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Post by Deleted on Feb 4, 2016 14:05:12 GMT -5
Informative opinions will be appreciated.
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Post by dreamboatcruise on Feb 4, 2016 14:20:29 GMT -5
I would think it is possible. If there are interested acquirers I would also think there would be parties interested in partnering, so I guess I believe that a scenario leading to higher shareholder value is as likely or more likely to involve multiple deals short of a buyout. Though I don't have lots of conviction in either of those scenarios. MNKD cannot survive without more cash and I don't think more cash will come from the markets or creditors until we get some deal for Afrezza marketing... or a really good deal with upfront and lots of promise for TS.
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Post by matt on Feb 4, 2016 15:18:32 GMT -5
The three biggest issues are cash, cash, and cash. Without more of it, and very soon, none of the ideas Matt is working on will ever happen.
Matt was clear that he is looking at non-exclusive deals and foreign deals for distribution of Afrezza, something that all but guarantees that no big pharma will participate. I can't remember a single big pharma deal that has gone down since the 1980's where the partner did not have global exclusivity, and part of the reason the small companies can get upfront payments is because they are willing to give global exclusivity. The kind of local or regional deals that may happen now might sell some Afrezza, but it won't come with a big initial chunk of cash and sales will take a while to get going.
TS is even more unlikely to generate big up-front chunks of cash. There is just too much uncertainty in drug delivery deals until the formulation work is complete and the regulatory hurdles are identified. There is a big difference between having an idea to use TS and actually having a working formulation to use TS; look how long it took MNKD to get insulin approved. Most of those efforts fail, that is the nature of the R&D business, and why almost all drug delivery deals are backloaded with milestones and royalties that are paid after the drug is approved.
Which begs the question of where the cash will come from to keep MNKD alive, and for that I don't have a good answer. The financial markets are not very friendly at the moment, the balance sheet cannot tolerate any more senior debt, and I don't see any quick hits for Afrezza or TS that will generate cash. Unless Al wants to increase his investment, all the sources of cash MNKD can still tap are pretty awful people to deal with.
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Post by mnholdem on Feb 4, 2016 15:22:55 GMT -5
Sanofi's own Pascale Witz was published recently (the article is posted here somewhere) stating that a new patient-driven model is needed today and that the old sales & marketing strategies are rapidly becoming obsolete.
eMarketing has grown so large. Take "Cyber-Monday" as a great example. Every retailer used to talk about Black Friday as the day "we'll finally be in the black." I believe that it was either last year or the year before that electronic sales on Cyber Monday exceeded Black Friday sales.
If MannKind get themselves a top-notch marketing executive who really understands eMarketing, I think it's very possible to introduce Afrezza to millions of diabetics and thousands of physicians who, up until now, haven't even heard of it.
If Matt can hire the right person for the job, I think that MannKind can use eMarketing to rapidly grow Afrezza sales. That sales growth will drive share price up. It's pretty hard to argue against the idea that sales has always been the key to survival. |
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Post by esstan2001 on Feb 4, 2016 15:36:30 GMT -5
... There is just too much uncertainty in drug delivery deals until the formulation work is complete and the regulatory hurdles are identified. There is a big difference between having an idea to use TS and actually having a working formulation to use TS; look how long it took MNKD to get insulin approved. Most of those efforts fail, that is the nature of the R&D business, and why almost all drug delivery deals are backloaded with milestones and royalties that are paid after the drug is approved. one thing to consider: Insulin administration is 3x daily for a chronic condition. Some of the applications under consideration are 1 shot (epi) / seldom shot (pain) deals, so the FDA hurdles may be substantially less, especially since Technosphere is now a component of an approved formulation for chronic treatment. |
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Post by dreamboatcruise on Feb 4, 2016 15:44:48 GMT -5
Sanofi's own Pascale Witz was published recently (the article is posted here somewhere) stating that a new patient-driven model is needed today and that the old sales & marketing strategies are rapidly becoming obsolete.
eMarketing has grown so large. Take "Cyber-Monday" as a great example. Every retailer used to talk about Black Friday as the day "we'll finally be in the black." I believe that it was either last year or the year before that electronic sales on Cyber Monday exceeded Black Friday sales.
If MannKind get themselves a top-notch marketing executive who really understands eMarketing, I think it's very possible to introduce Afrezza to millions of diabetics and thousands of physicians who, up until now, haven't even heard of it.
