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Post by docfrezza on Dec 9, 2015 10:41:31 GMT -5
Would love to hear of a similar meeting with T2's exclusively...but perhaps the powers that be are compiling data from T1's for T2's to eventually follow for optimal results? More thoughts on why T2's were excluded? docfrezza? liane? How do you know for sure that type 2 diabetic patients were excluded? I may have missed something. |
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Post by mindovermatter on Dec 9, 2015 10:44:22 GMT -5
Would love to hear of a similar meeting with T2's exclusively...but perhaps the powers that be are compiling data from T1's for T2's to eventually follow for optimal results? More thoughts on why T2's were excluded? docfrezza? liane? My thoughts are that SNY knows that T1s are a better fit for Afrezza as T1s are typically more diligent about their disease. Insurance companies, once they realize how well Afrezza works in controlling T1s compared to other meds, will be more interested in covering Afrezza for T1s than T2s who typically have less expensive means to control their diabetes. T2s will take a much longer time to adopt due to pricing. Maybe once insurance and docs see how well Afrezza works for T1s will they then start recommending it to T2s. Remember, Mannkind originally was only going after T1s not T2s. If I recall, the FDA wanted Mannkind to include T2s in their final study. |
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Post by sluggobear on Dec 9, 2015 10:49:32 GMT -5
Regarding Dexcom and SNY-Google partnership.
There was a conversation with Dtrouble on YMB yesterday about the use a CGM for his girlfriend. (I sure wish I didn't know ALL the Afrezza users and family members by name!) I think his girlfriend is a T1D who happily went off the pump and on to Toujeo and Afrezza. I don't know if he's on Proboards; he posts on Twitter as Stephen Parsons @dtroue1003.
My non-PWD observation is that it sounds like a lot of first time users have a settling-in period for dosing. A CGM would probably help a lot for getting new Afrezza users up to snuff on timing their puffs and dialing in their basal insulin, if they take basal. At the Mannkind-Sanofi advisory board meeting in San Diego, I assume discussion about Afrezza timing and dosing was prominent. Google and Sanofi might work together on the vagaries of insulin dosing and BG control, in order to provide insulin-using diabetics with an affordable, non-attached CGM. The future is in providing near normal BG control for PWD's with less cost and a lot more convenience.
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Post by kball on Dec 9, 2015 11:21:15 GMT -5
Would love to hear of a similar meeting with T2's exclusively...but perhaps the powers that be are compiling data from T1's for T2's to eventually follow for optimal results? More thoughts on why T2's were excluded? docfrezza? liane? How do you know for sure that type 2 diabetic patients were excluded? I may have missed something. I don't for certain. Anecdotal. |
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Post by bradleysbest on Dec 9, 2015 11:23:48 GMT -5
Be nice if Google bought a stake in MNKD at these "blue light" special prices!
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Post by docfrezza on Dec 9, 2015 11:47:43 GMT -5
How do you know for sure that type 2 diabetic patients were excluded? I may have missed something. I don't for certain. Anecdotal. As I suspected. Like I have said previously, very few know what was discussed at the meeting and who attended. I sat on a diabetes ad board about a month ago and I can guarantee you that no more than 40 or so people know what was discussed. These type of meetings are typically tight lipped. But I was able to confirm that this particular was an advisory board meeting. Can't tell you how I confirmed it, you just have to trust me on this. I do not want to lose my information source. |
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Post by Deleted on Dec 9, 2015 12:16:42 GMT -5
I don't for certain. Anecdotal. As I suspected. Like I have said previously, very few know what was discussed at the meeting and who attended. I sat on a diabetes ad board about a month ago and I can guarantee you that no more than 40 or so people know what was discussed. These type of meetings are typically tight lipped. But I was able to confirm that this particular was an advisory board meeting. Can't tell you how I confirmed it, you just have to trust me on this. I do not want to lose my information source. what are advisory boards responsible for? ( atleast relative to this case?) |
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Post by peppy on Dec 9, 2015 12:22:57 GMT -5
As I suspected. Like I have said previously, very few know what was discussed at the meeting and who attended. I sat on a diabetes ad board about a month ago and I can guarantee you that no more than 40 or so people know what was discussed. These type of meetings are typically tight lipped. But I was able to confirm that this particular was an advisory board meeting. Can't tell you how I confirmed it, you just have to trust me on this. I do not want to lose my information source. what are advisory boards responsible for? ( atleast relative to this case?)
The JAC Joint Advisory Committee between Sanofi and Mannkind?
