Related History worth a review

[jlaw277]

FWIW 

Helpful to look back at Minimed and look for parallels that can be drawn:

articles.latimes.com/1995-08-08/business/fi-32818_1_infusion-pump

www.nytimes.com/1999/02/11/business/stalking-wild-glucose-level-minimed-chief-aims-bring-big-changes-diabetes.html?pagewanted=1

Also worth reviewing is Insulet's IPO prospectus where you can see that DeSisto joined as CFO in 2001, became CEO in 2003.  Even at year end 2005, they still only had $50,000 in revenues but a lot of expenses as they progressed developing the Omnipod system.  When DeSisto eventually left the company, they had a market cap of approximately $2 billion.  Mission accomplished.  

Between Al Mann and DeSisto, in many ways they have been here before, which gives some credence to the idea that they know how to handle this most recent setback and the many challenges it presents.  

Insulet IPO Prospectus
www.sec.gov/Archives/edgar/data/1145197/000095013507002552/b63591rde424a.htm#108

From the Insulet Business Overview:

Since inception, we have devoted substantially all of our efforts to designing and developing the OmniPod System, raising capital and recruiting personnel. As a result, we were considered a development stage company pursuant to Statement of Financial Accounting Standards (“SFAS”) No. 7, Accounting and Reporting by Development Stage Enterprises, through December 31, 2005. The year 2006 is the first year during which we were an operating company and were no longer in the development stage. In October 2005, we shipped our first commercial OmniPod System. Since October 2005, in order to align the demand for the OmniPod System with our capacity to manufacture the OmniPod, we have engaged in limited marketing efforts focused in the Eastern United States and with some key diabetes practitioners, academic centers and clinics elsewhere in the United States. Our total revenues were $3.7 million for the year ended December 31, 2006. As of March 31, 2007, we have approximately 1,750 patients using the OmniPod System in the United States.

At present, the expansion of our business is constrained by our current capacity to manufacture the OmniPod insulin infusion device, and our primary near-term goal is to expand our manufacturing volume for OmniPods. Currently, the sale price of the OmniPod System is not sufficient to cover our direct manufacturing costs. We are in the process of completing the construction, testing and installation of automated manufacturing equipment to be used in the assembly of the OmniPod in order to increase our manufacturing volume. Increased volumes will allow for volume purchase discounts to reduce our raw material costs and improve absorption of manufacturing overhead costs.

During 2008, we expect to complete the planned automation of our existing manufacturing line, which is designed exclusively for the manufacture of the OmniPod, and begin construction of a second manufacturing line. Pending construction and installation of the remaining automated manufacturing equipment that we plan to use, we are manually performing these steps in the manufacturing process, which limits our ability to increase our manufacturing capacity and decrease our per unit cost of goods sold, thereby causing us to incur negative gross margins. We are exploring alternative site manufacturing capabilities both domestically and abroad. No assurances can be given that we will successfully complete the planned automation of our existing manufacturing line or subsequent lines in the future or otherwise reduce the per unit cost of manufacturing the OmniPod. Failure to do so would limit our production capacity and not allow us to achieve per unit cost improvements, which could severely constrain our ability to achieve profitability.

Additionally, as a medical device company, reimbursement from third-party payors is an important element of our success. If patients are not adequately reimbursed for the costs of using the OmniPod System, it will be much more difficult for us to penetrate the market. As of March 31, 2007, we had entered into contracts establishing reimbursement for the OmniPod System with national and regional third-party payors covering an estimated 92 million lives, and we believe that substantially all of the units sold have been reimbursed by third-party payors, subject to applicable deductible and co-payment amounts. As we expand our sales and marketing focus and increase our manufacturing capacity, we will need to maintain and expand available reimbursement for the OmniPod System.

Since our inception in 2000, we have incurred losses every quarter. In the year ended December 31, 2006, we incurred a net loss of $36.0 million compared to a net loss of $21.6 million for the same period in 2005. As of December 31, 2006, we had an accumulated deficit of $102.0 million. We have financed our operations through the private placement of equity securities and secured indebtedness. As of December 31, 2006, we had $30.0 million of secured debt outstanding, and, since inception, we have received net proceeds of $119.5 million from the issuance of redeemable convertible preferred stock.

