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Post by eddiemoy on May 21, 2015 22:06:37 GMT -5
here are some more observations between tesla and mnkd
model s - got the safest car in the world rating, over engineered... afrezza - safest insulin in the world, from the pk actions, less hypo's means safer than any other insulin!
model s - fastest 4 door sedan in the world afrezza - fastest acting insulin in the world
model s - someone buys the car, realize it is the best car in the world, they tell their friends, their friends buy, word of mouth advertising afrezza - early adopters getting great results, telling their peers, their peers try it, they love it tell more.... this is a compounding effect... added benefit is doctors who prescribe afrezza see the results it has on their patients and decide to prescribe more often.
model s - hurdles to sales, dealer networks working to restrict tesla sales state by state, the scumbag car sales men see their end. no supercharger network, now they have over 300 across the usa. point is the issues get solved and they are winning the battle state by state for direct to consumer sales. afrezza - hurdles to early sales FDA blackbox label, spirometer requirements, PA with insurance... i see all these issues going away, but will take time just like with tesla, even tesla still fighting with the dealer networks.
model s - production issue in the beginning, but now they are producing double what they were doing before afrezza - line 1 was to get the kinks out, line 2-3 are almost up and running, new lines are faster than first three lines.
model s - other countries didn't get their first shipment until a year later, now model s is in many countries afrezza - global product as well, need to get selling in usa started first. we are only 5 months into the selling cycle. please give this a little time. will go global as there is a global need.
tesla - more than one trick pony, model x coming, model 3 coming, stationary battery packs - all this takes time to develop mannkind - more than one trick pony, 4 API's selected for pipeline
elon has degree in physics al has degree in physics
elon hasn't sold a single share of his stock, he said he is first one in, last one out al has not sold a single share of his stock.
LOL
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Post by BD on May 21, 2015 22:11:33 GMT -5
BD , Thanks for using your Moderator super powers to reply to my deleted post I wasn't sure if my question was appropriate & the hour window I have to decide usually compels me to delete . I've done this many times But , I'm glad you brought it back from the grave yard & am bummed I didn't get to meet you & Liane today ! One day I hope to get the chance You guys rock ! Lynn Lynn, it wasn't deleted when I replied to it.
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Post by jimo on May 21, 2015 23:32:06 GMT -5
Let me interject a little second hand conversation I had recently with someone I trust that knows one of the SNY reps. (If you remember I basically "predicted" the launch date which was from same source). The rep was excited when selected to be on the Afrezza launch, was then a bit down when ran into the issues that have been brought up regarding the timelines for getting a script through, and most recently was genuinely excited and enthusiastic regarding the product and feedback from the MD's they have been working with. They explained the education is a process, the samples take a while to work through before actual scripts, but definitely stated that SNY was behind the product and most recently their U.S. VP of sales went along on a few of their visits/appointments and is definitely encouraged by the feedback from those that have been prescribing. I only bring this up because of the interpretation being taken from the meeting by those on the board and it is very much contrary to the feedback from one of the "soldiers" on the ground. Take it fwiw, Joey - I've interacted with Sanofi reps and have not had the same response. The most eye opening was one telling me "Toujeo is the future of Sanofi, good luck". The EU press this week confirms that sentiment. The fact Al is showing shareholders as Spirometry device and saying they have to figure out how to get them to doctors tells me Sanofi and MannKind are not on the same page. My feedback from the meeting was they punted on the hard questions and pointed at Sanofi which is complete BS. Hakaan is not the man for the job and has been put in a corner by Sanofi. I'm just stating the reality of our situation.