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Post by EveningOfTheDay on Dec 9, 2015 12:24:27 GMT -5
Be nice if Google bought a stake in MNKD at these "blue light" special prices! Right. incidentally that is something that has always bothered me. No one seems to be interested in taking a major stake even as the price continues to fall. Nobody wants to touch this even with a 10 foot pole. Why is that? |
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Post by kc on Dec 9, 2015 12:37:56 GMT -5
Be nice if Google bought a stake in MNKD at these "blue light" special prices! Right. incidentally that is something that has always bothered me. No one seems to be interested in taking a major stake even as the price continues to fall. Nobody wants to touch this even with a 10 foot pole. Why is that? I guess we are in for a long ride. Hopefully we get some news before the end of 2015. Very disappointing. but will still be here next month. |
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Post by cathode on Dec 9, 2015 12:40:54 GMT -5
Regarding Dexcom and SNY-Google partnership. There was a conversation with Dtrouble on YMB yesterday about the use a CGM for his girlfriend. (I sure wish I didn't know ALL the Afrezza users and family members by name!) I think his girlfriend is a T1D who happily went off the pump and on to Toujeo and Afrezza. I don't know if he's on Proboards; he posts on Twitter as Stephen Parsons @dtroue1003. My non-PWD observation is that it sounds like a lot of first time users have a settling-in period for dosing. A CGM would probably help a lot for getting new Afrezza users up to snuff on timing their puffs and dialing in their basal insulin, if they take basal. At the Mannkind-Sanofi advisory board meeting in San Diego, I assume discussion about Afrezza timing and dosing was prominent. Google and Sanofi might work together on the vagaries of insulin dosing and BG control, in order to provide insulin-using diabetics with an affordable, non-attached CGM. The future is in providing near normal BG control for PWD's with less cost and a lot more convenience. I am confused about what you mean. Verily (Google Life Sciences) would work with SNY on understanding how people respond to dosing so that Verily(?) can build a non-attached CGM? What do you mean by non-attached? Like the Novartis contact lens? How does SNY/Afrezza data help the engineers at Verily achieve this? I am buying the bigger connection between SNY/DXCM/GOOG, but don't really understand your specific speculations. Thanks. |
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Post by EveningOfTheDay on Dec 9, 2015 12:42:31 GMT -5
Right. incidentally that is something that has always bothered me. No one seems to be interested in taking a major stake even as the price continues to fall. Nobody wants to touch this even with a 10 foot pole. Why is that? I guess we are in for a long ride. Hopefully we get some news before the end of 2015. Very disappointing. but will still be here next month. Heck, how much longer we can go without a single word uttered from somebody in Mannkind. The silence was overwhelming when this was in the 5s, 4s and 3s. Now it is simply unbearable. Honestly WTF is going on? |
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Post by docfrezza on Dec 9, 2015 12:51:06 GMT -5
As I suspected. Like I have said previously, very few know what was discussed at the meeting and who attended. I sat on a diabetes ad board about a month ago and I can guarantee you that no more than 40 or so people know what was discussed. These type of meetings are typically tight lipped. But I was able to confirm that this particular was an advisory board meeting. Can't tell you how I confirmed it, you just have to trust me on this. I do not want to lose my information source. what are advisory boards responsible for? ( atleast relative to this case?) To discuss whatever the company wants to discuss and get input on. Beyond that vague statement it is hard to say. |
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Post by stevil on Dec 9, 2015 12:53:49 GMT -5
Would love to hear of a similar meeting with T2's exclusively...but perhaps the powers that be are compiling data from T1's for T2's to eventually follow for optimal results? More thoughts on why T2's were excluded? docfrezza? liane? My thoughts are that SNY knows that T1s are a better fit for Afrezza as T1s are typically more diligent about their disease. Insurance companies, once they realize how well Afrezza works in controlling T1s compared to other meds, will be more interested in covering Afrezza for T1s than T2s who typically have less expensive means to control their diabetes. T2s will take a much longer time to adopt due to pricing. Maybe once insurance and docs see how well Afrezza works for T1s will they then start recommending it to T2s. Remember, Mannkind originally was only going after T1s not T2s. If I recall, the FDA wanted Mannkind to include T2s in their final study. It's going to be extremely difficult to displace Metformin/sulfonylureas as the first line of treatment for type 2. Likely many years of explicit research as well. Not only to move the pendulum of theory and habit, but also to justify the vast price discrepancy. It will have to be proven that taking Afrezza (or insulin in general) can be explicitly linked to prolonged health. While just about everyone here will get in a fit about this, it's not been my impression that scientists always make logical leaps. Especially when those decisions are surrounded by money. Meaning, just because lower A1C's have been linked to declining neuropathies, and obviously insulin has been shown to lower A1C, there usually still need to be tests done to show that taking insulin sooner (instead of what's currently prescribed) leads to better success in regards to neuropathy. Unless studies have already started (or have been completed already), it's likely that years will be needed to show that type 2s taking insulin is more cost-effective than what's currently prescribed. |
