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Post by james on Jan 13, 2016 20:39:05 GMT -5
I'm wondering how they are going to be able to implement this on national basis. And how is this going to be low cost? Sorry for all the questions. This is a great idea but I'm not sure it'll be as easy and as low cost as Matt seems to think. I expect that MNKD would be legally prevented from owning, operating, or directly supporting these clinics. As I understand it, it is basically an open opportunity for providers with enough business acumen to pursue this on their accord. MNKD can only supply education materials and allow their name to be used by the provider on a marketing basis. Forward looking providers need to step up or this goes nowhere.
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Post by stevil on Jan 13, 2016 20:39:11 GMT -5
I think Matt was careful about not taking full credit for the clinic initiative (as in, SNY was involved in the discussions). I am adding shares for several reasons, the clinics are interesting, but will take time. It will help with awareness, but let's wait for proof of concept. Most insurance plans require PCP referrals to specialists, so there will still be a process, and there will probably be more than a handful of PCPs who will not refer to an urgent care center clinic. Having nothing to do with Afrezza and everything to do with public health, convenient access to diabetes care is important. Just because these clinics will be co-located with an urgent care center does not mean that the service being provided is urgent care. It would be more akin to primary care. The "urgent care" setting (such as in a Walmart) just gives the diabetes clinic visibility - taking health care directly to the patient. These could be staffed by a nurse practitioner, with a link to a physician or even an endo as needed. Many insurance plans would not need a referral to be seen at such a facility - specifically - regular Medicare needs no referral. A lot will depend on what plans these centers contract with. The key, though, is providing comprehensive basic diabetes care without bias toward a specific product. How does one do that while being sponsored by an insulin company? Does any governing agency oversee this? Then, if audited, how do they prove/disprove "care without bias toward a specific product?" Do they have to have matching script count % for every kind of insulin to keep governing body off their back?
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Post by robsacher on Jan 13, 2016 20:44:34 GMT -5
I was impressed with the Q & A, and will be adding shares. I am not sure Ray's comment about SNY's 1990's launch approach was a bit disingenuous (perhaps I missed the context). MNKD knew the launch plan upfront. Yes, but Sanofi had the $1 Billion in potential payments to influence MNKD that the rollout needed to be done their way! This is so cool. Of all the things I have been a part of regarding MannKind, this is something that brings me deepest satisfaction. Afrezza clinics!
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Post by robsacher on Jan 13, 2016 20:47:49 GMT -5
I think Matt was careful about not taking full credit for the clinic initiative (as in, SNY was involved in the discussions). I am adding shares for several reasons, the clinics are interesting, but will take time. It will help with awareness, but let's wait for proof of concept. Most insurance plans require PCP referrals to specialists, so there will still be a process, and there will probably be more than a handful of PCPs who will not refer to an urgent care center clinic. Having nothing to do with Afrezza and everything to do with public health, convenient access to diabetes care is important. Just because these clinics will be co-located with an urgent care center does not mean that the service being provided is urgent care. It would be more akin to primary care. The "urgent care" setting (such as in a Walmart) just gives the diabetes clinic visibility - taking health care directly to the patient. These could be staffed by a nurse practitioner, with a link to a physician or even an endo as needed. Many insurance plans would not need a referral to be seen at such a facility - specifically - regular Medicare needs no referral. A lot will depend on what plans these centers contract with. The key, though, is providing comprehensive basic diabetes care without bias toward a specific product. If I may add a thought, the key will be in providing comprehensive basic diabetes care without bias towards a specific product but with no bias against a specific product too.
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Post by od on Jan 13, 2016 20:47:53 GMT -5
I think Matt was careful about not taking full credit for the clinic initiative (as in, SNY was involved in the discussions). I am adding shares for several reasons, the clinics are interesting, but will take time. It will help with awareness, but let's wait for proof of concept. Most insurance plans require PCP referrals to specialists, so there will still be a process, and there will probably be more than a handful of PCPs who will not refer to an urgent care center clinic. Having nothing to do with Afrezza and everything to do with public health, convenient access to diabetes care is important. Just because these clinics will be co-located with an urgent care center does not mean that the service being provided is urgent care. It would be more akin to primary care. The "urgent care" setting (such as in a Walmart) just gives the diabetes clinic visibility - taking health care directly to the patient. These could be staffed by a nurse practitioner, with a link to a physician or even an endo as needed. Many insurance plans would not need a referral to be seen at such a facility - specifically - regular Medicare needs no referral. A lot will depend on what plans these centers contract with. The key, though, is providing comprehensive basic diabetes care without bias toward a specific product. liane, you could not have articulated "the key" better. I am on the fence re: your reimbursement assessment. I am very familiar with urgent and convenient care facilities, having launched the first located in Walmart (and other retailers). (Get this, I fought tooth and nail with my colleagues that the clinics needed to be covered by insurance; they were convinced that the pricing and convenience factor would make a cash business work.) No question, if a covered life does not require a referral and the 'center' is on a the payor panel, reimbursement will not be an issue. My understanding is that almost all exchange plans, including Platinum, require referrals from the PCP. Could there be carve-outs for diabetes centers? Of course. The point of my earlier post is that as much as I embrace the clinic concept, I think we are looking at a long road to traction.
