Why Did Afrezza Flop?

[tripoley]

"Inhaled insulins are not good for T2DM as these patients need a basal regimen"

Wow, what a freaking moron. T2s have plenty of basal floating around. The deficit is first phase insulin which Afrezza replaces. The only reason we use basal in T2s is convenience and a last ditch effort before they go on prandial insulin. Oh, and because Sanofi wanted to sell a buttload of Lantus.  

[greg]

Jan 14, 2016 22:37:23 GMT -5 kball said:

Thanks for the mildly entertaining exchange Stevil and Greg.

Show of hands, how many here wish they would've taken gregs advice and listened more.....to those that were skeptical long before the bloodbath the last 2 months?

I wish i had.

Even if this company rises from the ashes, how many of us will really make a lot of money?
And how many of us will sell long before any significant rise beyond a couple bucks. Just glad to recoup part of what we suspect may be lost for good?

"listened more....to those that were skeptical long before the bloodbath the last 2 months?"

With all due respect, given all the fud that's been spread the last three or four years, when should we have started to listen more? Should we have listened to fuerstein's skepticism two months ago, six months ago, 12 months ago, two years ago, or three years ago??

There's been so much fud we don't know anymore what's true and what's not. I had what's proven to be good information about six months ago, but my many years of experience with all the fud caused me to blow it off, to my detriment. In my opinion, one of the most important things when it comes to these message boards is to know whom to trust and who's got ulterior motives. That's one of the reasons I got into that exchange with Stevil. I'll trust everyone until he or she gives me one reason to doubt his or her veracity.

It's always good to have more information. But just a little bit of bad information thrown into the mix can make all of the information of little use, leading to bad decisions. I have no idea what can be done about it, but I, for one, have a problem with keeping members who are obviously intent on only sowing doubt, uncertainty, and fear, rather than really trying to inform. 

[slapshot]

Jan 16, 2016 10:53:16 GMT -5 greg said:

With all due respect, given all the fud that's been spread the last three or four years, when should we have started to listen more? Should we have listened to fuerstein's skepticism two months ago, six months ago, 12 months ago, two years ago, or three years ago??

There's been so much fud we don't know anymore what's true and what's not. I had what's proven to be good information about six months ago, but my many years of experience with all the fud caused me to blow it off, to my detriment. In my opinion, one of the most important things when it comes to these message boards is to know whom to trust and who's got ulterior motives. That's one of the reasons I got into that exchange with Stevil. I'll trust everyone until he or she gives me one reason to doubt his or her veracity.

It's always good to have more information. But just a little bit of bad information thrown into the mix can make all of the information of little use, leading to bad decisions. I have no idea what can be done about it, but I, for one, have a problem with keeping members who are obviously intent on only sowing doubt, uncertainty, and fear, rather than really trying to inform. 

I completely agree.

For me it was the assumption that Sanofi was in it for the long haul.  I genuinely believed that they would have the patience necessary for the market to develop and the wherewithal to make Afrezza a success.  In reality, it looks like they had decided to bail on Afrezza even before I made my assumption and began to buy in to Mnkd last summer.  Since i believed in Sanofi doing the right thing, i accepted that Afrezza was correctly priced to compete in the market and that insurance coverage would come in a matter of time, thus i ignored reality (of course neither Sanofi or Mannkind provided much info) and instead of determining the real reason behind the low scripts (Sanofi was inflexible and bailing), blamed things like low scripts, the lack of advertising, etc. on the lack of insurance coverage which was surely being addressed.  So instead of focusing on the cause of the problems (price) i was focusing on the effects (low scripts, lack of insurance, advertising, etc.) that were 'easily' explainable by things like the lack of insurance coverage and since Sanofi knew what it was doing it would all come in due time.

Now my conjecture is that Brandicourt never was on board with Afrezza so decided to set the price at a premium such that if it succeeded then they would make out like bandits but if it failed then that was that.  I (admittedly having no marketing or pharma background) just cant see how Sanofi could possibly defend their lack of pricing flexibility in the marketing of Afrezza as being reasonable.

Going forward, yes there are other marketing concerns as many of the threads are discussing, but to me it all starts with pricing.  Insurance coverage is paramount, and Afrezza must be competitively priced to compete in the market.

BTW, i am new to biotechs (have owned SNY and JNJ for several years) and really have no knowledge specific to the field so don't post much, but have enjoyed learning a bit and reading the message board  And dont worry about me, i only manage about 10% of my stock portfolio and MNKD is only 10% of that.  

[Deleted]

Jan 16, 2016 14:06:42 GMT -5 slapshot said:

Jan 16, 2016 10:53:16 GMT -5 greg said:

With all due respect, given all the fud that's been spread the last three or four years, when should we have started to listen more? Should we have listened to fuerstein's skepticism two months ago, six months ago, 12 months ago, two years ago, or three years ago??

There's been so much fud we don't know anymore what's true and what's not. I had what's proven to be good information about six months ago, but my many years of experience with all the fud caused me to blow it off, to my detriment. In my opinion, one of the most important things when it comes to these message boards is to know whom to trust and who's got ulterior motives. That's one of the reasons I got into that exchange with Stevil. I'll trust everyone until he or she gives me one reason to doubt his or her veracity.

It's always good to have more information. But just a little bit of bad information thrown into the mix can make all of the information of little use, leading to bad decisions. I have no idea what can be done about it, but I, for one, have a problem with keeping members who are obviously intent on only sowing doubt, uncertainty, and fear, rather than really trying to inform. 

