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Post by mannmade on Jul 17, 2015 19:41:14 GMT -5
I agree comparing the two make no sense. The reason I share my information with the board is because a lot of MNKD longs are expecting big things and soon. That's not happening. I am just trying to temper expectations. Comparing AWARENESS makes no sense??? I agree comparing sales # makes no sense but I'm not saying that. Becoming aware of afrezza is just easy as becoming aware of toujeo though. Come on guys. You are forgetting that the label for Afrezza does not allow Sanofi to extoll it's real virtues and true value such as better Hba1c control and way less severe Hypos. In fact, ironically enough, the label says Afrezza may cause sever hypos. If the FDA does not understand it then I expect it will take doctors time to figure it out. So to a doctor whose patient is under relative control ("control equaling 6.5/7.0 to 8.0 to many doctors, which I am not) there is no real advantage to prescribing Afrezza if they have not done a deeper dive than they normally might with a new drug. And to boot... it's more expensive than RAA's and harder to get through insurance (requiring more work from the doctor and/or his/her staff.) And lastly, let's not forget that there are at least two other major drug companies with reps who call on the same doctors who may be saying all sorts of things that we don't really hear to discredit Afrezza and/or at least saying there is no difference and it is more costly. Just my 2cents...
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Post by biotec on Jul 17, 2015 19:51:35 GMT -5
Comparing AWARENESS makes no sense??? I agree comparing sales # makes no sense but I'm not saying that. Becoming aware of afrezza is just easy as becoming aware of toujeo though. Come on guys. I am not advocating NOT to advertise but to do so once you know that KOL (aka the docs) understand the drug. I think Sanofi knows this and doesn't want to but the cart before the horse. Why do you think Sanofi hasn't bombard the airwaves already? I'll defer to their expertise in how to market a drug, especially a drug that has existing baggage, warranted or not, as Afrezza? I keep hearing the same story, Wait until the Doc's hear and understand Afrezza! Its been over 5 months on the market, And this month 1 year from FDA approval! (And 10 so years from 1rst trials) That's 1 year! Please Sanofi hit DTC very hard! So far I've heard of 6 people not happy with it. And many more that is. Its not for everyone.
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Post by notamnkdmillionaire on Jul 17, 2015 20:04:45 GMT -5
I am not advocating NOT to advertise but to do so once you know that KOL (aka the docs) understand the drug. I think Sanofi knows this and doesn't want to but the cart before the horse. Why do you think Sanofi hasn't bombard the airwaves already? I'll defer to their expertise in how to market a drug, especially a drug that has existing baggage, warranted or not, as Afrezza? I keep hearing the same story, Wait until the Doc's hear and understand Afrezza! Its been over 5 months on the market, And this month 1 year from FDA approval! (And 10 so years from 1rst trials) That's 1 year! Please Sanofi hit DTC very hard! So far I've heard of 6 people not happy with it. And many more that is. Its not for everyone. I hear you. Unfortunately, we don't know why Sanofi is doing what they are doing. They are hush due to "competitive reasons." Hopefully we will understand sooner rather than later.
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Post by gomnkd on Jul 17, 2015 20:10:35 GMT -5
My niece's boyfriend is a Type 1. I sent details about Sam Finta and the patient snapshot that Finta maintains. His feedback is, he is comfortable taking injections and don't see a need for Afrezza. How do you make them reconsider?
Nowadays when I see NRx in 300+, I applaud those brave souls who are willing to take the plunge.
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Post by notamnkdmillionaire on Jul 17, 2015 20:13:37 GMT -5
My niece's boyfriend is a Type 1. I sent details about Sam Finta and the patient snapshot that Finta maintains. His feedback is, he is comfortable taking injections and don't see a need for Afrezza. How do you make them reconsider? Nowadays when I see NRx in 300+, I applaud those brave souls who are willing to take the plunge. And there is the flip side of the docs not changing if patients are under control. There are going to be diabetics who are in control and see no need to change things up. Some just don't mind needles. That might change as more people use Afrezza and see their A1C's drop prompting others like your niece's boyfriend to try it. Other than that, I'd suggest to your niece that she dump him!
