow on Mar 10, 2024 13:42:42 GMT -5
Leerink conference Monday has Mannkind scheduled for a 1x1 meeting with no presentation. Followed by an Oppenheimer presentation scheduled for Wednesday maybe there will be more to talk about than the ATTD conference. I hate to say this but there is no link for the WEBCAST for the Leerink Conference. I don't think we will be able to listen. My bad Letitride....when you said "presentation" I took that as NO SLIDES. Wasn't think you meant NO WEBCAST. |
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Post by letitride on Mar 10, 2024 13:50:12 GMT -5
I believe Mannkind is only at Leerink for a 1x1 meeting there is no presentation. I will be watching the UTHR presentation on Tuesday.
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Post by dh4mizzou on Mar 11, 2024 11:28:57 GMT -5
What might we expect to hear, if anything, out of the Leerink 1-on-1 meeting today>
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