I completely agree.

For me it was the assumption that Sanofi was in it for the long haul.  I genuinely believed that they would have the patience necessary for the market to develop and the wherewithal to make Afrezza a success.  In reality, it looks like they had decided to bail on Afrezza even before I made my assumption and began to buy in to Mnkd last summer.  Since i believed in Sanofi doing the right thing, i accepted that Afrezza was correctly priced to compete in the market and that insurance coverage would come in a matter of time, thus i ignored reality (of course neither Sanofi or Mannkind provided much info) and instead of determining the real reason behind the low scripts (Sanofi was inflexible and bailing), blamed things like low scripts, the lack of advertising, etc. on the lack of insurance coverage which was surely being addressed.  So instead of focusing on the cause of the problems (price) i was focusing on the effects (low scripts, lack of insurance, advertising, etc.) that were 'easily' explainable by things like the lack of insurance coverage and since Sanofi knew what it was doing it would all come in due time.

Now my conjecture is that Brandicourt never was on board with Afrezza so decided to set the price at a premium such that if it succeeded then they would make out like bandits but if it failed then that was that.  I (admittedly having no marketing or pharma background) just cant see how Sanofi could possibly defend their lack of pricing flexibility in the marketing of Afrezza as being reasonable.

Going forward, yes there are other marketing concerns as many of the threads are discussing, but to me it all starts with pricing.  Insurance coverage is paramount, and Afrezza must be competitively priced to compete in the market.

BTW, i am new to biotechs (have owned SNY and JNJ for several years) and really have no knowledge specific to the field so don't post much, but have enjoyed learning a bit and reading the message board  And dont worry about me, i only manage about 10% of my stock portfolio and MNKD is only 10% of that.  

still own SNY? am asking not for spite .. but in general SNY seems to lost focus and is scrambling like a mad dog..

[slapshot]

i do, but am looking for the right time to get out (now that i missed the top and thinking the future does not look as bright)

[Deleted]

Jan 16, 2016 14:59:56 GMT -5 slapshot said:

i do, but am looking for the right time to get out

looks the same for others too I guess as they seem to be jumping ship. Since Chris left , they have been taking a beating coinciding with decrease in Lantus revenues

[Chris-C]

Jan 16, 2016 14:18:47 GMT -5 @iam2sekc4u2002 said:

Jan 16, 2016 14:06:42 GMT -5 slapshot said:

I completely agree.

For me it was the assumption that Sanofi was in it for the long haul.  I genuinely believed that they would have the patience necessary for the market to develop and the wherewithal to make Afrezza a success.  In reality, it looks like they had decided to bail on Afrezza even before I made my assumption and began to buy in to Mnkd last summer.  Since i believed in Sanofi doing the right thing, i accepted that Afrezza was correctly priced to compete in the market and that insurance coverage would come in a matter of time, thus i ignored reality (of course neither Sanofi or Mannkind provided much info) and instead of determining the real reason behind the low scripts (Sanofi was inflexible and bailing), blamed things like low scripts, the lack of advertising, etc. on the lack of insurance coverage which was surely being addressed.  So instead of focusing on the cause of the problems (price) i was focusing on the effects (low scripts, lack of insurance, advertising, etc.) that were 'easily' explainable by things like the lack of insurance coverage and since Sanofi knew what it was doing it would all come in due time.

Now my conjecture is that Brandicourt never was on board with Afrezza so decided to set the price at a premium such that if it succeeded then they would make out like bandits but if it failed then that was that.  I (admittedly having no marketing or pharma background) just cant see how Sanofi could possibly defend their lack of pricing flexibility in the marketing of Afrezza as being reasonable.
...

I agree as well. In revisiting Sanofi's decision to abandon Afrezza and when the decision might have been made, I have been reflecting on the ousting of Chris Viebacher and the unfortunate hiring of Olivier Brandicourt. I am now convinced that soon after his arrival, (two months into Afrezza's launch, which BTW, began during a period when SNY  was  without a permanent CEO) he made the decision to terminate the partnership ASAP but needed to await the legal opportunity to do so. This explains the "controlled launch" phenomenon as well as the near absence of mention of Afrezza during the SNY strategic plan announcements last fall. Afrezza was not mentioned because it was not part of the plan going forward. I worried about this but tried to explain it away as an artifact of being a small, early stage product within a large global conglomerate. Sanofi did the bare minimum to satisfy the conditions of their agreement and therefore, I believe, may be vulnerable to legal action. This WSJ article on Brandicourt gives some additional clues.

I  think it remains to be seen whether Brandicourt's decision to abandon Afrezza was based on a believe that it would compete with their other products. I think it had to do more with a need for Brandicourt to develop a quick plan to focus the company on some core products to shore up the diabetes portfolio and his perception that the "juice" from Afrezza wasn't worth the effort required for the "squeeze", as they say. After all, Brandicourt had experienced the challenges associated with a failed Exubera launch at Pfizer.

I'm curious about the early adopter conference they sponsored and what SNY learned. Hopefully, this information will get shared with Mannkind. I had a decoy effect on me, in that  I doubted they would sponsor sucn an effort if they knew they were going to abandon the effort at the earliest point in 2016. It is also possible that the managers on the front lines were not informed until SNY pulled the plug; although company rumors must have been running rampant. The relatively flat script numbers during the last six months of 2015 are consistent with an early decision to terminate the partnership. IMO, MNKD should have insisted on a clause requiring a payment of future milestones if the agreement was terminated after one year.

Regards to other die hard longs,
Chris C