Our long-term financial objective is to achieve and sustain profitable growth. Our efforts in 2007 will be focused primarily on expanding our manufacturing capacity, reducing our per unit production costs and expanding our sales and marketing efforts for the OmniPod System. The expansion of our manufacturing capacity will allow us to increase production volumes which will help us to achieve lower material costs due to volume purchase discounts and improve the absorption of manufacturing overhead costs. Achieving these objectives is expected to require additional investments in manufacturing and additional hiring of sales and administrative personnel with the goal of increasing our market penetration. We believe that we will continue to incur net losses in the near term in order to achieve these objectives, although we believe that the accomplishment of these combined efforts will have a positive impact on our financial condition in the future.

[jlaw277]

Seeing another person's post regarding the Minimed sale to Medtronic, the total transaction value was $3.7 billion.

articles.latimes.com/2001/may/31/business/fi-4587

[kbrion77]

Jan 8, 2016 8:56:25 GMT -5 jlaw277 said:

Seeing another person's post regarding the Minimed sale to Medtronic, the total transaction value was $3.7 billion.

articles.latimes.com/2001/may/31/business/fi-4587

And Medtronic basically paid $420MM for MRG (Artificial Pancreas) and scrapped it.

[mnholdem]

The fact that Duane DeSisto has some serious experience in negotiating reimbursements with third-parties payers may be a much bigger deal than many shareholders realize, IMHO.

[jlaw277]

Jan 8, 2016 9:35:36 GMT -5 mnholdem said:

The fact that Duane DeSisto has some serious experience in negotiating reimbursements with third-parties payers may be a much bigger deal than many shareholders realize, IMHO.

For those that didn't want to dive into the Insulet prospectus (probably a wise move) there is an interesting section starting on page 52 called Our Strategy which details things of real relevance to where MNKD stands today:

Low up-front cost and pay-as-you-go pricing structure. The OmniPod System’s unique patented design and proprietary manufacturing process have enabled us to provide CSII therapy at a relatively low up-front investment without removing any of the functionality of conventional insulin pumps. Whereas current list prices of conventional insulin pumps require an up-front investment of $5,000 to $6,500 and ongoing monthly supplies cost up to $200, the current list price of our Starter Kit, which includes the PDM, two OmniPods, the OmniPod System User Guide and our Interactive Patient Training CD, is $800, and the OmniPods, each worn for up to three days, have a list price of $34.50 per unit. We believe this pay-as-you-go pricing model significantly reduces the risk of investing in CSII therapy for third-party payors and makes CSII therapy much more accessible for people with insulin-dependent diabetes.

Our Strategy

Our goals are to expand the use of CSII therapy and to become a leading provider of CSII technology for people with insulin-dependent diabetes. We believe that the OmniPod System’s innovative design and ease-of-use will significantly expand the pool of candidates and the market for CSII therapy and make it the CSII therapy system of choice for healthcare professionals, people with insulin-dependent diabetes and third-party payors. The principal elements of our business strategy include:

• Promote awareness of the OmniPod System among thought leaders, key academic centers, diabetes clinics and top insulin-prescribing healthcare professionals. We plan to use our healthcare professional sales force to cultivate relationships with thought leaders, key academic centers, clinics and top insulin-prescribing healthcare professionals throughout the United States to help establish market acceptance of the OmniPod System. We believe that early acceptance of the OmniPod System by thought leaders and key recommenders will be important in establishing the OmniPod System as the system of choice for CSII therapy. We also plan to use our healthcare professional sales force to educate the broader referral base of physicians, certified diabetes educators and other clinicians focused on diabetes about the advantages of the OmniPod System. To date, in order to align the demand for the OmniPod System with our capacity to manufacture the OmniPod, we have only engaged in limited marketing efforts focused in the Eastern United States and with some key diabetes practitioners, academic centers and clinics elsewhere in the United States. As we further automate and expand our manufacturing capabilities, we plan to expand our sales and marketing efforts across the United States and internationally, and commence broader direct-to-consumer campaigns. We also intend to sponsor marketing studies seeking to demonstrate certain aspects of the efficacy of the OmniPod System.

• Promote awareness and trial experience of the OmniPod System among people with insulin-dependent diabetes. As our production capability expands, we plan to engage in an increasing number of promotional activities directly targeted to people with insulin-dependent diabetes. Given the OmniPod System’s discreet and easy-to-use design, we believe we have a substantial advantage over our competitors in promoting the lifestyle benefits of our solution to patients. We have recently begun efforts to promote the OmniPod System directly to people with insulin-dependent diabetes through online direct-to-consumer channels and events. We also encourage diabetes patients to try the OmniPod System through our Patient Demonstration Kit Program, which offers them the opportunity to experience the lifestyle and other benefits of the OmniPod System before making a purchase. We believe that this program is unique to the OmniPod System and will significantly differentiate the OmniPod System from conventional insulin pumps.

