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Post by Jstokcton on Nov 6, 2015 14:52:56 GMT -5
From the Sanofi Slide:
"Commercial focus on 1.1m uncontrolled basal insulin intensification patients."
I'm trying to think about this and would like other opinions.
Is this Sanofi's way of trying to get Afrezza to move up a Tier?
Is the new training in Vegas about this. Any thoughts on this?
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Post by lorcan458 on Nov 6, 2015 15:13:08 GMT -5
I think what they meant was until insurance is where they need it to be for widespread adoption, they are concentrating on a small subset of patients where the medical benefit is so great, that insurance won't be as much of an obstacle. The side benefit, is when it works beyond any previous treatment, it is further ammunition for a label change and it will build the ever increasing evidence that Afrezza truly is in a league of its own.
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Post by compound26 on Nov 6, 2015 15:20:18 GMT -5
From the Sanofi Slide: "Commercial focus on 1.1m uncontrolled basal insulin intensification patients." I'm trying to think about this and would like other opinions. Is this Sanofi's way of trying to get Afrezza to move up a Tier? Is the new training in Vegas about this. Any thoughts on this? My understanding is that Sanofi (and probably Mannkind) has just adjusted their strategy after they got the data of sales from the last several months. Originally, I think both Sanofi and Mannkind were always mentioning both the insulin intensification patients (T1s) and insulin initiation patients (T2s) as their targeted markets, with them sometimes even emphasizing the second group as their core target market. However, as we have seen in the last several months, apparently, T1s are more enthusiastic about Afrezza than T2s, even though the overall population of T1s are much smaller. I recall this board has discussed this phenomenon. Probably T1s are generally more concerned about managing their BG and are more knowledgeable about the subject. I also think it is much easier to dial in Afrezza if you have a CGM. Most T2s do not wear a CGM, while many T1s do. In that sense, T1s appear to be an easier market for Afrezza (compared with T2s). Perhaps it is also easier for T1s to get insurance prior authorization cleared. If indeed this is an adjustment in their marketing strategy. I think this is the right move. Once Sanofi and Mannkind take care of the T1s market, it will be much easier for them to move to the T2s market. |
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Post by peppy on Nov 6, 2015 15:29:05 GMT -5
From the Sanofi Slide: "Commercial focus on 1.1m uncontrolled basal insulin intensification patients." I'm trying to think about this and would like other opinions. Is this Sanofi's way of trying to get Afrezza to move up a Tier? Is the new training in Vegas about this. Any thoughts on this? slide: screencast.com/t/gmSavH3KGU good question I hadn't looked at it like that
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Post by robsacher on Nov 6, 2015 18:45:43 GMT -5
I think what they meant was until insurance is where they need it to be for widespread adoption, they are concentrating on a small subset of patients where the medical benefit is so great, that insurance won't be as much of an obstacle. The side benefit, is when it works beyond any previous treatment, it is further ammunition for a label change and it will build the ever increasing evidence that Afrezza truly is in a league of its own. Exactly. Well said and well written. |
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Post by mbseeking on Nov 6, 2015 19:08:59 GMT -5
There is another possibility.
Afrezza is sin binned by SNY.
By focusing on "uncontrolled basal insulin intensification patients." they are arguably targeting some of the hardest to treat patients. Even though Afrezza will likely help these patients it will do little to prove the superiority of the drug to the payers - properly structured clinical trials are required for that .
In the meantime SNY gets to flog a lot of other less effective drugs.
Afrezza doesnt die, but realises a fraction of its potential.
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Post by mnholdem on Nov 6, 2015 20:23:34 GMT -5
These are the patients who are getting treated with 1 daily basal injection + oral meds. They would likely resist the doctor telling them they need to add more injections to manage the disease, but an inhalable option for mealtime insulin might have greater appeal. I would think these patients would not be the hardest to treat, unless you're implying that they will reject the added expense of switching from Metformin to Afrezza.
