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Post by Deleted on Dec 9, 2015 21:10:14 GMT -5
The only reason I think it's too early for TV is because of the fight patients are having getting ins coverage. I also think there's a concern with endo's being able to give advice on dosing. My wife's old endo was old school. She kept telling her she was fine with her 6.5 a1c , while I watched her get up with low bs 2 or 3 nights a week. The more educated I got I realized that this meant she was having seriously high bs for her to avg out with 6.5. I finally got her away. My point is, until ins covers it without a battle, and endo's understand it, it will be a very negative experience for patients. A TV ad, herding patients into these negative experiences, could cteate a bad state of awareness vs. NO state of awareness. I believe this underground awareness and positive experience was expected to be much greater by MNKD & SNY... It's not, so now what? Have went through the exact same things trying to get my dad on Afrezza... Doctors are fearful.. tired of all of the reps.. new drugs... they are really busy and adhere to standard protocol.. a routine they have gotten use to and don't seem to want to change ... which is give the least amount of injectable insulin possible, teach the patient to eat very low carb and exercise, and target an A1C below 7 . I have tried to explain Afrezza to them when I went with my dad, but they listen with half an ear, or ignore me all together. Most have never heard of it .. Yes, unless docs are educated, and their is better insurance coverage a big DTC campaign could backfire... My dad almost starves himself btw and cant lose weight on Novolog .. he is a big man.. 6'1" .. I feel so bad for him the way he has to live his life and I'm sure his metabolism is so screwed up from all of this... During his brief 5 month period on Afrezza he lost 24lbs.... It is the most amazing insulin there is...
The only thing I can think of that SNY could do now is to start a huge educational campaign across the country with Dr. Steven Edelman at the head... Seminars and such.. as well as sending out a large group of better educated reps... I am hoping that is what this meeting in San Diego may have been a precursor to.. They could even put together a video featuring early adopters and Dr Edelman that could be distributed to hospitals etc.. My concern for the past year has always been whether or not MNKD had a financial plan for all of this.. They just have to .. As others have stated these people understand the pharma business .. most certainly they must have had some idea how long this would take, these people aren't stupid ... look how far they have come already just trying to bring this to market....
Does your dad's doc an endo? On board with Afrezza or your dad is his first patient?
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Post by sweedee79 on Dec 9, 2015 21:31:35 GMT -5
@ iam2sekc4u2002 ... My dad has only seen a GP for the last 20 years up until we started to pursue Afrezza... The GP referred us to an endo in a larger city(200K people). This endo had just visited with some SNY reps 2 weeks prior.. My dads A1C was 7.6 which is an acceptable range for someone his age so the endo tried to talk us out of it, but my dad insisted on Afrezza. So reluctantly the endo prescribed it.
It took us 5 months to get him on it after all of the hassle .. waiting for appointments... spirometry etc .. getting insurance approval .. He started in August. He felt better on Afrezza, more energy.. lost weight, but the dose wasn't high enough.. Docs tried to prescribe it the same way they prescribe Novolog.(don't understand). but in my dad's case he required a larger dose .. He was OK as long as he strictly watched his carbs... however one of the benefits of Afrezza is that you can take a larger dose without so much fear of going hypo... and not having to watch so closely what you eat.. it allows for a more normalized life... We couldn't get the docs to raise his dose.. so frustrating.. then as the final blow came, his insurance dropped Afrezza from its formulary effective 1/2016 .. He just got tired of the hassle .. and decided to wait until Afrezza is more established .. He was the only patient on Afrezza in one of the largest hospitals in the area...
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Post by Deleted on Dec 9, 2015 21:40:13 GMT -5
@ iam2sekc4u2002 ... My dad has only seen a GP for the last 20 years up until we started to pursue Afrezza... The GP referred us to an endo in a larger city(200K people). This endo had just visited with some SNY reps 2 weeks prior.. My dads A1C was 7.6 which is an acceptable range for someone his age so the endo tried to talk us out of it, but my dad insisted on Afrezza. So reluctantly the endo prescribed it.