• Expand third-party payor coverage for the OmniPod System. Third-party payor reimbursement is an extremely important determinant of patient use of CSII therapy. As of March 31, 2007, we had entered into contracts establishing reimbursement for the OmniPod System with national and regional third-party payors covering an estimated 92 million lives. These contracts provide reimbursement in each of the 26 states in which we currently sell the OmniPod System. To date, we have primarily focused on negotiating contracts with private insurers with a presence in the areas where we have concentrated our initial sales and marketing efforts, which has been in the Eastern United States. We plan to continue to work with additional third-party payors within these areas and, as we broaden our sales and marketing focus in the remainder of the United States, to enter into further coverage contracts.

• Enhance our automated manufacturing capabilities to increase capacity and reduce per unit production costs. We are currently producing the OmniPod on a partially automated manufacturing line at our Bedford, Massachusetts facility. During 2008, we intend to complete the planned automation of our existing line and begin construction of a second manufacturing line. We are also exploring alternative site manufacturing capabilities in Asia to ensure that we have sufficient capacity to meet future product demand and are able to achieve appropriate cost efficiencies as we grow our business. For example, to that end, we recently entered into a contract manufacturing agreement with a subsidiary of Flextronics International Ltd. in China for the supply of a sub-assembly of some of the OmniPod’s components. We believe that the automation of our manufacturing process will substantially reduce our per unit cost of goods sold, leading to positive gross margins from a current negative level, and enable us to significantly increase our production capacity, while maintaining high levels of quality, reliability and product safety.

• Continue research and development efforts to enhance the features of the OmniPod System and reduce per unit production costs. We plan to continue our research and development efforts to maintain our technology leadership in CSII therapy and reduce production costs of the OmniPod System. Our current research and development efforts are focused primarily on improving the functionality and design of the OmniPod System as well as developing a new OmniPod System that incorporates continuous glucose monitoring technology. We have partnered with Abbott Diabetes Care Inc., a global healthcare company that develops continuous glucose monitoring technology, to develop a product that will integrate the receiver portion of Abbott’s continuous glucose monitor, the FreeStyle Navigator, with the OmniPod System PDM. The FreeStyle Navigator is currently pending FDA approval and is not available on the market. We also plan to pursue the use of our proprietary OmniPod System technology for the delivery of other medications for the treatment of conditions other than diabetes.

• Maintain a customer-focused approach. The easy-to-use patented design and straightforward user interface of the OmniPod System and our efficient and effective customer training programs are intended to reduce the amount of time and effort associated with training and supporting patients in the use of the OmniPod System. We also provide direct technical support by telephone and Internet 24 hours a day, 7 days a week to patients, physicians and diabetes educators to promote safe and successful use of the OmniPod System. We certify healthcare professionals to train patients on the OmniPod System and provide patients with state-of-the-art training tools. In addition, we have a team of in-house insurance specialists who assist physicians and patients in obtaining reimbursement from third-party payors. We believe that our customer-focused approach is critical to facilitating rapid conversion of new customers and creating life-long relationships with our existing customers.

[jlaw277]

Al Mann - Q4 2007 Conference Call -

"As a result of these differences and benefits, we believe physicians will be attracted to Technosphere Insulin especially because of its ease of use and lack of any need for complex training as compared to some other therapies. After all, most type 2 diabetes patients are managed by primary care physicians and these physicians are in need of simpler insulin therapy that requires less patient training and results in lower incidences of side effects such as hypoglycemia.

The question and doubts about the market remind me of the skepticism and lack of understanding when I was rolling out insulin pumps at [Minimed]. That market has become a $1.5 billion business, quite large for medical devices.

Being a pioneer is never easy and this is especially so when one needs to convert an existing and well established market because it is natural for people to resist change, but change is necessary if we are going to bring people into the normal range of HbA1c. And we must succeed if we are to avoid the ravages of the diabetes epidemic.

In order to facilitate the launch of Technosphere Insulin we plan to create a decision infrastructure support group to educate the broad medical community and make the transition easier and smoother. We are already developing our science supporting launch program. We are also implementing a program of scientific publications and we are launching medical education and opinion leader outreach programs." - Al Mann - MNKD Quarterly Call 3/2008

==============
A buyout or quick new partnership would be an easy way out of the current situation, but what should be considered more seriously is what happens if those options are not quickly forthcoming. Looking at Al's experience at Minimed and Duane's experience at Insulet, the option outlined by Al in the preceding quotation is a likely near term measure. It is a scalable and focused approach that is relatively low in cost when compared with a 1,000 person salesforce where the average take-home is $150,000.