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Post by Deleted on Dec 9, 2015 13:03:31 GMT -5
Regarding Dexcom and SNY-Google partnership. There was a conversation with Dtrouble on YMB yesterday about the use a CGM for his girlfriend. (I sure wish I didn't know ALL the Afrezza users and family members by name!) I think his girlfriend is a T1D who happily went off the pump and on to Toujeo and Afrezza. I don't know if he's on Proboards; he posts on Twitter as Stephen Parsons @dtroue1003. My non-PWD observation is that it sounds like a lot of first time users have a settling-in period for dosing. A CGM would probably help a lot for getting new Afrezza users up to snuff on timing their puffs and dialing in their basal insulin, if they take basal. At the Mannkind-Sanofi advisory board meeting in San Diego, I assume discussion about Afrezza timing and dosing was prominent. Google and Sanofi might work together on the vagaries of insulin dosing and BG control, in order to provide insulin-using diabetics with an affordable, non-attached CGM. The future is in providing near normal BG control for PWD's with less cost and a lot more convenience. I am confused about what you mean. Verily (Google Life Sciences) would work with SNY on understanding how people respond to dosing so that Verily(?) can build a non-attached CGM? What do you mean by non-attached? Like the Novartis contact lens? How does SNY/Afrezza data help the engineers at Verily achieve this? I am buying the bigger connection between SNY/DXCM/GOOG, but don't really understand your specific speculations. Thanks. What he means is that Google (AKA Verily) has a partnership with Dexcom. Dexcom's newest sensor, the G5 sends glucose readings directly from the patient to a smartphone (previous Dexcom sensors sent the info to a Dexcom device to record the data - this is what Sam currently has as seen in his twitter posts). What the Google / Dexcom relationship is for is to develop a smaller less expensive bandage like sensor with a significantly lower price point. This new sensor which is still being developed will be sold into retail pharmacy channels. Dexcom will build the sensor and apparently, Google will help with the engineering. Here is a link: www.digitaltrends.com/android/google-dexcom-glucose-monitor/Google wants to own the data which they will be able to sell to health insurance companies, clinics / doctors / IDN's (so the providers can demonstrate that pools of patients are improving their glucose control, health, etc) and then the provider can get part of their reimbursement in the form of outcomes based vs fee for service which is where things are heading. Google's cut of the revenue does not start until nearly $1B and it is going to make a fortune. By the way, the folks at Dexcom apparently have some other toys in the box that measure more than just glucose so while diabetes is a massive market, for Google, it is the entry point. Why would Sanofi want in on all of this, well in short, MONEY. If they are smart, they bundle Afrezza with Lantus, Toujeo and in the future, a better basal and they will show via Google data that patients on the Sanofi combo of meds have better control, better health and reduced long term health complications. Based on where this is all heading, Sanofi would be foolish to let Afrezza and Mannkind fail. There is no other prandial insulin that is remotely close to performing as well as Afrezza. Another thing, Afrezza will significantly and adversely impact the pump market (kind of ironic right). Pumps had their day but they cost a lot, require a new infusion set every 3-4 days, patient has to constantly fiddle with the pump to adjust infusion rate, bolus, etc and the pump along with 42" of tubing hangs on a belt, stuffed in a bra yadda yadda. Pump replaced every 4-5 years at a cost of around $7,000 (remember plus 2 infusion sets / week at $15 - $20 each)... Afrezza + daily basal injection is way better, easier, more convenient better outcomes, etc. For the type 2 market, Mannkind can load up to 36 units on a cartridge. Share price sucks and no noise from management. Maybe its over and maybe its not. Either way, Afrezza is head and shoulders above any other product invented for diabetes in terms of controlling blood glucose levels, reducing A1c and maintaining better long term health. Edit: by sending patient glucose readings directly to smartphone, the phone can send it up to the Google cloud and patient can get feedback, good, bad or otherwise. A message to reduce carbs, take insulin 5 min after starting meal are a couple of examples. Artificial intelligence makes it nearly infinite as to what type of patient feedback would result based on glucose levels and other patient data that is constantly fed up to google cloud via sensor patient wears. Also, 3 of Dexcoms top management including Terry Greg and Kevin Sayer worked for Al Mann at Minimed. |
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