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Post by dreamboatcruise on Jul 17, 2015 20:32:27 GMT -5
My niece's boyfriend is a Type 1. I sent details about Sam Finta and the patient snapshot that Finta maintains. His feedback is, he is comfortable taking injections and don't see a need for Afrezza. How do you make them reconsider? Nowadays when I see NRx in 300+, I applaud those brave souls who are willing to take the plunge. Some of Sam's T1's had A1c that were way too high on trad RAA for whatever reason, so they had a real motivation to switch. Perhaps this guy simply has good control with trad RAA and believes in "if it ain't broke, don't fix it." If his A1c is meeting his target then why do you think he should reconsider?
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Post by newmnkdinvestor on Jul 17, 2015 20:43:56 GMT -5
My niece's boyfriend is a Type 1. I sent details about Sam Finta and the patient snapshot that Finta maintains. His feedback is, he is comfortable taking injections and don't see a need for Afrezza. How do you make them reconsider? Nowadays when I see NRx in 300+, I applaud those brave souls who are willing to take the plunge. Some of Sam's T1's had A1c that were way too high on trad RAA for whatever reason, so they had a real motivation to switch. Perhaps this guy simply has good control with trad RAA and believes in "if it ain't broke, don't fix it." If his A1c is meeting his target then why do you think he should reconsider? My old roommate is diabetic and we have discussed Afrezza. He is type 1 has low a1cs and has the same thought process. I dont get it but he is so used to the pump it doesnt phase him anymore.
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Post by spiro on Jul 17, 2015 21:43:27 GMT -5
It looks looks like some people on this thread are struggling to find answers. Spiro will try to help you guys out without gloating to much. You guys need to forget about the Type 1's, the real market for Afrezza is the over 20 million Type 2's who haven't heard about Afrezza yet. To put it simply, Afrezza will save a Type 2's pancreas from getting weakened or destroyed by oral medications. Spiro is amused when he hears some of the stories out there that Afrezza has spontaneously stopped working well. Good grief, it's human insulin, since when does human insulin stop working? Can someone tell these Type 1's, it's the disease. Diabetes is a nasty sucker, it is affected by a lot of factors during a diabetics daily routine. Things like stress, fatigue, exercise or a sudden change in diet can all influence glucose levels. Afrezza will never stop working, it will only start working better as the diabetic learns how to manage his disease better using Afrezza. Spiro has the pleasure of seeing how great Afrezza works everyday. Today, pre-dinner BG 96. 60 + carb dinner, 4 units Afrezza, 1 hr. BG 124, 2 hr, BG 84 3 hr, BG 86. Afrezza is taking the stress off of Spiro's pancreas during phase 1 digestion. It sure seems like Spiro's pancreas is cranking out a lot more insulin now, than it was 5 month's ago. That large piece of red velvet cake with butter-creme icing was incredible after dinner tonight.
Someway, somehow and hopefully someday Sanofi will get the message out to Type 2 diabetics. it's a quite simple message, early intervention in treating your Type 2 diabetes with Afrezza will save your pancreas, nerve endings, eyesight, liver, spleen and kidneys. Of course they can't say that, but isn't that what happens when your blood sugar is at normal levels? Uncontrolled diabetes is a nasty sucker, it destroys your body, system by system until your quality of life is gone. It's a slow death and it will come earlier than it should have.
Spiro here, not happy with the RX numbers, but there's always next Friday.
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Post by suebeeee1 on Jul 17, 2015 21:46:45 GMT -5
Some of Sam's T1's had A1c that were way too high on trad RAA for whatever reason, so they had a real motivation to switch. Perhaps this guy simply has good control with trad RAA and believes in "if it ain't broke, don't fix it." If his A1c is meeting his target then why do you think he should reconsider? My old roommate is diabetic and we have discussed Afrezza. He is type 1 has low a1cs and has the same thought process. I dont get it but he is so used to the pump it doesnt phase him anymore. I agree with the "if it ain't broke, don't fix it" routine for just about everything. Unfortunately, not all of these folks are in good control and many who think they are in good control because their doctors tell them they are (even if their AIc is above ADA recommendations). However, given all the diabetics that exist today, there are (according to the ADA) 1.7 million NEW diabetics diagnosed in this country ALONE each year. Even if doctors only start prescribing Afrezza to 1% of these patients, that is 19,000 new prescription each year. As word gets out, and the 99% sees how easy the 1% have it, I truly believe the 99% will figure out their treatment options are "broke". Let's hope by then all the lines are up and working!
