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Post by stevil on Jan 14, 2016 15:31:16 GMT -5
No they (BP, Endos, needle manufactures, pen manufactures, etc, etc, etc,) are terrified of the potential and what it could do to their revenue. The conspiracy theory? Not true. I have to agree. I can't speak for the drug and needle manufacturers- I'm sure they might be unethical, but I can say for certain that physicians do not view medicine in that way. Physicians will always have a job. There will always be some health crisis that needs an educated opinion and guidance. I'm sure you're well aware that the number of diabetics are growing. Prescribing Afrezza will not put any endos out of business. While there are certainly a few bad apples who are only in it for the money, I can tell you the vast majority will do whatever is in the best interest of their patient. We take an oath for crying out loud  |
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Post by ricguy on Jan 14, 2016 15:58:27 GMT -5
The conspiracy theory? Not true. I have to agree. I can't speak for the drug and needle manufacturers- I'm sure they might be unethical, but I can say for certain that physicians do not view medicine in that way. Physicians will always have a job. There will always be some health crisis that needs an educated opinion and guidance. I'm sure you're well aware that the number of diabetics are growing. Prescribing Afrezza will not put any endos out of business. While there are certainly a few bad apples who are only in it for the money, I can tell you the vast majority will do whatever is in the best interest of their patient. We take an oath for crying out loud I won't go as far as to say conspiracy theory but I will say that some of these Docs weren't educated (for whatever reason) on the benefits of Afrezza judging by the quotes that Harry posted. If they think Afrezza is all about going needless than they really don't know the real benefits for their patients. |
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Post by stevil on Jan 14, 2016 16:02:52 GMT -5
I have to agree. I can't speak for the drug and needle manufacturers- I'm sure they might be unethical, but I can say for certain that physicians do not view medicine in that way. Physicians will always have a job. There will always be some health crisis that needs an educated opinion and guidance. I'm sure you're well aware that the number of diabetics are growing. Prescribing Afrezza will not put any endos out of business. While there are certainly a few bad apples who are only in it for the money, I can tell you the vast majority will do whatever is in the best interest of their patient. We take an oath for crying out loud I won't go as far as to say conspiracy theory but I will say that some of these Docs weren't educated (for whatever reason) on the benefits of Afrezza judging by the quotes that Harry posted. If they think Afrezza is all about going needless than they really don't know the real benefits for their patients. I'm somewhat in agreement with you. I think the docs that got educated by reps SHOULD have known better. But there were a lot of continuing education magazines and other ways of distributing information about Afrezza that likely educated the docs. I would be surprised if these docs were greeted personally by the reps. And really, that's not SNY's issue. It's a label issue. Sure, they could show the info and graphs on afrezzapro.com, but they're still limited in what they can say about Afrezza. I very well could be wrong. I just don't think SNY sandbagged Afrezza. Not as badly as people think. I don't think they gave it much of a shot, but I do believe that they would have taken it if it had been wildly successful with what they did do. I just think they dropped it very early on because they didn't think the juice was worth the squeeze. Just my $0.02 |
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Post by factspls88 on Jan 14, 2016 16:24:51 GMT -5
The amount of negativity and misinformation is incredible. There was only one positive comment. This highlights to me the enormous challenge Mannkind faces to reverse these deeply held and misinformed attitudes. It is clear to me that Mannkind needs a salesforce that can counter these attitudes with user case studies (Sam Finta et al) and scientific data. There has to be a way to be able to talk about real user experience that does not violate FDA rules. After all, they were part of a focus group the endocrinologists attended in San Diego.
Harry do you have any idea how legit this publication is? The writer calls himself a staff writer but is not listed as part of the editorial staff. I wonder if he is a free lancer. I have become so jaded when it comes to bloggers and freelancers.
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Post by cjc04 on Jan 14, 2016 16:32:19 GMT -5
How or why these docs have those opinions isn't the issue.... How to CHANGE those opinions is now the issue, and it currently sits with MNKD alone.
Those opinions are the general consensus of docs & endo's across the country, and that's if they even know what Afrezza is. If this past year was an "educational" campaign by SNY, then they have failed more miserably than we realize. I PRAY that SNY has intentionally sandbagged Afrezza to either negotiate a better price now, or to try to kill it permanently, because if not, and they actually gave an effort, then MNKD is done. There is no way MNKD can change the current dialog alone.
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Post by agedhippie on Jan 14, 2016 16:43:34 GMT -5
My 10 cents? Because everyone focussed on the fact that it was not injected. Doctors do not care about that, they want results and the trial data did not support moving patients off their current insulin. Get trials data showing superior performance as well as no lung complications and Afrezza will fly. Without that it is going to be very slow going because there is not the sort of confirmation doctors look for.