I think that we ought to consider that Alfred Mann may have convinced Sanofi to go after the holy grail, which would be the medical community establishing Afrezza as the new standard for early treatment. Start by getting early Type 2 diabetics off Metformin and treated with basal+Afrezza ASAP. Then the resulting improvement in control (or even remission in some cases) of the diabetes must be proven with a real world study. For all this to happen, Sanofi must initially have 300-500 patients that have started using Afrezza, having failed with orals.
...which takes time. These are also the patients who qualify for pre-authorization by having previously used oral medication and still failed to control their blood glucose. What I find frustrating is that some insurers require that the patient has failed with TWO oral medications. Management used the phrase "the right patients" at one of their conferences. Perhaps this is what they meant. It's probably rare to find an early T2 who has already failed two orals.
Is this "2 oral med failures" a requirement to get covered for RAAs or is this simply a hurdle placed before all brand new diabetes medications? It doesn't seem to take this much for insurers to approve coverage for mealtime/bolus injectables.
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Post by peppy on Nov 6, 2015 21:28:47 GMT -5
from docfrezza's posts on this board;
If you go back and listen to the presentation from earlier today you will hear Matt use the words "real world". What is going on in the real world is very important. Patients are loving Afrezza. Practitioners that are using Afrezza are loving it. It is still my opinion that the biggest issue is that the marketing by Sanofi has been weak. In my opinion patients will push the initial sales by requesting Afrezza from their practitioners but as of this time many do not even know that it exists. Later, practitioners will use Afrezza because of the results they see in their practices, much like I have seen in my practice. That is the real world.
Read more: mnkd.proboards.com/user/1899/recent#ixzz3qliNopVA --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- If I read docfrezza correctly, he is saying, advertise Afrezza, and it will sell it's self.
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Post by seanismorris on Nov 6, 2015 21:54:31 GMT -5
mnholdem, I agree. There are many patient segment that should be targeted. Getting new diabetes patients, even pre-diabetics on Afrezza would have far reaching benefits. But, this is why investing in MannKind has been so frustrating... The insurance companies have said we are looking for superiority (for new drugs in general) and yet there are no new Clinical Trials to prove superiority. We all know Afrezza is superior and yet nothing is being done to prove it. Every day that goes by lessens the chance of MannKinds survival and keeps a fantastic drug out of patients hands.
I can forgive a slow launch but I can't forgive this the ongoing incompetence. Sanofi had 1/2 a year to plan the launch and MannKind had 10 years of R&D and market research to develop a plan. Where is the plan? Afrezza seems to have been cast adrift to see if anyone adopts it. I'm glad the T1s are passionate about Afrezza, I just hope they aren't left holding an empty bag..."sorry Afrezza is no longer available to lack of demand".
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Post by mnholdem on Nov 6, 2015 22:22:36 GMT -5
There is no excuse for why superiority tests haven't been started yet. None that I can think of, anyway. The select group of endos that has been initially targeted does have me wondering if some study is being conducted, but it's only a hunch. I hope my hunch is correct, though.
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Post by suebeeee1 on Nov 7, 2015 19:20:37 GMT -5
However, as we have seen in the last several months, apparently, T1s are more enthusiastic about Afrezza than T2s, even though the overall population of T1s are much smaller. I recall this board has discussed this phenomenon. Probably T1s are generally more concerned about managing their BG and are more knowledgeable about the subject. I also think it is much easier to dial in Afrezza if you have a CGM. Most T2s do not wear a CGM, while many T1s do. In that sense, T1s appear to be an easier market for Afrezza (compared with T2s). Perhaps it is also easier for T1s to get insurance prior authorization cleared. If indeed this is an adjustment in their marketing strategy. I think this is the right move. Once Sanofi and Mannkind take care of the T1s market, it will be much easier for them to move to the T2s market. T2s are not really considering this until they start looking down the barrel of a needle. Then Afrezza becomes as important to them as the T1s. As long as T2 are lulled into believing that oral medication is a safe and effective option, they aren't going to think about insulin at all. |
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