What the company needs to demonstrate to the market more than anything is traction and due to Sanofi's actions thus far we have a relatively low bar to grow from. If they can show some positive momentum then additional capital might be available whether it is from the ATM, Deerfield's of the world, a strategic or even Al. According to Griffin, the company has enough cash to survive 2016 which gives some flexibility. Given that the new CEO has been in a somewhat similar situation before, it might be worthwhile to take a look at his playbook from the past. Here is another excerpt from the Insulet prospectus starting on page 57. Keep in mind that the Sales & Marketing costs for 2006 were $6.2 million:

Sales and Marketing

Our sales and marketing effort is focused on generating demand and acceptance of the OmniPod System among healthcare professionals, people with insulin-dependent diabetes and third-party payors. Our marketing strategy is to build awareness for the benefits of the OmniPod System through a wide range of education programs, patient demonstration programs, support materials and events at the national, regional and local levels.

As of March 31, 2007, we had a sales and marketing team of 40 employees, which includes 20 employees in training and customer support. To date, in order to align the demand for the OmniPod System with our capacity to manufacture the OmniPod, we have only engaged in limited marketing efforts focused in the Eastern United States and with some key diabetes practitioners, academic centers and clinics elsewhere in the United States. As we further automate and expand our manufacturing capabilities, we plan to expand our sales and marketing efforts across the United States and internationally, and commence broader direct-to-consumer campaigns.

Healthcare professional focused initiatives. We believe that healthcare professionals play an important role in selecting patients for CSII therapy and educating them about CSII technology options. As of March 31, 2007, our healthcare professional sales force consisted of one Key Account manager and eight territory managers, who call on endocrinologists, internal medicine physicians focused on diabetes and certified diabetes educators. As of March 31, 2007, our territory managers were supported by 11 clinical specialists who certify healthcare professionals to train patients on the OmniPod and who provide ongoing clinical expertise and support during initial customer training. Our marketing to healthcare professionals focuses on positioning the OmniPod System as an innovative continuous insulin delivery system that makes CSII therapy easier to recommend. We plan to augment our healthcare professional focused marketing efforts with market studies to assess various aspects of the OmniPod System’s functionality and relative efficacy, which we believe will assist us in generating additional patient demand for the OmniPod System among the insulin-dependent diabetes population.

Some of our recent healthcare professional focused marketing initiatives include:

• the Key Account/Key Opinion Leader Program through which we cultivate relationships with industry thought leaders, key academic centers, clinics and top insulin-prescribing healthcare professionals throughout the United States in order to establish market acceptance of the OmniPod System;

• presentations and product demonstrations at key industry meetings including the American Diabetes Association Scientific Sessions, the American Association of Diabetes Educators Annual Meeting and the Diabetes Technology Meeting; and

• the OmniPod System 30-Day Experience Program, through which clinicians can place their first patient on the OmniPod System for 30 days at no charge to gain personal experience with the OmniPod System and experience the ease of training patients on the OmniPod System.

Patient focused initiatives. We sell the OmniPod System directly to patients through referrals from healthcare professionals and through patient leads generated through our promotional activities. Our marketing to patients focuses on positioning the OmniPod System as an innovative continuous insulin delivery system that makes diabetes a smaller part of life and strongly promotes the lifestyle benefits afforded by the OmniPod System.

Some of our recent patient focused marketing initiatives include:

• The Office Demonstration Kit Program, through which we provide healthcare professionals with an OmniPod System Starter Kit to enable them to demonstrate the OmniPod System to patients in the office.

• Our Patient Demonstration Kit Program that provides patients with a free trial of the OmniPod System by wearing a saline-filled OmniPod for three days and using a virtual PDM. This unique program enables potential customers to experience the lifestyle benefits, virtually pain-free insertion and ease of use of the OmniPod System before making a purchase. Given the unique design of the OmniPod System, we believe that we are the only manufacturer of CSII therapy devices capable of providing this type of program and believe it will provide us with a substantial advantage in marketing to patients that are considering or skeptical about CSII therapy.

• Our website, www.MyOmniPod.com, including PodWatch, our online newsletter, both of which have experienced substantial traffic since we launched the OmniPod System. Our website has been nominated for multiple design awards and includes product photography, animated product demonstrations, video of the OmniPod System in use and customer testimonials.

• Presentations and product demonstrations at our own OmniPod System consumer information sessions and other patient-focused diabetes conferences, events and support groups.

• Promotional materials distributed directly from us or through the healthcare professional highlighting the benefits of the OmniPod System.