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Post by jpg on May 21, 2015 23:42:01 GMT -5
Let me interject a little second hand conversation I had recently with someone I trust that knows one of the SNY reps. (If you remember I basically "predicted" the launch date which was from same source). The rep was excited when selected to be on the Afrezza launch, was then a bit down when ran into the issues that have been brought up regarding the timelines for getting a script through, and most recently was genuinely excited and enthusiastic regarding the product and feedback from the MD's they have been working with. They explained the education is a process, the samples take a while to work through before actual scripts, but definitely stated that SNY was behind the product and most recently their U.S. VP of sales went along on a few of their visits/appointments and is definitely encouraged by the feedback from those that have been prescribing. I only bring this up because of the interpretation being taken from the meeting by those on the board and it is very much contrary to the feedback from one of the "soldiers" on the ground. Take it fwiw, Joey - I've interacted with Sanofi reps and have not had the same response. The most eye opening was one telling me "Toujeo is the future of Sanofi, good luck". The EU press this week confirms that sentiment. The fact Al is showing shareholders as Spirometry device and saying they have to figure out how to get them to doctors tells me Sanofi and MannKind are not on the same page. My feedback from the meeting was they punted on the hard questions and pointed at Sanofi which is complete BS. Hakaan is not the man for the job and has been put in a corner by Sanofi. I'm just stating the reality of our situation. Yes Toujoe is big, very very big for Sanofi but at the same time I really think Sanofi can manage to promote more then one drug no? Especially 2 that kind of go together and will hurt their competition big time. If Sanofi only plans on marketing Toujeo I would sell my Sanofi stock... Why would they be so focused anyway? At best Toujeo can soften the blow from the loss of Lantus. Afrezza can reinforce Toujeo medium and long term. It's seems rather obvious (which doesn't mean a BP will figure it out but they should see this).
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Post by jimo on May 21, 2015 23:53:58 GMT -5
I agree they can do & should do more for afrezza but why aren't they? The potential for Afrezza is huge but my frustration comes from Sanofi's lack of planning & effort and MannKinds inability to influence change. MannKind is taking matters into their own hands because Sanofi must not think the issue is important enough to correct themselves.
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Post by u1682002 on May 22, 2015 0:39:55 GMT -5
Can anyone else in this meeting confirm the Pfizer insulin still good for use?
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Post by jpg on May 22, 2015 0:45:14 GMT -5
I agree they can do & should do more for afrezza but why aren't they? The potential for Afrezza is huge but my frustration comes from Sanofi's lack of planning & effort and MannKinds inability to influence change. MannKind is taking matters into their own hands because Sanofi must not think the issue is important enough to correct themselves. As I've said many times before (sorry to be so boringly repetitive) medical time and investor time isn't clocked at the same speed. To MDs prescribing something in the first 6 months it's out is really fast. More so with drugs that have alternatives. Less so with drugs that make the difference between near term life and death (cancers that have no other or only poor therapies etc.). Look how relatively slowly some life altering oncology drugs have been (Gleevec) and are (Jakafi) taken up and you will understand the slow clock speed of medicine. Investors live quarter to quarter (the patient ones!). Not medicine. Now throw in a lumbering BP who is scared to it's core of loosing Lantus (and gets a surprise early Toujeo approval and a new CEO) and what are they going to jump on? The relatively easy win which will soon face huge competitive pressure: Toujeo (a me to slightly better drug that is incrementally better and super easy to figure out and sell especially to people who are already using injections and might have to take one less a day). In contrast no matter how much Sanofi pushes Afrezza understanding Afrezza will take time to figure out and it will need user validation as is now happening. Who truly no longer believes it is a remarkably superior drug? How many investors (let alone the detractors) didn't even know the results the early adopters are getting were possible? The AFs, Kliffs and MFs of the world are no longer attack the drug because it is so obviously superior. If they attack it they simply look stupid and dishonest. Now they are back tracking, discretely acknowledging it is a good drug but attacking the business model and saying great drugs don't necessarily make good investments (news to me though: the drug industry is rather dependant on good drugs and I'm rather certain Sanofi and other BPs have figured this out...). Obviously yes Sanofi could probably have done a much better job of setting things up better for Afrezza but at the same time the few months of early adopter experience was and is a necessary exercise. Hopefully Sanofi will figure out how to get payers to pay for the drug and do what they are supposed to be experts at... They have no reason to botch this and a 65% stake in a great drug to make this work. From what I am seeing they are slowing getting things moving. I don't really care if they are 8 weeks behind as long as they get moving in the right direction.
