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Post by centralcoastinvestor on Oct 10, 2015 1:23:21 GMT -5
I have been reflecting recently on how I should feel about the weekly game show we all play called name that Afrezza script count. I must admit that I had an overly rosy outlook on how fast the script counts were going to grow once marketing started. This expectation has lead me to watch each week with a morbid fascination that this is the week where its going to break big. Instead, the march upward is agonizingly slow and steady. I think Sanofi knew this was going to happen which is why they pre-warned the market that the launch would be in two stages. That being said, I still expected huge, quick results. That expectation has lead me to be disappointed almost every week.
There are two words I want to focus on here. The first word: expectation. If I had been expecting a very slow start, with perhaps a year before script traction, then the weekly script counts would be satisfying. I must reset my expectations to be in line with the realities that Afrezza is facing. There are numerous headwinds that will take time to overcome. These include insurance coverage, doctor education, patient education and advertising. I absolutely loved the recent post about the brilliant strategy of Sanofi that also became a Seeking Alpha article. Its going to take time. I will continue to beat that into my head. Unfortunately, I'm stubborn and it will take time for my mind to adjust. Oh well.
Now lets focus on the second word: steady. Each week the script count tends to go up a little bit. Just steady, slooooooow growth and small numbers. Mannkind has been beat to death in the media and by analysts about the slow start of Afrezza. However, I want to point out that todays number is better than the script number two months ago. I bet the script number two months from now will be better than today. There is a point coming when the latest steady script number will be 1000 and then 2000 and so on. There is a tipping point coming that will then cause the script count to cut the other way. That steady slow growth will become the rally cry for why Afrezza and Mannkind is the investment to own. I "patiently" look forward to the day when I hear an analyst say that Mannkind is a strong buy because of the steady growth of Afrezza.
Some final thoughts. As evidenced in the social media arena, Afrezza works and works very well. In fact, many have described Afrezza as a paradigm shift in diabetic treatment. It appears that once a patient changes to Afrezza they will not be changing back. Therefore, that steady script number will not change for any reason. Because people need to control their diabetes in all seasons, in a good economy or bad economy until there is a cure. That kind of consistency in a drug will make Mannkind stock very valuable indeed.
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Post by kball on Oct 10, 2015 7:36:36 GMT -5
I think we've all been rattled since early summer.
I remember Al stating he thought Afrezza would become the standard initial treatment for diabetes.
But i don't recall him saying when.
The older i get the harder it is to look out 5 years, but it feels like we will need between 5-10 years for this transition if its to take place.
Couple years for insurance placement.
And maybe a few more before most endos, and many drs see enough data and hear from enough angry patients to be convinced and start prescribing.
I have yet to sell a single share... but overall i'm down 29% (would be 36% if i didn't lend shares)
* Mannakin (my word) since sept 2014
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Post by centralcoastinvestor on Oct 10, 2015 9:24:26 GMT -5
I think we've all been rattled since early summer. I remember Al stating he thought Afrezza would become the standard initial treatment for diabetes. But i don't recall him saying when. The older i get the harder it is to look out 5 years, but it feels like we will need between 5-10 years for this transition if its to take place. Couple years for insurance placement. And maybe a few more before most endos, and many drs see enough data and hear from enough angry patients to be convinced and start prescribing. I have yet to sell a single share... but overall i'm down 29% (would be 36% if i didn't lend shares) * Mannakin (my word) since sept 2014 I have been an investor in Mannkind since 2007. I am a true Mannkind groupy. I am probably small potatoes in terms of how much I own compared to many here. But it's a lot for me and my family. I went through both CRLs and learned about bear raids. I held through the ADCOM, that was stressful. I don't think I will hold through another ADCOM again. Once Afrezza was FDA approved and a partner was found in Sanofi, I was convinced we had reached the promised land. Nope. I know I have violated so many investment rules with this stock. I own more than I should and I have "fallen in love" with the stock. But I am stubborn, I will see this through no matter what. As I once posted on the YMB, they can take my shares from my cold dead fingers. I believe that Afrezza will change how diabetes is treated and Technosphere will change how many drugs are delivered. Period. |
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Post by ezrasfund on Oct 10, 2015 9:50:41 GMT -5
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Post by rrtzmd on Oct 10, 2015 11:12:04 GMT -5
Well, to be fair, no one has used afrezza for any truly extended period of time -- 5-10 years. Is that correct? COPD, emphysema, lung cancer can require long periods of time to develop. The fact that afrezza has a measurable effect on lung function while being used is disconcerting, even if it does appear to resolve after discontinuing the drug. If the FDKP and insulin and preservatives are cleared so rapidly from the lung, what causes the measurable, persistent detrimental effect on lung function?