Marketing research. In addition to our initiatives focused on healthcare professionals and patients, we also plan to continue evaluating the benefits of the OmniPod System in marketing research efforts to assess certain aspects of the efficacy of the OmniPod System.

Some potential studies include:

• an evaluation of the OmniPod System by various user sub-populations, such as very young pediatric patients, women with gestational diabetes and cancer patients undergoing chemotherapy;

• an evaluation of the OmniPod System in the hospital setting, both for diabetes patients and for glucose control in non-diabetic patients after surgery, transplantation, trauma and other circumstances in which normal metabolic function may be disrupted; and

• our participation in studies funded by the Juvenile Diabetes Research Foundation concerning the development of an artificial pancreas.

Training and Customer Support

Given the chronic nature of diabetes, we believe that thorough training and ongoing customer support are important to developing a long-term relationship with the patient. We believe that it is crucial for patients to be trained as the experts in the management of their diabetes. At the same time, we believe that providing reliable and effective customer support reduces patients’ anxiety and contributes to overall product satisfaction. In order to provide a complete training and customer support solution, we utilize a combination of live training in the office of the healthcare professional, interactive media, as well as online and telephonic support that is available 24 hours a day, 7 days a week. As of March 31, 2007, we had a training and customer support team of 20 employees.

Training. We believe that the amount of effort required for healthcare professional offices to train patients to use CSII therapy has been a key barrier limiting penetration of this therapy. With the fewest steps required to start insulin delivery, the OmniPod System was designed to be easy to use and to significantly reduce the burden associated with training patients to use CSII therapy.

We are committed to ensuring that each patient receives product training and education to take advantage of the benefits of the OmniPod System. To facilitate and make the customer training as efficient and effective as possible, we have developed an Interactive Training CD that is included with the Starter Kit shipped to new customers. The Interactive Training CD provides patients with an overview of CSII therapy and educates patients on how the OmniPod System works using easy-to-understand lessons and interactive tutorials. Utilization of the Interactive Training CD reduces product-related training time and allows clinic staff to spend more time on basic diabetes management training and therapy optimization.

Our training support for healthcare professional offices is tailored to the individual needs of recommending offices. In some cases, we certify office-based healthcare professionals to train patients on the OmniPod System through our Certified Pod Trainer Program. In addition, we may assist them with the first customer training as part of the process of transitioning the ongoing training responsibilities to these healthcare professionals. In other cases, a member of our Certified Pod Trainer consultant group will conduct the patient training for an office that does not have the capability or capacity to complete patient training. We have established a network of over 100 Certified Pod Trainers, or CPTs, who will conduct customer training at the healthcare site. We provide all CPTs with a training kit that includes a methodology and documentation for training patients on effective use of the OmniPod System. We believe the CPT Program is a valuable way for us to develop and maintain relationships with key providers in the marketplace.

Customer Support. We seek to provide our customers with high quality customer support, from product ordering to insurance investigation, fulfillment and ongoing support. We have integrated our customer support systems with our sales, reimbursement, billing, telephone and website in order to provide customers with seamless and reliable customer support.

Our customer support staff is proactively involved with both healthcare professionals and patients. When a patient initiates their order for the OmniPod System, our customer support staff assist the patient with completing order forms and collecting additional data as required by the patient’s insurance provider. Once the order forms are complete, we investigate the patient’s insurance coverage for the OmniPod System and contact the customer to notify them of benefits. We believe it is important from a customer satisfaction perspective, as well as a healthcare professional perspective, that we handle the insurance investigation process efficiently and promptly. We also offer healthcare professionals assistance in generating insurance appeals for customers who are denied coverage. We believe that our insurance investigation infrastructure will enable us to effectively support the growing demand for the OmniPod System.

Upon approval from the customer, the customer’s order is shipped to the customer’s home and our customer support staff notifies the provider of the ship date and reviews training plans with the customer. A customer support representative follows up with new customers at the first re-order and patients can subsequently be placed on automatic re-order for OmniPod supplies, simplifying the diabetes management process and preventing patients from experiencing inadvertent supply shortages.

One last thing to point out is the Insulet's Scientific Advisory Board.  I think you will see some familiar names.

Our scientific advisory board provides specific expertise in the areas of clinical applications, physician education and research and development relevant to our business. Scientific advisory board members meet with our management from time to time to discuss our present and long-term activities in these areas. Our scientific advisory board members include:

Robert Sherwin, M.D. (Chairman). Dr. Sherwin is C.N.H. Long Professor of Medicine, Director of the Yale Center for Clinical Investigation and Interim Section Chief of Endocrinology and Metabolism at Yale University in New Haven, Connecticut.