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Post by kball on Jul 18, 2015 7:00:02 GMT -5
My niece's boyfriend is a Type 1. I sent details about Sam Finta and the patient snapshot that Finta maintains. His feedback is, he is comfortable taking injections and don't see a need for Afrezza. How do you make them reconsider?Nowadays when I see NRx in 300+, I applaud those brave souls who are willing to take the plunge. As is my good friend from high school with a similar mindset. Comfortable taking 5+ injections per day plus finger pricks testing bg (for 30+ years). Add in the fact his dr (and therefore my friend) considers A1c of 7.0 good control. I've had at least 3 longish conversations about Afrezza w him. His ears did perk up when i mentioned the test group seeing A1c's in the 5's now. He still hasn't seen need to try it. Also had a stent put in in his 40's so you would think connecting the dots it may benefit him
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Post by kball on Jul 18, 2015 7:07:04 GMT -5
It looks looks like some people on this thread are struggling to find answers. Spiro will try to help you guys out without gloating to much. You guys need to forget about the Type 1's, the real market for Afrezza is the over 20 million Type 2's who haven't heard about Afrezza yet. To put it simply, Afrezza will save a Type 2's pancreas from getting weakened or destroyed by oral medications. Spiro is amused when he hears some of the stories out there that Afrezza has spontaneously stopped working well. Good grief, it's human insulin, since when does human insulin stop working? Can someone tell these Type 1's, it's the disease. Diabetes is a nasty sucker, it is affected by a lot of factors during a diabetics daily routine. Things like stress, fatigue, exercise or a sudden change in diet can all influence glucose levels. Afrezza will never stop working, it will only start working better as the diabetic learns how to manage his disease better using Afrezza. Spiro has the pleasure of seeing how great Afrezza works everyday. Today, pre-dinner BG 96. 60 + carb dinner, 4 units Afrezza, 1 hr. BG 124, 2 hr, BG 84 3 hr, BG 86. Afrezza is taking the stress off of Spiro's pancreas during phase 1 digestion. It sure seems like Spiro's pancreas is cranking out a lot more insulin now, than it was 5 month's ago. That large piece of red velvet cake with butter-creme icing was incredible after dinner tonight. Someway, somehow and hopefully someday Sanofi will get the message out to Type 2 diabetics. it's a quite simple message, early intervention in treating your Type 2 diabetes with Afrezza will save your pancreas, nerve endings, eyesight, liver, spleen and kidneys. Of course they can't say that, but isn't that what happens when your blood sugar is at normal levels? Uncontrolled diabetes is a nasty sucker, it destroys your body, system by system until your quality of life is gone. It's a slow death and it will come earlier than it should have. Spiro here, not happy with the RX numbers, but there's always next Friday. Help me out...butert cream icing? Wouldn't have occurred to me.
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Post by kball on Jul 18, 2015 9:55:54 GMT -5
^ Not playing fair, Spiro! Registering complaint.
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Post by dreamboatcruise on Jul 18, 2015 11:29:48 GMT -5
kball... I would certainly hope that an A1c of 7 becomes something that isn't tolerated. If I knew someone in that situation I probably would gently push to consider changes. (BTW... you're signature quote at the bottom of your posts makes me nervous. If you're screwed, what would I be given that MNKD is by far my largest holding rather than second largest?) spiro... could not agree with you more. It seems that the ideal use of Afrezza is early intervention for T2. Once T2 progresses, beta cells are impaired and insulin resistance builds up, the disease becomes more complicated to manage even with Afrezza. RAA's may last too long, but Afrezza may outrun meals. At that point, patients need CGMs or the mindset to be diligent about testing throughout the day to get best control... and savvy enough to learn how to match insulin to meals. Many patients simply are not conscientious. Even if SNY and MNKD wanted to do a clinical trial to show better A1c, there is a chance that for more advanced T2 it would be hard to develop a protocol that didn't require CGM or more testing than reasonable patient compliance would support. BUT... the results you've achieved Spiro, are a glimpse of the holy grail... early intervention when the body's natural processes just need a quick boost at the start of a meal, the protocol is as simple as can be and seems to have remarkable results. It will take time to gather evidence and do the arm twisting required to get insurers on board with Afrezza that early in disease progression. I hate to call a Lead Global Moderator anecdotal but even with results from the many Spiros pooled together I doubt it is enough for the insurers to consider a statistically meaningful pool of clinical results. Hopefully we'll hear news of an FDA trial along these lines sometime within the coming year. Can you imagine a trial actually designed with an end goal of showing stopping disease progression in its tracks! I'm less impatient about blasting America with TV ads than I am about the process of getting better clinical data to support the real paradigm change that T2 diabetes treatment, and the people living through it, need. From a near term investor expectation point of view one should put Spiro's wonderful results in the context that without the additional complications that prompted using Afrezza as a first line Rx, there are only 4% of people with insurance for whom their insurance would easily cover prescribing it this way (as per formularylookup.com data, if it is accurate).