It took us 5 months to get him on it after all of the hassle .. waiting for appointments... spirometry etc .. getting insurance approval .. He started in August. He felt better on Afrezza, more energy.. lost weight, but the dose wasn't high enough.. Docs tried to prescribe it the same way they prescribe Novolog.(don't understand). but in my dad's case he required a larger dose .. He was OK as long as he strictly watched his carbs... however one of the benefits of Afrezza is that you can take a larger dose without so much fear of going hypo... and not having to watch so closely what you eat.. it allows for a more normalized life... We couldn't get the docs to raise his dose.. so frustrating.. then as the final blow came, his insurance dropped Afrezza from its formulary effective 1/2016 .. He just got tired of the hassle .. and decided to wait until Afrezza is more established .. He was the only patient on Afrezza in one of the largest hospitals in the area... Did they learn at least now how to prescribe and how Afrezza works / is capable of. You can atleast email them afrezza pro. Com anonymously .., may be they will look into it . Hope
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Post by gamblerjag on Dec 9, 2015 21:44:28 GMT -5
sweede.. sorry for your dad.. I know it was working well for him.. shame.
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Post by gamblerjag on Dec 9, 2015 21:45:47 GMT -5
agree.. Matt's "fingers crossed" is right up there with Hakan's "come make us an offer"..
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Post by purge on Dec 9, 2015 21:59:30 GMT -5
So we are down to crossing fingers? That is worse than being down to having hope. Crossing fingers is ten times worse than hope. Until this management team comes clean once and for all and stop being evasive, opaque, and deceitful with wall street and retail shareholders, I am convinced we are worse off than any of us could ever believe. This madness with the silence, evasiveness, opaque, jibberish responses questions from retail shareholder and wall street, the more I am being convinced that the shorts arguments and the short thesis was right all along. It is everything at this point. I have had it with this management team. I wish I went away after Al promised us "Minimal dilution." All we are asking for is a frank discussion and transparency. At this point, I have lost all confidence.
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Post by mssciguy on Dec 9, 2015 22:09:00 GMT -5
So we are down to crossing fingers? That is worse than being down to having hope. Crossing fingers is ten times worse than hope. Until this management team comes clean once and for all and stop being evasive, opaque, and deceitful with wall street and retail shareholders, I am convinced we are worse off than any of us could ever believe. This madness with the silence, evasiveness, opaque, jibberish responses questions from retail shareholder and wall street, the more I am being convinced that the shorts arguments and the short thesis was right all along. It is everything at this point. I have had it with this management team. I wish I went away after Al promised us "Minimal dilution." All we are asking for is a frank discussion and transparency. At this point, I have lost all confidence. Funny you should mention, "confidence" .. check out the NYT, they have a great analysis today (or maybe yesterday, I read it online except for Sunday) -- did you know that the term "confidence game" came from a guy a couple hundred years ago who would say to passerbys on the street, "Do you have enough confidence in me to lend your watch until tomorrow" --- and he did this over and over and over. I think you have it very very wrong about MNKD being a confidence game. Like many I am down tens of thousands, it sucks, it's painful, and there are some (hopefully temporary) creases in my face.. but go to clinicaltrials.gov or the equivalent in the EU, go to uspto or wipo, come on man, there are also tens of thousands of man hours (okay sorry people hours) invested in patents, intellectual property... Tomorrow I will graze the published patent data and put it in my blog for global distribution. NOTE that pending patents are secret, so there is this huge time lag... and those crack addicts (af??--- no, judging by his waistline, he swapped that for food and alcohol addiction) very long time lag between secrecy and negotiation and anything that shows up on uspto and wipo. AND..... if it's really good, you keep it a trade secret
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Post by sweedee79 on Dec 9, 2015 23:05:16 GMT -5
@ iam2sekc4u2002 ... My dad has only seen a GP for the last 20 years up until we started to pursue Afrezza... The GP referred us to an endo in a larger city(200K people). This endo had just visited with some SNY reps 2 weeks prior.. My dads A1C was 7.6 which is an acceptable range for someone his age so the endo tried to talk us out of it, but my dad insisted on Afrezza. So reluctantly the endo prescribed it.
