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Post by mnkdfan on Apr 11, 2015 10:37:55 GMT -5
With Afrezza, the doctor does not have to spend much time to train a patient to use the inhaler so adding an in office spirometer test and being able to also charge for the service should not be a deterrent for these Endos (i would think). Liane, do you think this question for MNKD management at the annual meeting is of value? I've got to believe Sanofi/MNKD must have a strategy to streamline this lung test access since it's not rocket science. Why spend billions in development and millions in advertising if a huge hurdle is this simple test. We should buy the book and send to MNKD and Sanofi Would love to know what this team is doing differently to overcome the lung testing delays. I've sent a message to MNKD through the investor connection. Don't have Matt's email or I would send him this question.
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Post by liane on Apr 11, 2015 11:35:22 GMT -5
Here's Matt's email:
mpfeffer@mannkindcorp.com
Being "in the business", I just don't see spirometry as a high hurdle. It can either be done in the physician's office (for which he/she can bill insurance), at a local hospital, or at a free-standing facility.
It would be useful to see if they are hearing any feedback on this requirement.
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Post by mnkdfan on Apr 11, 2015 12:00:10 GMT -5
Thank you for your feedback Liane!....It would seem MNKD may have discussions on the topic but the reality is not supportive of Matt's assessment. If MNKD/Sanofi wants to see a faster adoption of Afrezza, they must avoid all the pitfalls of Exubera and remove or minimize the obstacles of getting Afrezza out to patients. Hard to see the logic in spending so much time and money to get here and not do anything different to remove a major momentum killer for marketing your product at a key moment.
In the case of my colleague giving up on getting his Afrezza samples, he will wait 3 more months to see his Endo and ask again then. I hope I am wrong and that there is a strategy in place for expediting the lung testing for patients.
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Post by rockyp on Apr 11, 2015 13:51:08 GMT -5
I was speaking with my son's friend's mom last night who is an endo. She said that she has sent a handful of patients out for the spirometry test but none of them had "good enough" results to start Afrezza. My understanding was there was no absolute minimum value to "qualify" for Afrezza; the doctor just needed to know the baseline value so they could perform periodic tests in the future in order to ensure that lung function did not diminish over time. She indicated that there was a minimum threshold of either 70% or 80% (I forget which number she said) of "nominal" lung capacity (as a function of age, gender, etc., I presume)the patient had to meet in order to be eligible for Afrezza.
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Post by jpg on Apr 11, 2015 17:01:31 GMT -5
A handful of patients would mean 3 or 4 to me? I wouldn't be surprised if the endo selected older frailer patients to start off with. Patients who should really really be on insulin but just can't do it because they are frail. Often these older patients have COPD (FEV1<70 or 80% depending on other numbers for the Tiffeneau ratios) or other lung issues (restrictive etc) and sometimes they just have poor collaboration. A poor test is often discernible if you are there doing the test and looking at the loops but that doesn't get you on Afrezza anymore then someone who really has bad lungs. I would guess easily 20-25% of 'normal older frail individuals' (if there isn't a contradiction in that sentence...) will have normal lungs (theoretically candidates for Afrezza) but below 80% FEV1s?
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dean
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Post by dean on Apr 13, 2015 16:46:13 GMT -5
Unfortunately I will not have the opportunity to attend. May I suggest to those that will attend: 1. Send preemptive emails to all mnkd officers/principals representing the company at the shareholder meeting, requesting a guarantee that they will not cut off questions from retail investors. At a minimum get them to commit answering x number of questions. Maybe they won't respond or commit but they will surely get the message that we retail investors expect and have a right to better communications on matters affecting shareholder value. 2. Construct a one page flyer and distribute to all attendees, retail-institutional-analysts-mnkd-etc everyone there, laying out our perspective on mnkd management's dismal performance in creating shareholder value, delineating concise important questions for mnkd to answer, and a demand statement calling for mnkd to develop a plan on creating shareholder value to include how and when.
Of course there are things mnkd will not/does not want to say. Excuses will range from competitive and legal reasons to telling us we must remain patient to everything in between. Distributing the flyer will hopefully help build a fire under mnkd mngmnt, particularly when they see the flyer is being read by analysts and the world at large. Many of you likely experienced and enjoyed, as I have, those biotech companies that pride themselves in excellent shareholder communications and have stated on the record that creating shareholder value is a top priority for them. There is much much more mnkd mngmnt can do that they simply do not do with regard to showing respect to shareholders. This upcoming shareholder meeting is very important for our voices to be heard. We will not have another opportunity for a year to truly express ourselves in such a pivotal forum with many eyes and ears observing. Let us not look back at this as a lost opportunity.
