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Post by MnkdMainer (MM) on Dec 4, 2015 11:51:12 GMT -5
Here is what my father, a retired orthopedic surgeon and very heavily invested MNKD long, discovered from speaking with his friend, a local pharmacist: The relative wholesale cost of pen injected Humalog vs. Afrezza (which the pharmacist had never even heard of) was $1.12 for Humalog and $2.50 for Afrezza, comparing 4 units of each.
Has anyone on this board investigated this issue? If the reported information is correct, is there any wonder why Afrezza is not being covered by insurance and why it isn't selling as we expected?
We were told by MNKD's management that Afrezza was to be priced competitively with insulin pens. Why would they say that if they knew that Sanofi was intending to make it more than twice as expensive? Is Sanofi breaching its contractual obligation with MNKD by pricing Afrezza so high?
I'm not looking for any speculation here, but if someone knows something relevant to this issue, I'd love to hear it.
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Post by vissertrades on Dec 4, 2015 12:16:33 GMT -5
Good question for our mis-management to answer as they did say what you stated regarding pricing and more than double the cost is not competitive in my eyes...
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Post by rrtzmd on Dec 4, 2015 12:20:45 GMT -5
Here is what my father, a retired orthopedic surgeon and very heavily invested MNKD long, discovered from speaking with his friend, a local pharmacist: The relative wholesale cost of pen injected Humalog vs. Afrezza (which the pharmacist had never even heard of) was $1.12 for Humalog and $2.50 for Afrezza, comparing 4 units of each. Has anyone on this board investigated this issue? If the reported information is correct, is there any wonder why Afrezza is not being covered by insurance and why it isn't selling as we expected? We were told by MNKD's management that Afrezza was to be priced competitively with insulin pens. Why would they say that if they knew that Sanofi was intending to make it more than twice as expensive? Is Sanofi breaching its contractual obligation with MNKD by pricing Afrezza so high? I'm not looking for any speculation here, but if someone knows something relevant to this issue, I'd love to hear it. Have you tried searching the board? I believe the topic has been thrashed a number of times. |
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Post by bill on Dec 4, 2015 12:37:57 GMT -5
My recent posts hypothesize that SNY realized Al was right and decided to place a premium on the Afrezza price even though it hampered US insurance and sales in 2015--though somewhat mitigated by their Afrezza savings card. If I'm right they've been gathering enough data to justify that price all summer, two studies and early adopter data that they're now using to get better insurance coverage in 2016. I also suspect they'll use it to get approval, a better label, and favorable pricing in other markets. My other big guess is that the shorts figured out what was happening and that neither SNY or MNKD would talk about it until at least December when SNY may reveal they're ready to formally launch Afrezza with TV ads, perhaps an improved label, and more DTC marketing.
I hope I'm right and that the shorts will soon change their tune...
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Post by EveningOfTheDay on Dec 4, 2015 13:04:45 GMT -5
Here is what my father, a retired orthopedic surgeon and very heavily invested MNKD long, discovered from speaking with his friend, a local pharmacist: The relative wholesale cost of pen injected Humalog vs. Afrezza (which the pharmacist had never even heard of) was $1.12 for Humalog and $2.50 for Afrezza, comparing 4 units of each. Has anyone on this board investigated this issue? If the reported information is correct, is there any wonder why Afrezza is not being covered by insurance and why it isn't selling as we expected? We were told by MNKD's management that Afrezza was to be priced competitively with insulin pens. Why would they say that if they knew that Sanofi was intending to make it more than twice as expensive? Is Sanofi breaching its contractual obligation with MNKD by pricing Afrezza so high? I'm not looking for any speculation here, but if someone knows something relevant to this issue, I'd love to hear it. A number of us has been wondering about the exact same thing for quite a while, but I am afraid speculation is all you will get for why Afrezza is priced at such a premium when initially we were told it would be priced competitively. Neither Sanofi, obviously, nor Mannkind, not so obviously, have given any reasons for this or any indication that it will change any time soon. |
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Post by EveningOfTheDay on Dec 4, 2015 13:08:06 GMT -5
My other big guess is that the shorts figured out what was happening and that neither SNY or MNKD would talk about it until at least December when SNY may reveal they're ready to formally launch Afrezza with TV ads, perhaps an improved label, and more DTC marketing. I know you say at least December, but what makes you think we are to expect any change in December? Is it just because it is the end of the year? Or do you have other considerations. |
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Post by peppy on Dec 4, 2015 13:31:56 GMT -5
Here is what my father, a retired orthopedic surgeon and very heavily invested MNKD long, discovered from speaking with his friend, a local pharmacist: The relative wholesale cost of pen injected Humalog vs. Afrezza (which the pharmacist had never even heard of) was $1.12 for Humalog and $2.50 for Afrezza, comparing 4 units of each. Has anyone on this board investigated this issue? If the reported information is correct, is there any wonder why Afrezza is not being covered by insurance and why it isn't selling as we expected? We were told by MNKD's management that Afrezza was to be priced competitively with insulin pens. Why would they say that if they knew that Sanofi was intending to make it more than twice as expensive? Is Sanofi breaching its contractual obligation with MNKD by pricing Afrezza so high? I'm not looking for any speculation here, but if someone knows something relevant to this issue, I'd love to hear it. FYI: Somewhere I read the exact units of insulin per cartridge. I found this easily. Each TI cartridge containing 10 U or 20 U of insulin approximates 3 units or 6 units of sc