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Post by Deleted on May 22, 2015 6:39:25 GMT -5
Lynn, Was going to respond to your post last night but it mysteriously vanished. So now that it is back, I'll give my .02 for free and believe me, will be worth every penny you are paying for it. My frustration is that Afrezza appears to be one of the greatest drugs of all time. Because it works fast, reduces A1c and vastly reduces incidences of hypoglycemia, it will significantly reduce long term health complications for people with diabetes (CV issues, retinopathy, neuropathy & nephropathy) while improving their quality of life on a day to day basis, i.e.: easy dosing, virtually eliminates the psychological and physiological impact of hypoglycemia, quick action means patient does not have to wait for hours to see where their blood glucose levels will flatten out at, etc. I think many do not realize the emotional, psychological and time burden that people with diabetes live with. For anyone interested, google "diabetic foot wound" and once the results come up, click on the images tab and warning, what you will see is not for the faint of heart. Afrezza will help reduce the incidences of diabetic wounds and the suffering that goes with it. PS - foot wounds often result in amputation and mortality rate jumps significantly especially when it is an above the knee amputation. Gruesome, yes I know but it is also the reality. Over the last 20 years or so we have seen improvement in insulins brought to market and even some of the oral meds have been pretty good as well as improved delivery systems (thinner shorter needles, insulin pens etc) but nothing, and I mean nothing comes close to the potential impact and improvement in the quality of life that Afrezza offers so for all the worlds complaining about big pharma and their evil ways, Afrezza is the wonder drug and if patients, doctors, payors do not embrace it in a big way, then the message that will be received is status quo is what is truly wanted and improvement in patient health, quality of life and reducing healthcare costs is not really desired, kind of harsh but it is my take. The shareholder meeting itself was not much of an event. The Q&A didn't do much for me either and they guy who peppered Mannkind execs regarding stock options, etc from my perspective made a fool of himself. I enjoyed the factory tour and speaking with a couple of the dreamboat device engineers learning a bit more about it and them and the product. Both seemed to be capable individuals and enthusiastic about the products they have created. The prior authorization thing should subside a bit in the next few months and there are software programs that run on pharmacy computers to streamline the process www.covermymeds.com so while this is an issue, it is a reality to be managed and nothing more. Spirometry issue should be resolved shortly too. Sanofi mucked that one up and addressing it is hardly a monumental challenge. Glad NRx popped a bit this week as this is my biggest concern. Joey's earlier post about his indirect interaction with a Sanfoi rep who is selling Afrezza brings one of my biggest concerns front and center which is the cost of pharma reps between salaries, bonus, cars, training, allocated overhead etc is significant and as a public company, Sanofi watches expenses and corresponding revenues closely so with the time and money invested in marketing Afrezza, at some point, if the $$ coming in does not warrant the spend, they cut bait. No idea if this is a big concern for Sanofi at this point in time or they are ironing out the kinks as we speak and they are not phased by slow uptake and some of the issues that have surfaced. I believe Hakan is way out of his league and maybe once Rx count and revenue start to show a healthier trend he may be replaced but for now, that would create too much instability and the devil you know is still better than the devil you know... Did I leave the meeting more confident or enthusiastic, no. I left thinking that Afrezza is if not the then one of the greatest Rx products ever. I also left thinking that if Sanofi does not get their act together this year, we will be in a world of hurt. Part ways with them as a business partner and starting anew, while allowed by the contractual agreements is not possible for many reasons. Hopefully Rx #s (new and refills) start to grow week over week in a consistent manner as this is the only metric that matters
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Post by otherottawaguy on May 22, 2015 7:06:01 GMT -5