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Post by hopetoretire on Apr 13, 2015 19:18:56 GMT -5
Unfortunately I will not have the opportunity to attend. May I suggest to those that will attend: 1. Send preemptive emails to all mnkd officers/principals representing the company at the shareholder meeting, requesting a guarantee that they will not cut off questions from retail investors. At a minimum get them to commit answering x number of questions. Maybe they won't respond or commit but they will surely get the message that we retail investors expect and have a right to better communications on matters affecting shareholder value. 2. Construct a one page flyer and distribute to all attendees, retail-institutional-analysts-mnkd-etc everyone there, laying out our perspective on mnkd management's dismal performance in creating shareholder value, delineating concise important questions for mnkd to answer, and a demand statement calling for mnkd to develop a plan on creating shareholder value to include how and when. Of course there are things mnkd will not/does not want to say. Excuses will range from competitive and legal reasons to telling us we must remain patient to everything in between. Distributing the flyer will hopefully help build a fire under mnkd mngmnt, particularly when they see the flyer is being read by analysts and the world at large. Many of you likely experienced and enjoyed, as I have, those biotech companies that pride themselves in excellent shareholder communications and have stated on the record that creating shareholder value is a top priority for them. There is much much more mnkd mngmnt can do that they simply do not do with regard to showing respect to shareholders. This upcoming shareholder meeting is very important for our voices to be heard. We will not have another opportunity for a year to truly express ourselves in such a pivotal forum with many eyes and ears observing. Let us not look back at this as a lost opportunity. If we are voting on this idea, I vote no. Management is not the enemy. If you think they are, then sell your shares immediately. They will not be pressured into changing their stripes. The answer to all questions will be: "Sanofi is in charge of marketing the product and we cannot comment on the subject". The tactic will backfire and "build a fire under" short sellers, not a fire under management. Management is not going to change. If unhappy with that, it is perfectly understandable, but you need to sell and move on. It really is just that simple. The AM will only reveal information they already want to reveal, not information requested by tiny retail investors. They are not going to alter the game plan every time we complain. We are insignificant to the big shareholders and that's just the way it is. I still trust the big shareholders/decision makers/strategists will make millions for themselves with their secretive strategy and product - I will get crumbs from the table, and since I am not a millionaire who can be a big shot, I am happy to acknowledge my position, and reap whatever I reap in the long run.
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dean
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Post by dean on Apr 13, 2015 20:21:47 GMT -5
hopetoretire, your comments are duly noted and offer another perspective for all to consider. Although you suggest several times that I should sell my shares it is not something I plan on doing anytime soon. My investment conviction lies in the underlying strength of the device technology and the medical benefits of afrezza plus other tbd applications.
There are a lot of very smart people on this board. Given the relatively short amount of time that we will have to be heard, my post seeks to have board members discuss and plan an integrated STRATEGY for the shareholder meeting. Comments such as yours, soliciting suggestions from board members, weighing pros and cons among board members is part of the process. With that in mind it doesn't add to the conversation of discussing/agreeing on a unified goal/strategy by making condescending remarks such as if you are not happy sell your shares.
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Post by me on Apr 13, 2015 20:37:47 GMT -5
Unfortunately I will not have the opportunity to attend. May I suggest to those that will attend: 1. Send preemptive emails to all mnkd officers/principals representing the company at the shareholder meeting, requesting a guarantee that they will not cut off questions from retail investors. At a minimum get them to commit answering x number of questions. Maybe they won't respond or commit but they will surely get the message that we retail investors expect and have a right to better communications on matters affecting shareholder value. 2. Construct a one page flyer and distribute to all attendees, retail-institutional-analysts-mnkd-etc everyone there, laying out our perspective on mnkd management's dismal performance in creating shareholder value, delineating concise important questions for mnkd to answer, and a demand statement calling for mnkd to develop a plan on creating shareholder value to include how and when. Of course there are things mnkd will not/does not want to say. Excuses will range from competitive and legal reasons to telling us we must remain patient to everything in between. Distributing the flyer will hopefully help build a fire under mnkd mngmnt, particularly when they see the flyer is being read by analysts and the world at large. Many of you likely experienced and enjoyed, as I have, those biotech companies that pride themselves in excellent shareholder communications and have stated on the record that creating shareholder value is a top priority for them. There is much much more mnkd mngmnt can do that they simply do not do with regard to showing respect to shareholders. This upcoming shareholder meeting is very important for our voices to be heard. We will not have another opportunity for a year to truly express ourselves in such a pivotal forum with many eyes and ears observing. Let us not look back at this as a lost opportunity. If we are voting on this idea, I vote no. Management is not the enemy. If you think they are, then sell your shares immediately. Hopetoretire, thank you for your realistic perspective on retail investing. Many retail investors get caught up in thinking they have Buffet- or Soros-like weight in their demands, when they own few shares (few being less than 5% outstanding). Your comment is sage advice and serves the retail investor well. At the point that retail investors learn to invest only in companies in which they believe in/trust the management, they'll be a lot happier...and more successful. Otherwise, as our redneck friends might say, "Thar's yer sign!" It's time to sell.