insulin, respectively. www.fda.gov/downloads/advisorycommittees/committeesmeetingmaterials/drugs/endocrinologicandmetabolicdrugsadvisorycommittee/ucm390865.pdf page 152 See the word approximates screencast.com/t/t7G737iH
1.2 units per 4 unit cartridge 2.4 units per 8 unit cartridge
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Post by bill on Dec 4, 2015 13:37:24 GMT -5
My other big guess is that the shorts figured out what was happening and that neither SNY or MNKD would talk about it until at least December when SNY may reveal they're ready to formally launch Afrezza with TV ads, perhaps an improved label, and more DTC marketing. I know you say at least December, but what makes you think we are to expect any change in December? Is it just because it is the end of the year? Or do you have other considerations. Several potential catalysts could make December the tipping point. The early adopters meeting in San Diego may be followed by the real SNY launch because there might now be too many people aware that SNY really is behind Afrezza. SNY's sitting on a lot of data from the two studies and the early adopters. At some point they're probably going to use for their EU / JPM applications, perhaps with improved labeling. In addition, improved insurance coverage for Afrezza and/or TV ads may happen in December, which would also signal SNY's commitment. I'm also hopeful that MNKD will hire their new CEO and he would be able to shed some light about what's been going on behind the scenes with SNY and TS partnerships. Finally, with Al as CEO its possible he might be able to close the TS partnership or two that had eluded Hakan before his demotion. If any of these happen, the shorts may decide they're risking too much to continue hammering the stock price and we'll see some spontaneous covering. |
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Post by factspls88 on Dec 4, 2015 13:41:02 GMT -5
I don't think SNY will run any advertising before the end of the year. I'm guessing they'd not want individuals starting Afrezza during the heavy holiday eating season - too much variability to blur results. Better to start after the New Year as individuals are getting a fresh start with their health. Also, ad budgets for 2016 will have been approved and ready to be enacted. The latter just my opinion based on my own corporate experience with ad spends.
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Post by EveningOfTheDay on Dec 4, 2015 13:44:45 GMT -5
Several potential catalysts could make December the tipping point. The early adopters meeting in San Diego may be followed by the real SNY launch because there might now be too many people aware that SNY really is behind Afrezza. SNY's sitting on a lot of data from the two studies and the early adopters. At some point they're probably going to use for their EU / JPM applications, perhaps with improved labeling. In addition, improved insurance coverage for Afrezza and/or TV ads may happen in December, which would also signal SNY's commitment. I'm also hopeful that MNKD will hire their new CEO and he would be able to shed some light about what's been going on behind the scenes with SNY and TS partnerships. Finally, with Al as CEO its possible he might be able to close the TS partnership or two that had eluded Hakan before his demotion. If any of these happen, the shorts may decide they're risking too much to continue hammering the stock price and we'll see some spontaneous covering. I am more inclined to think we will not see anything different until the end of the first quarter of 2016 or perhaps even until we are in the second quarter, but here it is hoping you are right and I an wrong. With aloha, |
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Post by kball on Dec 4, 2015 13:55:11 GMT -5
I don't think SNY will run any advertising before the end of the year. I'm guessing they'd not want individuals starting Afrezza during the heavy holiday eating season - too much variability to blur results. Better to start after the New Year as individuals are getting a fresh start with their health. Also, ad budgets for 2016 will have been approved and ready to be enacted. The latter just my opinion based on my own corporate experience with ad spends. Well, you have to factor in how long it will take patients to GET a Rx once they WANT an Rx. Ads could start right now and most new patients wouldn't start until January anyway jmho |
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Post by longinvstr on Dec 4, 2015 14:32:00 GMT -5
My recent posts hypothesize that SNY realized Al was right and decided to place a premium on the Afrezza price even though it hampered US insurance and sales in 2015--though somewhat mitigated by their Afrezza savings card. If I'm right they've been gathering enough data to justify that price all summer, two studies and early adopter data that they're now using to get better insurance coverage in 2016. I also suspect they'll use it to get approval, a better label, and favorable pricing in other markets. My other big guess is that the shorts figured out what was happening and that neither SNY or MNKD would talk about it until at least December when SNY may reveal they're ready to formally launch Afrezza with TV ads, perhaps an improved label, and more DTC marketing. I hope I'm right and that the shorts will soon change their tune... I'm with you; Afrezza pricing is rational IF the label gets changed. The net present value of future, worldwide sales over the next 5-10 years would be wildly affected. IMO, it's too soon to concede non-inferior w/ an equivalent price and much easier to adjust down (later) than to increase after label improvement. I hope (there it is again) that over the next 2-3 months, we'll have the assurances we need regarding additional MNKD (life) time to demonstrate & prove the value we all know is within. |
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Post by MnkdMainer (MM) on Dec 4, 2015 21:10:27 GMT -5
Thanks, all, for the replies. Unfortunately, I detect more speculation than anything else. With the company's current financial predicament and the beating taken by shareholders, I believe that management had a duty to its shareholders to correct its prior statement, as this has the effect of an ongoing misrepresentation to shareholders.