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Post by sam221 on Jan 14, 2016 16:44:28 GMT -5
Interesting article. There is more to the failure than just an inept SNY. Lessons learned: In porting TS to another API, the sole benefit cannot be that it can be inhaled. The resistance to inhaled drugs is deep. The key resistance is to the inhaled drug to chronic condition like diabetes (daily use). I'm not sure the resistance will be that strong for a short term use superfast acting inhaled drug. |
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Post by kball on Jan 14, 2016 16:45:07 GMT -5
Not exactly regarding "why the flop", but i wanted to throw this out to those who may be viewing these boards from high places--
just as sanofi invited early adopters to a SD gathering to glean information (for whatever reasons its not important now), it might benefit Mannkind to invite some of the forum members here for a similar experience (they probably know which ones they would) in which to brainstorm some ideas and strategy.
Maybe 20-25 people at about $1000 bucks expense per would be my guess.
Just a thought
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Post by harryx1 on Jan 14, 2016 16:45:21 GMT -5
factspls88 - I'm not sure about the writer but they also have it listed under Cardiology stevil - I know a few doctors and have seen first hand on how they can be biased towards certain companies/treatments as some do research, speeches, etc and are compensated. So don't bite the hand that feeds as they say.
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Post by rockstarrick on Jan 14, 2016 16:47:49 GMT -5
stevil, I disagree, I believe if Sanofi would have given the PWD the opportunity to choose, by advertising just 1 TV commercial so more PWD knew about afrezza, the script numbers would have looked quite a bit different. I also find it completely unprofessional and unexceptable that the very day Sanofi notified MNKD they were ending the partnership, Sanofi Canada flat out lied to a PWD that asked them when afrezza would be available in Canada, (see my thread Sanofi Canada) to view the tweet. Also, keep in mind that I was one that defended the slow launch by Sanofi, and also defended the decision not to advertise via TV until after Healthcare Providers and patients were educated, (boy do I feel stupid !!) I hope sanofis shareprice continues to fall and PWD boycott the company. I wouldn't piss in their ears if their brains were on fire. Just my opinion of Sanofi, I enjoy reading your professional input. Boycott Sanofi
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Post by greg on Jan 14, 2016 16:48:09 GMT -5
The amount of negativity and misinformation is incredible. There was only one positive comment. This highlights to me the enormous challenge Mannkind faces to reverse these deeply held and misinformed attitudes. It is clear to me that Mannkind needs a salesforce that can counter these attitudes with user case studies (Sam Finta et al) and scientific data. Harry do you have any idea how legit this publication is? The writer calls himself a staff writer but is not listed as part of the editorial staff. I wonder if he is a free lancer. I have become so jaded when it comes to bloggers and freelancers. I think what we really need is a national expose, whether on 60 minutes or some other reputable news outlet, perhaps by someone like Cheryl Atkinson. This would expose corruption and/or ineptitude in the pharmaceutical industry, the medical profession, the FDA, and most definitely Wall Street. One of the things I find bewildering, among so much else in the MNKD story, is the fact that the current realities, mandated by the FDA, has doctors prescribing Afrezza in a manner that's inconsistent with both what the developer of the drug wants and what most successful users of the drug recommend. Such an expose would benefit diabetics, MannKind, and its investors, and, maybe, light a fire under the SEC. I had high hopes that Ted Mann and Rolling Stones might get the ball rolling but obviously that never happened. |
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Post by jurystillout on Jan 14, 2016 16:51:20 GMT -5
When a sales rep sells it as an inhaled insulin that's all the DR hears and he/she makes a judgement based on whether the inhaled component is worth his time and effort. It should be sold as a system to more closely mimic the pancreas and by the way you don't have to jab yourself with a needle. DR's seem to think that the inhaled piece is just a delivery gimmick.
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Post by spiro on Jan 14, 2016 16:53:17 GMT -5
Spiro thinks those doctors are just plain old stubborn and stupid folks, unwilling to learn about about how a great new insulin like Afrezza can actually help some of their patients manage their diabetes a little better. They are basically unwilling to accept change. They actions are basically detrimental to a lot of their patients. How foolish they are behaving.
Spiro here, enjoying the benefits of a truly remarkable insulin product.