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Post by xoxoxoxo on Jul 18, 2015 13:03:15 GMT -5
thanks for the update and info. It goes to what I have always feared and staeted before that adoption will be slow and that doctors set in their way will be stubborn about trying new things. Even with the scientific presentation, doubt still lingers. Is the presentation not geared to clear up how Afrezza works differently than current insulin? Per your remarks, it appears so because the doc stated they don't yet understand the dosing. One has to scratch their head if this is the case. It also reinforces what I stated a day or two ago that all you need is one or two patients to help break that misconception dam of doctors for the doctors to realize how it works. The doctors will always stick to the notion that if a patient is under control, there is no need to change meds. And that explains the slow launch and less than stellar scripts. Yeah, I think the doc saw the presentation, but it didn't really click with regards to dosing. I don't think people accept the concept that 8u of Afrezza is ok even if they only need 5u. Hopefully after they get a few patients on it and see the results they'll change their minds. I really don't see that happening quickly, we're talking like 6 months from now.
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Post by kball on Jul 18, 2015 18:09:44 GMT -5
kball... I would certainly hope that an A1c of 7 becomes something that isn't tolerated. If I knew someone in that situation I probably would gently push to consider changes. (BTW... you're signature quote at the bottom of your posts makes me nervous. If you're screwed, what would I be given that MNKD is by far my largest holding rather than second largest?) spiro... could not agree with you more. It seems that the ideal use of Afrezza is early intervention for T2. Once T2 progresses, beta cells are impaired and insulin resistance builds up, the disease becomes more complicated to manage even with Afrezza. RAA's may last too long, but Afrezza may outrun meals. At that point, patients need CGMs or the mindset to be diligent about testing throughout the day to get best control... and savvy enough to learn how to match insulin to meals. Many patients simply are not conscientious. Even if SNY and MNKD wanted to do a clinical trial to show better A1c, there is a chance that for more advanced T2 it would be hard to develop a protocol that didn't require CGM or more testing than reasonable patient compliance would support. BUT... the results you've achieved Spiro, are a glimpse of the holy grail... early intervention when the body's natural processes just need a quick boost at the start of a meal, the protocol is as simple as can be and seems to have remarkable results. It will take time to gather evidence and do the arm twisting required to get insurers on board with Afrezza that early in disease progression. I hate to call a Lead Global Moderator anecdotal but even with results from the many Spiros pooled together I doubt it is enough for the insurers to consider a statistically meaningful pool of clinical results. Hopefully we'll hear news of an FDA trial along these lines sometime within the coming year. Can you imagine a trial actually designed with an end goal of showing stopping disease progression in its tracks! I'm less impatient about blasting America with TV ads than I am about the process of getting better clinical data to support the real paradigm change that T2 diabetes treatment, and the people living through it, need. From a near term investor expectation point of view one should put Spiro's wonderful results in the context that without the additional complications that prompted using Afrezza as a first line Rx, there are only 4% of people with insurance for whom their insurance would easily cover prescribing it this way (as per formularylookup.com data, if it is accurate). This has been on my mind as well. I wonder how many T2's on orals test at most maybe once a day, if that. (as to your question in paragraph 1, similarly screwed i'd imagine)
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