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Post by dreamboatcruise on Dec 4, 2015 23:09:44 GMT -5
Here is what my father, a retired orthopedic surgeon and very heavily invested MNKD long, discovered from speaking with his friend, a local pharmacist: The relative wholesale cost of pen injected Humalog vs. Afrezza (which the pharmacist had never even heard of) was $1.12 for Humalog and $2.50 for Afrezza, comparing 4 units of each. Has anyone on this board investigated this issue? If the reported information is correct, is there any wonder why Afrezza is not being covered by insurance and why it isn't selling as we expected? We were told by MNKD's management that Afrezza was to be priced competitively with insulin pens. Why would they say that if they knew that Sanofi was intending to make it more than twice as expensive? Is Sanofi breaching its contractual obligation with MNKD by pricing Afrezza so high? I'm not looking for any speculation here, but if someone knows something relevant to this issue, I'd love to hear it. Someone can correct me if I am wrong, but statements I am aware of from MNKD saying that were before the SNY deal was inked. No, I would highly doubt there is a minimum pricing in the agreement that SNY is ignoring. I would assume the pricing was set by the committee... of course SNY would win if there was a disagreement because the agreement does give them that power. From MNKD's prior statements we can presume that SNY either convinced MNKD of this strategy or simply used their override vote. I do agree that it would be nice if MNKD were to at least acknowledge that the pricing has turned out to be different even if they couldn't give the reasoning... but whose kidding whom, that ain't going to happen. Back in summer I thought the high price was because they felt they were in a strong enough position to quickly prove that they deserved a premium price. Of course now I tend to think everything I think must be wrong... but it's hard to figure out when to stop that circular reasoning. Though one note: The pens also require needle which are supposed to only be used once. Further, Afrezza price is not based on units so a 12u is not 3x a 4u. The overall cost for difference for payers is thus not likely to be as high as the original data for this thread would imply... but Afrezza is still meaningfully more. |
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Post by mssciguy on Dec 4, 2015 23:42:47 GMT -5
Here is what my father, a retired orthopedic surgeon and very heavily invested MNKD long, discovered from speaking with his friend, a local pharmacist: The relative wholesale cost of pen injected Humalog vs. Afrezza (which the pharmacist had never even heard of) was $1.12 for Humalog and $2.50 for Afrezza, comparing 4 units of each. Has anyone on this board investigated this issue? If the reported information is correct, is there any wonder why Afrezza is not being covered by insurance and why it isn't selling as we expected? We were told by MNKD's management that Afrezza was to be priced competitively with insulin pens. Why would they say that if they knew that Sanofi was intending to make it more than twice as expensive? Is Sanofi breaching its contractual obligation with MNKD by pricing Afrezza so high? I'm not looking for any speculation here, but if someone knows something relevant to this issue, I'd love to hear it. Someone can correct me if I am wrong, but statements I am aware of from MNKD saying that were before the SNY deal was inked. No, I would highly doubt there is a minimum pricing in the agreement that SNY is ignoring. I would assume the pricing was set by the committee... of course SNY would win if there was a disagreement because the agreement does give them that power. From MNKD's prior statements we can presume that SNY either convinced MNKD of this strategy or simply used their override vote. I do agree that it would be nice if MNKD were to at least acknowledge that the pricing has turned out to be different even if they couldn't give the reasoning... but whose kidding whom, that ain't going to happen. Back in summer I thought the high price was because they felt they were in a strong enough position to quickly prove that they deserved a premium price. Of course now I tend to think everything I think must be wrong... but it's hard to figure out when to stop that circular reasoning. Though one note: The pens also require needle which are supposed to only be used once. Further, Afrezza price is not based on units so a 12u is not 3x a 4u. The overall cost for difference for payers is thus not likely to be as high as the original data for this thread would imply... but Afrezza is still meaningfully more. the liquid insulins also have periodic serious quality issues which are dealt with as quietly as possibly, enough said. There's also been a great deal of speculation regarding price, involving potential issues like negotiation power with insurers, or relative pricing for other countries. Who the hail knows how Sanofi thinks? It's a different kind of company in some ways... I remember a decade ago they had this great weight loss product called rimonabant, great promise, but then there was some kind of leak about studies in mice where it turned them into jumping mice. They called them "popcorn mice" --- rimonabant was toast... BUT NOW... there is B.E.D. binge eating disorder... back to the future, give them speed to keep them thin  We'll know soon enough what's up. Afrezza will survive and thrive. Whether Sanofi is involved I don't care. They don't earn any love, not yet. |
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