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Post by ezrasfund on Oct 10, 2015 13:41:48 GMT -5
Well, to be fair, no one has used afrezza for any truly extended period of time -- 5-10 years. Is that correct? COPD, emphysema, lung cancer can require long periods of time to develop. The fact that afrezza has a measurable effect on lung function while being used is disconcerting, even if it does appear to resolve after discontinuing the drug. If the FDKP and insulin and preservatives are cleared so rapidly from the lung, what causes the measurable, persistent detrimental effect on lung function? I don't know anything about the preservatives in Afrezza. What preservatives do they use? Otherwise I think you are just reinforcing my point that any new treatment can be maligned by saying the long term effects are not known. In the real world Afrezza has been used for more than 5 years by a small group of diabetics who used Exubera and transitioned to Afrezza under a compassionate use program, but not a useful sample size. Many of the diabetics who are early and enthusiastic users of Afrezza would be especially concerned about lung function, including singer Adam Lasher, triathlete Gustavo B, scuba diver and all around thrill seeker Brian S. Even Afrezzauser has been know to drop into the pool for a 2 mile swim. |
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Post by harryx1 on Oct 10, 2015 14:12:46 GMT -5
Well, to be fair, no one has used afrezza for any truly extended period of time -- 5-10 years. Is that correct? COPD, emphysema, lung cancer can require long periods of time to develop. The fact that afrezza has a measurable effect on lung function while being used is disconcerting, even if it does appear to resolve after discontinuing the drug. If the FDKP and insulin and preservatives are cleared so rapidly from the lung, what causes the measurable, persistent detrimental effect on lung function? Maybe you need to do a little DD: mnkd.proboards.com/thread/1974/afrezza-pulmonary-safety-studies |
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Post by trondisc on Oct 11, 2015 3:11:12 GMT -5
Your last paragraph says it all! Thanks for creating this thread. Allow my 2 cents if you have not seen posted in another thread yet already....
"I would love to see Afrezza succeed and change the world for Type 1/2 diabetics. More importantly I'm hoping future Technosphere developments might actually include Google as a premiere partner alongside Sanofi. Wireless digital health monitoring done entirely with Google/Cloud & the power of MannKind's Technosphere hardware. Numbers are numbers however for the most part 2015 hasn't been terrible. NRx/TRx climbing with 3 to 4 week consecutive averages then the occasional hiccup before treading higher once more. "The NRx & TRx *are* slowly increasing however should I be concerned that the NRx/TRx 10/02 total dipped slightly for the first time since late August? Anyways just seeking some honesty commentary." {/me}
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Post by bretzyboy on Oct 11, 2015 8:33:10 GMT -5
Has this been discussed?
Getting and keeping a CDL is more difficult for those using insulin. Although the American Diabetes Association has been successful in improving the common sense factor of the regulations there are still constraints that using Afrezza could greatly reduce.
I didn't realize this until a conversation with a friend who owns a vineyard and is borderline diabetic expressed concerned about losing his CDL if he had to use an injectable protocol in the future.
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Post by centralcoastinvestor on Oct 11, 2015 9:58:25 GMT -5
Has this been discussed? Getting and keeping a CDL is more difficult for those using insulin. Although the American Diabetes Association has been successful in improving the common sense factor of the regulations there are still constraints that using Afrezza could greatly reduce. I didn't realize this until a conversation with a friend who owns a vineyard and is borderline diabetic expressed concerned about losing his CDL if he had to use an injectable protocol in the future. I'm going to show some ignorance here. What is a CDL? Thanks. |
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Post by mssciguy on Oct 11, 2015 10:07:13 GMT -5
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Post by prmco26 on Oct 11, 2015 10:08:41 GMT -5
Help me out, please. If, as I have read on YMB and elsewhere, the weekly scrip counts do not include data from CVS (now including Target) and Walgreen, and possibly other big chains like Walmart and Costco as well, then exactly what value do they have? Thanks in advance.
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Post by jonnykrush on Oct 11, 2015 10:20:26 GMT -5
Help me out, please. If, as I have read on YMB and elsewhere, the weekly scrip counts do not include data from CVS (now including Target) and Walgreen, and possibly other big chains like Walmart and Costco as well, then exactly what value do they have? Thanks in advance. 1) I believe they extrapolate their data out to account for the big chain non reporters, and 2) script data, even if consistently under reported will show an overall growth (or lack thereof) trend line. |
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Post by mssciguy on Oct 11, 2015 10:54:38 GMT -5
Help me out, please. If, as I have read on YMB and elsewhere, the weekly scrip counts do not include data from CVS (now including Target) and Walgreen, and possibly other big chains like Walmart and Costco as well, then exactly what value do they have? Thanks in advance. From my understanding, the figures are adjusted to give a final number that approximates the total including those non-participants. However, the figures are useful, but maybe only to +/- 25%. If you use monthly totals or a moving average, some of the noise will be reduced. Of course, once Afrezza goes global (and it has, just a little so far), the US insurance industry won't be as large an influence in thwarting Rx growth. That's what we are all waiting for  Danbury did not triple capacity just for grins. |
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Post by rrtzmd on Oct 11, 2015 11:28:08 GMT -5
Sorry, my mistake! No preservatives but they do have polysorbate 80 on the list of ingredients.
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