It took us 5 months to get him on it after all of the hassle .. waiting for appointments... spirometry etc .. getting insurance approval .. He started in August. He felt better on Afrezza, more energy.. lost weight, but the dose wasn't high enough.. Docs tried to prescribe it the same way they prescribe Novolog.(don't understand). but in my dad's case he required a larger dose .. He was OK as long as he strictly watched his carbs... however one of the benefits of Afrezza is that you can take a larger dose without so much fear of going hypo... and not having to watch so closely what you eat.. it allows for a more normalized life... We couldn't get the docs to raise his dose.. so frustrating.. then as the final blow came, his insurance dropped Afrezza from its formulary effective 1/2016 .. He just got tired of the hassle .. and decided to wait until Afrezza is more established .. He was the only patient on Afrezza in one of the largest hospitals in the area... Did they learn at least now how to prescribe and how Afrezza works / is capable of. You can atleast email them afrezza pro. Com anonymously .., may be they will look into it . Hope I am educating everywhere I can... I didn't think of Afrezza Pro... thank you. I don't think the docs are interested in changing based on anything I say.. But my dad has a diabetes coordinator who he sees and spends more time with than the docs... She is an RN. and is way more knowledgeable, open minded and helpful when it comes to Afrezza. When my dad has an issue we call her and she talks to the docs.. I gave her Sams twitter name so she could go there and see what early adopters are saying. I also stress my concerns to her.. she says docs are slow to change sometimes especially when it comes to a new therapy which strays from their standard way of doing things.... But she has been on our side which I appreciate very much .. So there is hope .. It is just that SNY and MNKD need to figure out how to get this moving faster so that patients don't have to go through this... most would not.. It is only because I have knowledge of it that this went as far as it did... other patients will not.. they will let their docs talk them out of it.. same as the endo tried to talk us out of it ..
I know this isn't very encouraging... but as investors I think it is important to know what is happening .. I am sure that SNY knows this as they are in contact with patients via their websites etc... and hopefully are coming with a full scale plan to attack this asap... The point being .. ducks need to be in a row before DTC ads chase patients to the docs.. I post our story on Twitter.. and to SNY ..
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Post by mssciguy on Dec 9, 2015 23:11:52 GMT -5
Did they learn at least now how to prescribe and how Afrezza works / is capable of. You can atleast email them afrezza pro. Com anonymously .., may be they will look into it . Hope I am educating everywhere I can... I didn't think of Afrezza Pro... thank you. I don't think the docs are interested in changing based on anything I say.. But my dad has a diabetes coordinator who he sees and spends more time with than the docs... She is an RN. and is way more knowledgeable, open minded and helpful when it comes to Afrezza. When my dad has an issue we call her and she talks to the docs.. I gave her Sams twitter name so she could go there and see what early adopters are saying. I also stress my concerns to her.. she says docs are slow to change sometimes especially when it comes to a new therapy which strays from their standard way of doing things.... But she has been on our side which I appreciate very much .. So there is hope .. It is just that SNY and MNKD need to figure out how to get this moving faster so that patients don't have to go through this... most would not.. It is only because I have knowledge of it that this went as far as it did... other patients will not.. they will let their docs talk them out of it.. same as the endo tried to talk us out of it .. sweedee79 you are such an authentic and caring soul. Your father raised a good daughter. Best wishes to you. You will never forget or regret being so kind. Good for him, good for you (although it may not be obvious yet).
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Post by boytroy88 on Dec 9, 2015 23:18:21 GMT -5
I will,,,, once he sees and hears my wife's results and becomes a fan. Does your wife use a cgm? If so your endo will see the Afrezza capability in a week .. Lol I can only imagine ... Or inhale while endo is around and see the sugar surfing I'm sorry...I must of missed something. You did say that your wife approached the endo back in April. I'm not very well versed in this but how long does it take before the patients sees results? It's December now. Does it take more than 8 months? I'm not trying to nitpick but I'm just confused.