If Matt can hire the right person for the job, I think that MannKind can use eMarketing to rapidly grow Afrezza sales. That sales growth will drive share price up. It's pretty hard to argue against the idea that sales has always been the key to survival. Insurance coverage is a huge issue. We're all hoping that that was a significant factor in around 2/3 of patients not continuing Afrezza after trying it. No emarketing solves that. We've had some online, we've had magazines and we've had direct mail. Unfortunately there is little that can be done in the world of drugs in emarketing that is likely to catch on like wildfire. Too many FDA restrictions. Even take the amazing results the early adopters have had... they are tweeted and the really outstanding ones might get 40 retweets. More than one of the doctors that participate here have stated that they are skeptical that emarketing or social media is something that would sway many doctors. Do you REALLY think that smart drug companies would still be spending billions on marketing/sales... if a shoestring budget and some 25 year old that knows how to market shoes online would achieve the same thing? Rapid Afrezza sales are a long ways off and will not come cheaply. I think the best we could hope for is some targeted approach (perhaps the "clinic") that can rebuild confidence in Afrezza... great patient results and clarifying that a majority don't drop use after trying because of flaws in product... then we might get the money needed to really do marketing/sales. |
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Post by bearcatmax on Feb 4, 2016 15:45:35 GMT -5
The three biggest issues are cash, cash, and cash. Without more of it, and very soon, none of the ideas Matt is working on will ever happen. Matt was clear that he is looking at non-exclusive deals and foreign deals for distribution of Afrezza, something that all but guarantees that no big pharma will participate. I can't remember a single big pharma deal that has gone down since the 1980's where the partner did not have global exclusivity, and part of the reason the small companies can get upfront payments is because they are willing to give global exclusivity. The kind of local or regional deals that may happen now might sell some Afrezza, but it won't come with a big initial chunk of cash and sales will take a while to get going. TS is even more unlikely to generate big up-front chunks of cash. There is just too much uncertainty in drug delivery deals until the formulation work is complete and the regulatory hurdles are identified. There is a big difference between having an idea to use TS and actually having a working formulation to use TS; look how long it took MNKD to get insulin approved. Most of those efforts fail, that is the nature of the R&D business, and why almost all drug delivery deals are backloaded with milestones and royalties that are paid after the drug is approved. Which begs the question of where the cash will come from to keep MNKD alive, and for that I don't have a good answer. The financial markets are not very friendly at the moment, the balance sheet cannot tolerate any more senior debt, and I don't see any quick hits for Afrezza or TS that will generate cash. Unless Al wants to increase his investment, all the sources of cash MNKD can still tap are pretty awful people to deal with. They still have the 30 mil loan from Al available on top of current cash. Matt has said he would be willing to increase this as well I believe. |
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Post by stevil on Feb 4, 2016 15:54:37 GMT -5
Sanofi's own Pascale Witz was published recently (the article is posted here somewhere) stating that a new patient-driven model is needed today and that the old sales & marketing strategies are rapidly becoming obsolete.
eMarketing has grown so large. Take "Cyber-Monday" as a great example. Every retailer used to talk about Black Friday as the day "we'll finally be in the black." I believe that it was either last year or the year before that electronic sales on Cyber Monday exceeded Black Friday sales.
If MannKind get themselves a top-notch marketing executive who really understands eMarketing, I think it's very possible to introduce Afrezza to millions of diabetics and thousands of physicians who, up until now, haven't even heard of it.