Can anyone else in this meeting confirm the Pfizer insulin still good for use? During the tour we had a presentation (chat) with two of the quality control white coats. They told us that the company conducts regular testing of the supply and there are no issues with degradation. Last round of testing was during May. OOG
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Post by esstan2001 on May 22, 2015 7:13:23 GMT -5
Can anyone else in this meeting confirm the Pfizer insulin still good for use? yes. tested regularly, and annual drug storage reports sent to FDA. OOG beat me to this with a better answer below. :-)
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Post by kball on May 22, 2015 7:56:12 GMT -5
Let me interject a little second hand conversation I had recently with someone I trust that knows one of the SNY reps. (If you remember I basically "predicted" the launch date which was from same source). The rep was excited when selected to be on the Afrezza launch, was then a bit down when ran into the issues that have been brought up regarding the timelines for getting a script through, and most recently was genuinely excited and enthusiastic regarding the product and feedback from the MD's they have been working with. They explained the education is a process, the samples take a while to work through before actual scripts, but definitely stated that SNY was behind the product and most recently their U.S. VP of sales went along on a few of their visits/appointments and is definitely encouraged by the feedback from those that have been prescribing. I only bring this up because of the interpretation being taken from the meeting by those on the board and it is very much contrary to the feedback from one of the "soldiers" on the ground. Take it fwiw, Joey - I've interacted with Sanofi reps and have not had the same response. The most eye opening was one telling me "Toujeo is the future of Sanofi, good luck". The EU press this week confirms that sentiment. The fact Al is showing shareholders as Spirometry device and saying they have to figure out how to get them to doctors tells me Sanofi and MannKind are not on the same page. My feedback from the meeting was they punted on the hard questions and pointed at Sanofi which is complete BS. Hakaan is not the man for the job and has been put in a corner by Sanofi. I'm just stating the reality of our situation. This strikes me as extremely odd as well. But thinking about it a little more...it "could" have something to do with Sanofi's recent kickback troubles. Perhaps having Mannkind step in during this situation mitigates any more legal troubles down the line? (the optimist in me)
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Post by kball on May 22, 2015 8:04:55 GMT -5
Lynn, Was going to respond to your post last night but it mysteriously vanished. So now that it is back, I'll give my .02 for free and believe me, will be worth every penny you are paying for it. My frustration is that Afrezza appears to be one of the greatest drugs of all time. Because it works fast, reduces A1c and vastly reduces incidences of hypoglycemia, it will significantly reduce long term health complications for people with diabetes (CV issues, retinopathy, neuropathy & nephropathy) while improving their quality of life on a day to day basis, i.e.: easy dosing, virtually eliminates the psychological and physiological impact of hypoglycemia, quick action means patient does not have to wait for hours to see where their blood glucose levels will flatten out at, etc. I think many do not realize the emotional, psychological and time burden that people with diabetes live with. For anyone interested, google "diabetic foot wound" and once the results come up, click on the images tab and warning, what you will see is not for the faint of heart. Afrezza will help reduce the incidences of diabetic wounds and the suffering that goes with it. PS - foot wounds often result in amputation and mortality rate jumps significantly especially when it is an above the knee amputation. Gruesome, yes I know but it is also the reality. Over the last 20 years or so we have seen improvement in insulins brought to market and even some of the oral meds have been pretty good as well as improved delivery systems (thinner shorter needles, insulin pens etc) but nothing, and I mean nothing comes close to the potential impact and improvement in the quality of life that Afrezza offers so for all the worlds complaining about big pharma and their evil ways, Afrezza is the wonder drug and if patients, doctors, payors do not embrace it in a big way, then the message that will be received is status quo is what is truly wanted and improvement in patient health, quality of life and reducing healthcare costs is not really desired, kind of harsh but it is my take. The