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Post by cfield23 on Dec 9, 2015 23:27:16 GMT -5
Nice one kball. I'll bring the coffee to the soup line, I'm practically there as well. I don't have any stats to bare this out, but it is investments like Mnkd that show why retailers rarely combine any sizable volume (relative I know) holding thru extreme up and downs over long periods of time, with bounces and double take downs, then radical take and hold downs for months, and then finally back up big and often up very big. Only the extremely large money can afford to do this consistently and ride out the entire curve especially as the timing is all over the map. If these large investors are the "house" then the analogy fits that house usually wins, LB notwithstanding. All I know is it takes a lot of money to make a lot of money, the very very rare large retail timing play notwithstanding. Stating the obvious for many here, but this is yet another example. For those still long, I believe this is about to finally flip and the profits will be large (per capita) as they should be. Just looking at the the entries by tutes were up at $3-$4-$5. They must be about ready to flip the switch and ride this up as they harmonize with a catalyst, which call me cynical, but believe they have information on that we don't have. Info is power, money is power, time to return is power. But with all of that, this is one of the most unique opportunities I've seen in a long time. Many financially oriented power brokers have this wrong. No way this fails because of that. Not this one. It has a solid first year of patient real world success, and has a ginormous potential patient base worldwide. This for Afrezza, TS apps notwithstanding. Sometimes it is useful to repeat some obvious things during these trying times. Maybe I depressed more than inspire, guess it's all relative. :-) This is an awesome post.
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Post by monger on Dec 10, 2015 0:34:39 GMT -5
Here is Matt's reply, which was prompt:
Michael,
I agree with all you have said, and have been pushing for the same. I was hoping for some CEO news that might provide an excuse, particularly since the update should come from the CEO, not the CFO. Fingers crossed, we can do something soon.
Matt
Take it for what its worth, which is probably not much. My take is that hopefully very soon we will have some news on the CEO front, and that Matt is pushing to get more info out. They are being incredibly cautious about any info being released; since Matt stated that he has been pushing for it, it sounds like Al and the Board are keeping a very tight lid on info. I really do appreciate Matt taking the time to reply. I parsed Matt's email through a very expensive weather prediction program on a Cray Super Computer to determine whether this forecast called for thunderbolts and lightning (very, very frightening!), was entirely comprised of hot air, or indicated sunny weather ahead. The program said that clearly a new CEO had not been appointed yet, and that Matt was hoping that a CEO announcement would occur soon because he is not directly involved in the search and has no knowledge of the progress being made. That's why he can only hope; he believes that it would be reasonable for such an event to happen soon, and he's impatient for it, even though he's not in the loop on this matter. However, he believes that when a new CEO is appointed, it might provide an excuse for the release of additional information. Based on moderate barometric readings, the program was unable to predict whether the update Matt alluded to indicated a favorable high pressure area, or an unfavorable low pressure area. But we do know, based on his statement that the update should come from the CEO and not the CFO, that this known to Matt update is above his pay grade. That suggests to me that the announcement is very significant, and that Matt knows what it is, and possibly the time frame associated with the announcement. This is in addition to his agreement that telling everyone the details of the funds raised during the recent TASE, um, experiment, would be a good idea. The software didn't like the statement, "Fingers crossed, we can do something soon," because a), the software has no fingers to cross and doesn't understand the concept, and b) because extra spaces make the program nervous. They think they might indicate sloppy typing indicative of a mental lapse caused by stress or heavy drinking, perhaps just a simple transcription error, or possibly missing code, like "we can do WTF, god knows what, well I hope something soon". Or maybe those spaces are actually nulls and there has been a SQL injection attack of some kind. However, the software believes that this is the crux of the communication and can only be interpreted by a human with various mental errors and impaired judgment, such as confirmation bias, negative affect disorder, and other delusional and possibly magical thinking, and therefore not predicted with as much certainty as to whether you need your umbrella tomorrow. The software mentioned something about butterflies flapping