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Post by joeypotsandpans on Apr 14, 2015 19:17:55 GMT -5
Just to add, for those that are wanting to go and are torn between time and expense etc., this may make you feel better. Last year the meeting was taped (especially the Q&A session which was respectful and courteous) and you were able to see it shortly thereafter. As far as the formalities, Al holds the gold so he makes the rules...not sure if he will be the one leading the meeting this year but you can be sure whoever is, is just a proxy for him. I enjoyed going to the meeting last year more so from the perspective of meeting Al and sharing some conversation with him along with Matt and Hakan not to mention meeting some genuine fellow shareholders. Actually the thing that gave me "chills" for lack of a better term so to speak was the original Afrezza patent framed on the wall. I'm sure the facility at Danbury will be a bit more "lively" then the office building in Valencia. Other takeaways was the exuding of confidence and demeanor from the officers at the time, you came away just knowing that there was a suitor for partnering with the company. Hopefully, those that attend will leave with that same confidence even without things being specifically spelled out. Regarding Lianes poll for when to meet, a large group of us met up for breakfast prior to meeting and after we all proceeded to the building. That worked fine and afterwards most went their separate ways. Just make sure if you're car pooling to not let the driver have too many energy drinks combined with high sugar snacks...phew!! that was some ride back
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Post by suebeeee1 on Apr 15, 2015 10:18:36 GMT -5
I've never gone to an annual meeting for any of my investments before. What do I need to do in order to go? Do I need to let them know and get a ticket or something for admission?
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Post by liane on Apr 15, 2015 11:41:01 GMT -5
Just show up (and maybe meet all of us for breakfast).
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Post by seanismorris on Apr 15, 2015 12:58:58 GMT -5
What are your (other) investors opinion on our current Directors of Mannkind?
I'd like to see some new faces and young (relatively) blood brought in...
We've had the same Directors for the last 10 years and all are over 70.
Experience is good...but how many of these Directors are actively in the medical 'business' these days?
'Things' at Mannkind often seem to move more slowly than they should. I'd like a more aggressive business attitude going forward, weather it be acquisitions, partnerships, etc.
FYI Director Ages: 89, 77, 77, 73, 71, 71
And, technically the CEO is also a Director (65) but I didn't count him (he's there by default).
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Post by joeypotsandpans on Apr 15, 2015 19:51:15 GMT -5
What are your (other) investors opinion on our current Directors of Mannkind? I'd like to see some new faces and young (relatively) blood brought in... We've had the same Directors for the last 10 years and all are over 70. Experience is good...but how many of these Directors are actively in the medical 'business' these days? 'Things' at Mannkind often seem to move more slowly than they should. I'd like a more aggressive business attitude going forward, weather it be acquisitions, partnerships, etc. FYI Director Ages: 89, 77, 77, 73, 71, 71 And, technically the CEO is also a Director (65) but I didn't count him (he's there by default). ....one of my favorite lines "experience is not expensive... it's priceless"
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Post by kball on Apr 16, 2015 7:19:21 GMT -5
What are your (other) investors opinion on our current Directors of Mannkind? I'd like to see some new faces and young (relatively) blood brought in... We've had the same Directors for the last 10 years and all are over 70. Experience is good...but how many of these Directors are actively in the medical 'business' these days? 'Things' at Mannkind often seem to move more slowly than they should. I'd like a more aggressive business attitude going forward, weather it be acquisitions, partnerships, etc. FYI Director Ages: 89, 77, 77, 73, 71, 71And, technically the CEO is also a Director (65) but I didn't count him (he's there by default). ....one of my favorite lines "experience is not expensive... it's priceless" Looks like a nursery school class compared to Berkshire Hathaway!...Actually they are close tbh
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