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Post by factspls88 on Jan 14, 2016 16:57:14 GMT -5
When a sales rep sells it as an inhaled insulin that's all the DR hears and he/she makes a judgement based on whether the inhaled component is worth his time and effort. It should be sold as a system to more closely mimic the pancreas and by the way you don't have to jab yourself with a needle. DR's seem to think that the inhaled piece is just a delivery gimmick. Some in the article did not even realize that Afrezza was a prandial insulin only and made comments as if it were a basal. |
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Post by joeypotsandpans on Jan 14, 2016 16:59:12 GMT -5
Ok, I had to post this in the main area because at best it's laughable not to mention what lengths they are going to go to to discredit Afrezza. Meet the Doctors of Dinosaurs... who most will hopefully fall to the wayside. www.medpagetoday.com/Cardiology/Type1Diabetes/55663?utm_source=dlvr.it&utm_medium=twitterLast week, drugmaker Sanofi pulled out of its agreement with MannKind Corporation to sell the inhaled insulin product called Afrezza. The device, cleared by the FDA in June of 2014 on its third try, apparently flopped when it hit the market, earning only a few million dollars in 9 months on the market. MedPage Today spoke to several doctors about whether, and why or why not, they prescribed Afrezza. Jennifer Holst, MD, University of Pittsburgh School of Medicine: "I did prescribe Afrezza to some patients. Inhaled insulin is a nice option for some patients with diabetes who prefer to inhale a medication than to inject. This is the second time that inhaled insulin has come out to market, and then been pulled off. Afrezza was much easier to use than the previous inhaled insulin." Thank you Jennifer for the honest reply and interestingly enough the testimonial to the easier to use statement at the end, ironically some physicians were too lazy to understand the dosing differences.Lee Green, MD, MPH, University of Michigan Health System: "I never did prescribe it; just didn't see a need for it." Lee, I'm glad you're not my physician...you need to do a better job of staying on top of the latest and greatest meds for your patientsFilip Knop, MD, PhD, University of Copenhagen: "I guess the well-established long-term safety of injected insulin outweighs the -- in my opinion -- questionable benefits of inhaled insulin. My patients with diabetes basically NEVER complain about insulin injections. The gauge of modern needles is so small that you basically can't feel the injection. Maybe needle-phobia is a problem among US patients, but -- really(!) -- it's not a problem that my patients mention very often -- despite my often asking them." Most patients don't admit being needle phobic, Filip I wonder how many of your patients are non compliant, question for you DID YOU EVER ASK THEM IF THEY WOULD THINK THEY WOULD PREFER INHALED INSULIN IF GIVEN THE CHOICE and how many of them even are aware that it is availableHoward Weintraub, MD, New York University Langone Medical Center: "I have not used inhaled insulin. I have been more comfortable with basal insulin preparations. This would not represent any major loss for me or any of my patients." Howard do you even know WTF you are talking about, this is a prandial insulin...seriously you are at NYU Medical Center, you can't make this stuff upDavid Armstrong, MD, PhD, University of Arizona College of Medicine: "I know about this and it is an enormous shame. This is a drug with wonderful promise that will now not likely be realized. As a surgeon who specializes in preventing some of the end stage complications of this disease, I do not have occasion to prescribe it, but I do see the devastating results of diabetes and therefore am something of a customer myself!" David gets it!! and unfortunately via the end results of non compliant patients, we need David to speak in the future and maybe put him on the newly formed councilJoel Zonszein, MD, Albert Einstein College of Medicine: "I was perplexed when Sanofi made the decision to market it and I hope they've learn a lesson. As a clinician that treat individuals with diabetes I can attest that inhaled insulins, no matter how good ... have only a small place, if at all, in the current market. Joel, my son interviewed at Albert Einstein last year, if you were going to be one of his colleagues I may have been perplexed at how they admitted you to the staff. Fortunately, he opted to go elsewhere for his residency. "no matter how good have only a small place..." seriously ignorant statement."Inhaled insulins are not good for management of type 1 diabetes (where a basal and prandial regimens needs to be properly crafted for each patient by either multiple injections or CIIS pumps). Inhaled insulins are not good for T2DM as these patients need a basal regimen ... The pen syringes and needles used nowadays are excellent and almost painless -- thus, there is no need for inhaled insulins to replace these. Again, out of touch with the benefits of Afrezza and closed minded does not bode well for your patients Joel"Physicians often have a dark cloud in their mind with regards to large amounts of insulin in the lungs and if they can cause malignancy after years of use. There are also issues with the inhaled insulin as far as problems with the lungs, bronchitis, asthma, pulmonary function, etc." It is amazing to me how some attain their medical degrees, unfortunately the degrees don't show how they did during their training and education prior to getting their degrees. A student who excels and one who squeaks by in the same program end up with the same degree on the wall. At the same time there are some who think they are always right and don't have the character to continue to learn. I would love to interview some of these same so called physicians after about 3-5 yrs. from now and see what they think when you repeat some of their ignorant statements to them IN FRONT OF SOME OF THEIR PATIENTS.  |
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