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Post by liane on Jan 13, 2016 20:48:27 GMT -5
stevil, This would be private enterprise setting up a free-standing diabetes clinic providing all manner of basic diabetes care, supported by billing the patient's insurance. MNKD could consult to them regarding the requirements of prescribing Afrezza (in particular the spirometry), but so could any other diabetes drug manufacturer. The medical staff would be free to prescribe whatever course of action is needed, but having actually received some education from MNKD, they actually might come to believe that Afrezza is often an appropriate course.
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Post by robsacher on Jan 13, 2016 20:49:58 GMT -5
New Jersey I'm wondering how they are going to be able to implement this on national basis. And how is this going to be low cost? Sorry for all the questions. This is a great idea but I'm not sure it'll be as easy and as low cost as Matt seems to think. There is a third party involved who will be footing most of the bill. Likely, it is the company that already owns the clinics. This will be another profit making operation in their facilities.
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Post by robsacher on Jan 13, 2016 20:51:16 GMT -5
Spiro, so happy to know that he made the move!
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Post by babaoriley on Jan 13, 2016 20:54:39 GMT -5
I have now been authorized to divulge a little something about these clinics. Many of you remember a very fine poster who was quite active here for quite a long time (like the rest of us, he wasn't much for stock prognostication ), but he's long on intelligence, creativity (these two characteristics are most unusual in UCLA guys) and work ethic; he's also a persistent guy (yes, the gutty little Bruin in him). And as a stubborn individual, he is intent on not allowing MannKind to sink slowly and quietly under the waves (think "Titanic"), but to fight this out and prevail. He and his business partner (another sharp guy who I also have met on a few occasions), are the brain trust behind these "clinics." They've been working (hard) on this concept for over a year, and approached Matt and MannKind about it a few months ago when they had it sufficiently polished. Matt was excited about the idea and so they have been running hard with it with MNKD's knowledge and blessing. They are pretty far down the line on this idea, it's not something that got thought up a couple of months (or days) ago (like Matt's presentation today), so it has some thought and substance behind it. In fact, I got a kick out of the Rob S. post about clinics a while back, and immediately contacted my friend about it, telling him how was it that I was bound to silence (some crap about attorney-client privilege - he actually hired me for a dollar so he could let me in on what he was up to!), but that Rob Sacher knew about the idea and was posting about it! My understanding is that Rob's mention was a total coincidence - great minds! I'm speaking, of course, of our old buddy, MannMade, who has made himself scarce around these parts for quite a while, first, because he's been very busy with this venture, and second, to avoid any appearance of impropriety (he also had to pick up a late shift at McDonald's when the stock tanked down to $1.50 (anyone remember those lofty, heady days, way back in November or December?). To the extent that MannMade would like to share any further details, I will leave that up to him. But he's part of the turnaround effort, and he's probably gotten more doctors interested (some very interested, actually) in Afrezza than Sanofi! Until those clinics start to click for him, I will continue to get together with him often, always with the same greeting, "that's two Big Mac Meals and supersize them, please." Godspeed and best of luck to MannMade and his partner (his partner is not a poster, but is as good a stock prognosticator as the rest of us!).
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Post by robsacher on Jan 13, 2016 20:55:34 GMT -5
Just because these clinics will be co-located with an urgent care center does not mean that the service being provided is urgent care. It would be more akin to primary care. The "urgent care" setting (such as in a Walmart) just gives the diabetes clinic visibility - taking health care directly to the patient. These could be staffed by a nurse practitioner, with a link to a physician or even an endo as needed. Many insurance plans would not need a referral to be seen at such a facility - specifically - regular Medicare needs no referral. A lot will depend on what plans these centers contract with. The key, though, is providing comprehensive basic diabetes care without bias toward a specific product. liane, you could not have articulated "the key" better. I am on the fence re: your reimbursement assessment. I am very familiar with urgent and convenient care facilities, having launched the first located in Walmart (and other retailers). (Get this, I fought tooth and nail with my colleagues that the clinics needed to be covered by insurance; they were convinced that the pricing and convenience factor would make a cash business work.) No question, if a covered life does not require a referral and the 'center' is on a the payor panel, reimbursement will not be an issue. My understanding is that almost all exchange plans, including Platinum, require referrals from the PCP. Could there be carve-outs for diabetes centers? Of course. The point of my earlier post is that as much as I embrace the clinic concept, I think we are looking at a long road to traction. Yes, there will be a long road to traction but if the public has an opportunity to choose their insulin of choice, knowing that Afrezza will be offered as one possible choice means that Afrezza will gain market share. How much remains to be scene but this is a wonderful way in which diabetics can learn about Afrezza and decide whether or not it is right for them. All we need is a fighting chance and that chance comes with allowing a patient the opportunity to know that Afrezza is an option.