their wings, but said it boils down to one of two binary conditions. If you're negative and paranoid, this will be interpreted to mean that Matt hopes to god that someone figures out something soon before the plane hits the ground because the altimeter is spinning like a top. How bleak can you be? This could mean the end of the partnership, some terrible and unknown to us and off the wall financial problem that is preventing Al from putting more money in the company, or something else so dire, it makes the hair on the back of your neck stand up. Zombies, maybe. The software gives that a 30% probability based on semantic analysis, and the fact that the software does not like Zombie Literature. Or Vampire Lit. If you're overwhelmingly positive in the face of facts that look like FUD but might still be facts but you don't think so even though some of the FUD of months ago is clearly now fact, but maybe that was accidental precognition disguised as FUD, "do something" will be interpreted to mean that they will find a way to do something to get the information out, that they can't announce now. This information could be positive and perhaps unexpected results from some trials, or it could be a new Technosphere partnership that is still under non-disclosure, or it could be some really powerful launch plans that Sanofi has but won't execute for another 6 months and doesn't want anyone talking about. In that case, Matt hopes that can at least say Sanofi is in this for the long haul, and they have a great plan that has been discussed in detail and that involves pouring a lot of money into the launch, but we're not going to go into details except to say it won't happen until Q3 or something. Or it might be something that hasn't even been discussed on this board, although that is a pretty small set of data. The software gives this positive outcome a 70% probability. Personally, my immediate reaction was overwhelmingly positive to his short email, and I found it odd that there were a number of very negative reactions to it. Anyone who gambles, er, invests should understand how absolutely limited he is in what he can say. He definitely left ambiguity in his statement, so I don't think he can be accused of spilling anything since there is disagreement about what the heck he even meant. I'm still long and not going anywhere, although if I had a time machine yeah, I'd have been "long" gone and waiting with all cash for the bottom. Given my belief that there is something very positive on the horizon, an announcement already known to certain people like Matt, the problem is how far away that announcement is. I'm definitely not expecting it any time soon. Oh, and the program says the weather forecast for Danbury tomorrow is a high of 59, a low of 39, and--is this a surprise?--partly sunny. Or maybe partly cloudy. Like the direction of MNKD, I can't tell which.
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Post by EveningOfTheDay on Dec 10, 2015 1:36:32 GMT -5
I parsed Matt's email through a very expensive weather prediction program on a Cray Super Computer to determine whether this forecast called for thunderbolts and lightning (very, very frightening!), was entirely comprised of hot air, or indicated sunny weather ahead... ...Oh, and the program says the weather forecast for Danbury tomorrow is a high of 59, a low of 39, and--is this a surprise?--partly sunny. Or maybe partly cloudy. Like the direction of MNKD, I can't tell which.
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Post by EveningOfTheDay on Dec 10, 2015 1:55:40 GMT -5
OK, so I have been thinking a bit about Matt's beat-around-the-bush answer... no, I am afraid I do not have any insight to share wit you guys. Actually the best insights might have come from the supercomputer Monger consulted, but then again might have not.
However, if I am getting this straight, Matt is admitting that there are potential news that should be shared, but only by the CEO. Of course Hakan would have been able to do this, but he conveniently (for the company) resigned, apparently, just days before he could give us this news. Of course we do have Alfred Mann as the interim CEO, but, also apparently, this news are either so good or so bad, or perhaps so inconsequential, nobody knows as of yet, that can only be delivered to us by no one but the true and only future CCCCCC EEEEEE OOOOOOO, so I guess, once again, we, the retail shareholders, are out of luck.
Beyond this, the only thing I can say is that either Matt thinks it is cute to pretend sympathizing with us, the little people, in an extremely patronizing way, or even worst, he is so callous and detached he does not even realize how patronizing his replay sounds.
Farther beyond that all I can really say with any level of certainty is that I really really need a vacation from all this.
With much aloha to you all,
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Post by jpg on Dec 10, 2015 2:45:05 GMT -5
Agree. This is absurd. Mannkind does have a CEO and he happens to be the biggest shareholder and fired/ resigned the previous CEO.
Absurd.
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