John Buse, M.D., Ph.D. Dr. Buse is Chief of the Division of Endocrinology and Director of the Diabetes Care Center at the University of North Carolina in Chapel Hill, North Carolina.

Steven Edelman, M.D. Dr. Edelman is Professor of Medicine, Diabetes and Endocrinology at the University of California in San Diego and Founder and Director of Taking Control of Your Diabetes.

Lois Jovanovic, M.D. Dr. Jovanovic is Chief Executive Officer and Chief Scientific Officer at the Sansum Diabetes Research Institute in Santa Barbara, California.

Francine Kaufman, M.D. Dr. Kaufman is Chair of the Division of Endocrinology and Metabolism at the Children’s Hospital Los Angeles and Professor of Pediatrics at the University of Southern California School of Medicine in Los Angeles, California.

Howard Wolpert, M.D. Dr. Wolpert is Senior Physician and Director of the Insulin Pump Program at the Joslin Diabetes Center at Harvard Medical School in Boston, Massachusetts.

[note that Howard Zisser, director of the artificial pancreas project, later joined the company as the Chief Medical Director - it could be a coup to get him to come to MNKD ]

www.marketwired.com/press-release/insulet-appoints-dr-howard-zisser-as-the-companys-first-medical-director-nasdaq-podd-1842069.htm


=====
The take away for me is that DeSisto built all this from scratch.  This was the plan as is laid out above and as we can see, he executed on it delivering a $2+ billion market cap company with a No.2 spot in the market. There are a lot of relevant parallels to where MNKD sits today.  Mann and DeSisto have an incredible combination of expertise and know-how that should be more than capable to deal with the "loss" of Sanofi and to establish the role and reputation of Afrezza in the marketplace.    

[Deleted]

this is what we want. hopefully he lays the plan on paper fast enough and hit the ground running - still use the Sanofi credit facility and run it up as its not due until 2024?

[stevil]

This is all well and good, but why don't people spend their efforts researching companies like MNKD that went bankrupt to draw parallels? Y'all wonder why you were blind to what happened yet you only allow yourself to see half the story...

Open both eyes, then make your judgement...

[dudley]

Many parallels indeed.  The difference is that Afrezza represents even MORE of a disruptive force than the insulin pump.  From what we have seen already Afrezza users can in many cases not only ditch their pumps but also reduce their basal insulin dosage.  That's just T1. The T2 market is many times larger and we have already seen the massive benefits T2 users are also getting from Afrezza.  Afrezza represents the single biggest threat to the Big Pharma diabetes oligopoly that has ever emerged.  Guaranteed big pharma (including Sanofi!) is aware of the threat.  Thus trying to smother the acorn before it can grow into a sturdy oak.

The forces of darkness have been relentless.  Shorts, bashers, paid hack "journalist" assassins - it has been a non-stop deluge.  Why would ANYONE spend such amazing amounts of time and energy to badmouth a tiny biotech just trying to help the diabetic community?  If they weren't so scared they would pay no attention to MNKD and just leave them alone.

One of my biggest hopes is that Al Mann gets to live long enough to see probably his biggest accomplishment in diabetes finally emerge as the blockbuster it deserves to be.  Just the thrill of watching him proved right once again and Kliff, Feurstein, Motley Tool and all the rest of the disgusting trolls and idiot analysts just wither away is a delicious thought.  That will be at least as sweet as the financial rewards that would come from the story playing out in Al's favor.

Maybe I'm just a hopeless dreamer and way too emotionally invested but I can't help myself.  The story itself is just bigger than life and the product is peerless.  I just can't see it dying before it's time.  I can't help but feel the "tipping point" is not too far off where scripts break into the thousands and then all those patients begin the same patterns, which only reinforces the momentum.

I'm actually glad in some ways Sanofi bailed - they were doing squat and now there is opportunity for creative new approaches rather than being held hostage by them.  Long and strong.  I didn't buy to hold for 11 months and call it over.  I bought to hold for years and watch it grow into an international success story and I can't see that possibility is dead at all.

[Deleted]

Upon approval from the customer, the customer’s order is shipped to the customer’s home and our customer support staff notifies the provider of the ship date and reviews training plans with the customer. A customer support representative follows up with new customers at the first re-order and patients can subsequently be placed on automatic re-order for OmniPod supplies, simplifying the diabetes management process and preventing patients from experiencing inadvertent supply shortages.