shareholder meeting itself was not much of an event. The Q&A didn't do much for me either and they guy who peppered Mannkind execs regarding stock options, etc from my perspective made a fool of himself. I enjoyed the factory tour and speaking with a couple of the dreamboat device engineers learning a bit more about it and them and the product. Both seemed to be capable individuals and enthusiastic about the products they have created. The prior authorization thing should subside a bit in the next few months and there are software programs that run on pharmacy computers to streamline the process www.covermymeds.com so while this is an issue, it is a reality to be managed and nothing more. Spirometry issue should be resolved shortly too. Sanofi mucked that one up and addressing it is hardly a monumental challenge. Glad NRx popped a bit this week as this is my biggest concern. Joey's earlier post about his indirect interaction with a Sanfoi rep who is selling Afrezza brings one of my biggest concerns front and center which is the cost of pharma reps between salaries, bonus, cars, training, allocated overhead etc is significant and as a public company, Sanofi watches expenses and corresponding revenues closely so with the time and money invested in marketing Afrezza, at some point, if the $$ coming in does not warrant the spend, they cut bait. No idea if this is a big concern for Sanofi at this point in time or they are ironing out the kinks as we speak and they are not phased by slow uptake and some of the issues that have surfaced. I believe Hakan is way out of his league and maybe once Rx count and revenue start to show a healthier trend he may be replaced but for now, that would create too much instability and the devil you know is still better than the devil you know... Did I leave the meeting more confident or enthusiastic, no. I left thinking that Afrezza is if not the then one of the greatest Rx products ever. I also left thinking that if Sanofi does not get their act together this year, we will be in a world of hurt. Part ways with them as a business partner and starting anew, while allowed by the contractual agreements is not possible for many reasons. Hopefully Rx #s (new and refills) start to grow week over week in a consistent manner as this is the only metric that matters One of my favorite posts ever on this forum. Thx Scotta
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Post by robsacher on May 22, 2015 9:08:52 GMT -5
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Post by mnholdem on May 22, 2015 10:09:17 GMT -5
Sanofi supposedly has three teams, whose responsibilities include: - Afrezza sales only
- Toujeo sales only
- Afrezza and Toujeo sales together
My first thought after I read jimo's posting of comments made by a Sanofi sales rep, "Toujeo is the future of Sanofi, good luck" was, "Which team, if any, has that rep has been assigned to?" That alleged remark seems very suspect to me, since Sanofi sales reps are trained to promote ALL of Sanofi's family of diabetes treatments, and not just the ones that they are assigned to.
It's possible, I suppose, that the agreement between Al Mann and Sanofi has sales expenses related to Afrezza at the lowest possible. Sales reps promote many drugs, so MannKind's portion of sales expense may be relatively small. I would imagine that the two sides hammered out how all this would be calculated. Regardless, signing up Sanofi to do the sales and marketing is considerably less expensive than if MannKind were to have ventured into sales & marketing by themselves.
Al is no slouch and probably got us a good deal. It would be so easy to see Sanofi as having an attitude of "we're only going to give what MannKind has paid for" but I do not think that's the case at all.
Given the size of the U.S. diabetes market I would, however, like know how many actual sales reps are pushing Afrezza.
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Post by Deleted on May 22, 2015 10:14:52 GMT -5
Sanofi supposedly has three teams, whose responsibilities include: - Afrezza sales only
- Toujeo sales only
- Afrezza and Toujeo sales together
My first thought after I read jimo's posting of comments made by a Sanofi sales rep, "Toujeo is the future of Sanofi, good luck" was, "Which team, if any, that rep has been assigned to?" That alleged remark seems very suspect to me, since Sanofi sales reps are trained to promote ALL of Sanofi's family of diabetes treatments, and not just the ones that they are assigned to. Struck me as someone who heard from a guy from a guy and is now basing his entire thesis on it, especially after reviewing his last 10+ posts.
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