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Post by robsacher on Jan 13, 2016 20:58:36 GMT -5
stevil , This would be private enterprise setting up a free-standing diabetes clinic providing all manner of basic diabetes care, supported by billing the patient's insurance. MNKD could consult to them regarding the requirements of prescribing Afrezza (in particular the spirometry), but so could any other diabetes drug manufacturer. The medical staff would be free to prescribe whatever course of action is needed, but having actually received some education from MNKD, they actually might come to believe that Afrezza is often an appropriate course. Also, those who are employees in these clinics can also be vetted by those who own the clinics who may have an interest in having diabetics know that Afrezza is an option.
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Post by esstan2001 on Jan 13, 2016 21:00:30 GMT -5
Right on Liane, stay tuned on this one. one of our own is very involved in this development. Spiro here, not doing cartwheels, but feeling a little better about things. Spiro, a little birdie told me that they have an (as of yet) undisclosed plan to focus sales efforts on small regional centers... and they got this idea from George Rho's article- I saw it there in print. Wasn't this your idea? We will have to make sure that Matt sends you all commissions on the sales in the Florida keys. Maybe we can send Baba down there as the 'enforcer'. I think we will have to see how much leverage Liane has with him now. But it may not take too much, he confessed to me liking sailing on small catamarans... Hobie cats I believe- I think he wants to get back into it, and start a charter operation down there near you know, Cuba... smuggling out old American car parts to keep the locals up and running.
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Post by robsacher on Jan 13, 2016 21:02:13 GMT -5
I have now been authorized to divulge a little something about these clinics. Many of you remember a very fine poster who was quite active here for quite a long time (like the rest of us, he wasn't much for stock prognostication ), but he's long on intelligence, creativity (these two characteristics are most unusual in UCLA guys) and work ethic; he's also a persistent guy (yes, the gutty little Bruin in him). And as a stubborn individual, he is intent on not allowing MannKind to sink slowly and quietly under the waves (think "Titanic"), but to fight this out and prevail. He and his business partner (another sharp guy who I also have met on a few occasions), are the brain trust behind these "clinics." They've been working (hard) on this concept for over a year, and approached Matt and MannKind about it a few months ago when they had it sufficiently polished. Matt was excited about the idea and so they have been running hard with it with MNKD's knowledge and blessing. They are pretty far down the line on this idea, it's not something that got thought up a couple of months (or days) ago (like Matt's presentation today), so it has some thought and substance behind it. In fact, I got a kick out of the Rob S. post about clinics a while back, and immediately contacted my friend about it, telling him how was it that I was bound to silence (some crap about attorney-client privilege - he actually hired me for a dollar so he could let me in on what he was up to!), but that Rob Sacher knew about the idea and was posting about it! My understanding is that Rob's mention was a total coincidence - great minds! I'm speaking, of course, of our old buddy, MannMade, who has made himself scarce around these parts for quite a while, first, because he's been very busy with this venture, and second, to avoid any appearance of impropriety (he also had to pick up a late shift at McDonald's when the stock tanked down to $1.50 (anyone remember those lofty, heady days, way back in November or December?). To the extent that MannMade would like to share any further details, I will leave that up to him. But he's part of the turnaround effort, and he's probably gotten more doctors interested (some very interested, actually) in Afrezza than Sanofi! Until those clinics start to click for him, I will continue to get together with him often, always with the same greeting, "that's two Big Mac Meals and supersize them, please." Godspeed and best of luck to MannMade and his partner (his partner is not a poster, but is as good a stock prognosticator as the rest of us!). Baba, I'm floored. I had no idea this was really in the works.
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Post by bradleysbest on Jan 13, 2016 21:03:13 GMT -5
So my good fortune relies upon a gutty lil Bruin.....Ughhhhhhh
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Post by boytroy88 on Jan 13, 2016 23:02:05 GMT -5
So my good fortune relies upon a gutty lil Bruin.....Ughhhhhhh Lol... Lest we all forget Mr. Mann is also a graduate of cal univ la.... But he just came to the realization that Univ. of So. Calif. is the better school and thus we were graced by his contributions.
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