The Coach program can be transitioned. And should be easy for support than the OmniPod

[mindovermatter]

Jan 8, 2016 16:29:20 GMT -5 stevil said:

This is all well and good, but why don't people spend their efforts researching companies like MNKD that went bankrupt to draw parallels? Y'all wonder why you were blind to what happened yet you only allow yourself to see half the story...

Open both eyes, then make your judgement...

Mannkind hasn't declared BK though. Odds aren't good the company survives but let's not make a claim that hasn't happened yet. 

[mindovermatter]

Jan 8, 2016 9:35:36 GMT -5 mnholdem said:

The fact that Duane DeSisto has some serious experience in negotiating reimbursements with third-parties payers may be a much bigger deal than many shareholders realize, IMHO.

Or not. Different times, different product, different atmosphere. You and others are making the same mistake that was made in assuming SNY was going to stick with Afrezza. No one knows what is in store or whether or not Duane will have any success at all. 

When Mark Pincus stepped down at Zynga and MSFT vet Don Mattrick came in, everyone thought Don would be able to turn ZYNGA around because he had so much gaming experience and knew the industry well based on his great performance while at MSFT.

How did Don do?

Don totally failed and was removed after 2 years. Pincus came back to take the CEO helm. Zynga is still floundering. It helped it had a few billion in cash which has dwindled down to 1 billion as of now but it's eating it up. If only Mannkind had that much cash on hand.

Point is, past performance is no guarantee of future success.

Mannkind is in a world of hurt and the company has to show it can pivot very quickly. Desisto has to perform something close to a miracle to turn the company around. I am not saying he can't but he's going to need a lot of prayers answered.

[stevil]

Jan 8, 2016 16:34:13 GMT -5 mindovermatter said:

Jan 8, 2016 16:29:20 GMT -5 stevil said:

This is all well and good, but why don't people spend their efforts researching companies like MNKD that went bankrupt to draw parallels? Y'all wonder why you were blind to what happened yet you only allow yourself to see half the story...

Open both eyes, then make your judgement...

Mannkind hasn't declared BK though. Odds aren't good the company survives but let's not make a claim that hasn't happened yet. 

I'm not making a claim about what has happened yet. The point of this thread was to use history to find similar companies whose stories ended up being successful. This board often times lacks balance. Very few drugs get developed with the intention of being a middle-of-the-road product. With the cost of R&D and marketing, only the best of the best ideas get pulled from to get brought to market. Every drug that gets developed was probably thought to be a blockbuster in its own right. 

For the record- I'm still on the Afrezza train. I still think it's an amazing product and I hope I'm wrong. But with social media and the internet, nothing extraordinary stays a secret anymore. At some point you just have to accept that maybe there isn't enough interest in Afrezza to thrive. The odds were already stacked against us when we were with SNY, and despite the spin the eternal optimists keep trying to use to say we're better off now, it's never a good thing when you get dropped by a company that specializes in the very business your product was tailored for. 

I'm not buying that SNY was afraid it'd cut into the market share of their other medications. The only way for it to do that would be for Afrezza to reach blockbuster status. Then, guess what? They have a new blockbuster on their hands. The only logical reason SNY decided to drop Afrezza was because they didn't think it would be a profitable addition to their portfolio. If they really saw such disruptive potential behind it, they wouldn't let it fall into the hands of their competitors... because, guess what? There goes all that market share again and this time they're not recouping any of it. Instead, they're losing all of it. 

I'm not saying that SNY did all they could to make sure Afrezza was a success, but I'm not saying they didn't, either. Gallop polls don't form their statistics after polling every single person in the US. They take a small sample size and extrapolate their data to make their generalizations. And they've done a pretty decent job if you do a study on them. Statistics are freakishly accurate when used well. Trend lines are accurate an overwhelming majority of the time. So why am I saying all of this? Because maybe instead of rolling out and spending $100 million to market this new drug, they took their time and were a little more strategic about it. I'm sure SNY knows who the right Docs were to contact in regards to being a little looser in their prescribing habits. They probably targeted them first. Then, it's not difficult to make inferences based off of feedback from them. 

The truth is, there are so many different variables that go into why Afrezza will succeed or fail. Insurance price, doctors willingness to prescribe, patient willingness to change a potentially lifelong brand that they're comfortable with and understand, etc. We need to remember that Afrezza didn't reinvent the wheel. There hasn't really been a dire need for a new insulin medication. The stuff we have now, while inferior, still produces decent results. If you own something that does what it's supposed to and gives you the results you expect, do you listen to people that try to sell you on "the next best thing?" I usually blow those people off. 

I'm not saying it's impossible. I'm saying it's even more improbable than before that Afrezza becomes what we all hope for it to become. By all means, do your research. Just make sure that you're being fair to yourself by looking for the rule and not the exception. An analogy I would draw for the feeling I get after reading some posters on this board is that they would sell their house to buy every powerball ticket they could afford and then be devastated when they didn't win. In reality, they didn't realize that what they were dumping their money into wasn't really that wise of an investment in the first place. It still makes me sad the people that put more money into this stock with the expectation that it will return appreciably. Any investment should be met with extreme caution and speculative at best. What sign, thus far, has Afrezza shown that it can be successful?

[factspls88]

Jan 8, 2016 9:35:36 GMT -5 mnholdem said:

The fact that Duane DeSisto has some serious experience in negotiating reimbursements with third-parties payers may be a much bigger deal than many shareholders realize, IMHO.

Agree so long as Afrezza is at a price competitive to Humalog and Novolog. 

[mindovermatter]

Jan 8, 2016 16:57:42 GMT -5 stevil said:

Jan 8, 2016 16:34:13 GMT -5 mindovermatter said:

Mannkind hasn't declared BK though. Odds aren't good the company survives but let's not make a claim that hasn't happened yet. 

I'm not making a claim about what has happened yet. The point of this thread was to use history to find similar companies whose stories ended up being successful. This board often times lacks balance. Very few drugs get developed with the intention of being a middle-of-the-road product. With the cost of R&D and marketing, only the best of the best ideas get pulled from to get brought to market. Every drug that gets developed was probably thought to be a blockbuster in its own right. 

For the record- I'm still on the Afrezza train. I still think it's an amazing product and I hope I'm wrong. But with social media and the internet, nothing extraordinary stays a secret anymore. At some point you just have to accept that maybe there isn't enough interest in Afrezza to thrive. The odds were already stacked against us when we were with SNY, and despite the spin the eternal optimists keep trying to use to say we're better off now, it's never a good thing when you get dropped by a company that specializes in the very business your product was tailored for. 

I'm not buying that SNY was afraid it'd cut into the market share of their other medications. The only way for it to do that would be for Afrezza to reach blockbuster status. Then, guess what? They have a new blockbuster on their hands. The only logical reason SNY decided to drop Afrezza was because they didn't think it would be a profitable addition to their portfolio. If they really saw such disruptive potential behind it, they wouldn't let it fall into the hands of their competitors... because, guess what? There goes all that market share again and this time they're not recouping any of it. Instead, they're losing all of it. 

I'm not saying that SNY did all they could to make sure Afrezza was a success, but I'm not saying they didn't, either. Gallop polls don't form their statistics after polling every single person in the US. They take a small sample size and extrapolate their data to make their generalizations. And they've done a pretty decent job if you do a study on them. Statistics are freakishly accurate when used well. Trend lines are accurate an overwhelming majority of the time. So why am I saying all of this? Because maybe instead of rolling out and spending $100 million to market this new drug, they took their time and were a little more strategic about it. I'm sure SNY knows who the right Docs were to contact in regards to being a little looser in their prescribing habits. They probably targeted them first. Then, it's not difficult to make inferences based off of feedback from them. 

The truth is, there are so many different variables that go into why Afrezza will succeed or fail. Insurance price, doctors willingness to prescribe, patient willingness to change a potentially lifelong brand that they're comfortable with and understand, etc. We need to remember that Afrezza didn't reinvent the wheel. There hasn't really been a dire need for a new insulin medication. The stuff we have now, while inferior, still produces decent results. If you own something that does what it's supposed to and gives you the results you expect, do you listen to people that try to sell you on "the next best thing?" I usually blow those people off. 

I'm not saying it's impossible. I'm saying it's even more improbable than before that Afrezza becomes what we all hope for it to become. By all means, do your research. Just make sure that you're being fair to yourself by looking for the rule and not the exception. An analogy I would draw for the feeling I get after reading some posters on this board is that they would sell their house to buy every powerball ticket they could afford and then be devastated when they didn't win. In reality, they didn't realize that what they were dumping their money into wasn't really that wise of an investment in the first place. It still makes me sad the people that put more money into this stock with the expectation that it will return appreciably. Any investment should be met with extreme caution and speculative at best. What sign, thus far, has Afrezza shown that it can be successful?

understand. BTW, Gallup got out of polling, specifically politics at least for the primaries as they were woefully off during 2012 election. They haven't yet decided if they will poll for the presidential race. So even Gallup has seen things change so drastically that their bread and butter polling is no longer legit.