If Matt can hire the right person for the job, I think that MannKind can use eMarketing to rapidly grow Afrezza sales. That sales growth will drive share price up. It's pretty hard to argue against the idea that sales has always been the key to survival. Insurance coverage is a huge issue. We're all hoping that that was a significant factor in around 2/3 of patients not continuing Afrezza after trying it. No emarketing solves that. We've had some online, we've had magazines and we've had direct mail. Unfortunately there is little that can be done in the world of drugs in emarketing that is likely to catch on like wildfire. Too many FDA restrictions. Even take the amazing results the early adopters have had... they are tweeted and the really outstanding ones might get 40 retweets. More than one of the doctors that participate here have stated that they are skeptical that emarketing or social media is something that would sway many doctors. Do you REALLY think that smart drug companies would still be spending billions on marketing/sales... if a shoestring budget and some 25 year old that knows how to market shoes online would achieve the same thing? Rapid Afrezza sales are a long ways off and will not come cheaply. I think the best we could hope for is some targeted approach (perhaps the "clinic") that can rebuild confidence in Afrezza... great patient results and clarifying that a majority don't drop use after trying because of flaws in product... then we might get the money needed to really do marketing/sales. I can see emarketing being really successful in the future, but I'm not sure its time has come yet. I'm not nearly as tech-savvy as some of my classmates. They're able to organize all of their notes onto their ipads. The best I can do is use a stylus to write on mine. Anyway, the reason I see emarketing being successful in the future- even apart from the billions of dollars it would save- is that the younger generations don't want printed paper anymore. It's clutter. Even for the books that I read, I use digital copies. you can use search functions and other handy things... It's just quicker than having to go to an index, thumb through the alphabet, find that page number, go back, you get the point. If there's one thing I've learned since starting medical school it's how to be more efficient in everything that I do. I almost make a game out of cutting corners. Ok, sorry... rambling... So why I think emarketing will be the wave of the future, if done properly, is that it allows physicians to have some control over what they research. They can be given lists of pathologies and click on the ones that interest them and have a whole slew of drugs and their mechanisms pop up. I guess I'm not there yet, but I imagine I'll need a brief refresher on some of the mechanisms when I get to that point. All that information would be accessible right at the hands of the doctor. If the marketing company does it right, they should be able to add visual effects (but nothing elaborate that will waste time or distract) to keep things vivid and interesting. So everything would be in one place as well as allowing the physician to peek at his/her own leisure. I'm pretty sure I'd be more interested in drugs if I had a digital catalogue that had charts and graphs and empirical data that was easy to find and access. I'd want to stay up on the "latest and greatest". Anyway, just my opinion... |
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Post by dreamboatcruise on Feb 4, 2016 17:01:39 GMT -5
I can see emarketing being really successful in the future, but I'm not sure its time has come yet. I'm not nearly as tech-savvy as some of my classmates. They're able to organize all of their notes onto their ipads. The best I can do is use a stylus to write on mine. Anyway, the reason I see emarketing being successful in the future- even apart from the billions of dollars it would save- is that the younger generations don't want printed paper anymore. It's clutter. Even for the books that I read, I use digital copies. you can use search functions and other handy things... It's just quicker than having to go to an index, thumb through the alphabet, find that page number, go back, you get the point. If there's one thing I've learned since starting medical school it's how to be more efficient in everything that I do. I almost make a game out of cutting corners.Ok, sorry... rambling... So why I think emarketing will be the wave of the future, if done properly, is that it allows physicians to have some control over what they research. They can be given lists of pathologies and click on the ones that interest them and have a whole slew of drugs and their mechanisms pop up. I guess I'm not there yet, but I imagine I'll need a brief refresher on some of the mechanisms when I get to that point. All that information would be accessible right at the hands of the doctor. If the marketing company does it right, they should be able to add visual effects (but nothing elaborate that will waste time or distract) to keep things vivid and interesting. So everything would be in one place as well as allowing the physician to peek at his/her own leisure. I'm pretty sure I'd be more interested in drugs if I had a digital catalogue that had charts and graphs and empirical data that was easy to find and access. I'd want to stay up on the "latest and greatest". Anyway, just my opinion... yes... people are consuming things online or electronically, but that doesn't translate into some miracle new cheap way of marketing drugs. I for one, no longer subscribe to any paper magazines... I read them all on a tablet. To whatever extent I paid attention to ads in the print edition I suppose I now do with the electronic versions... and I suspect the publishers get roughly the same ad revenue based on the number of distributed copies. That isn't some revolution, and really is just a minor tweak to the ad model. Are banner ads going to be the revolutionary emarketing that changes things? I've seen them here. It appears that the site Tudiabetes only uses googleads for placement so presumably Afrezza ads might pop up there occasionally... but even if somehow ads targeting for those kind of sites is improved and shown more often, what percentage of PWD population really participates in those on a regular basis. I would think the articles they've written would have already done about as much for awareness as would be possible with ads. As for as catalogs of drugs for doctors... I believe that already exists as apps for tablets and phones. I'm sure Afrezza is included. I can see where perhaps there is some cost savings to be had via electronic marketing to docs... such as targeting professional endo organizations with webiners vs free lunch talks... but the reason the free lunch is given is that the food and the networking opportunity makes it more likely a busy doc will bother sitting through the talk. Personally I liked the idea of an Afrezza bus going to various diabetes events. Marketing in the real world and targeted at people that aren't treating their diabetes like something they only think about once every 6 months when they have to go and get scolded once again by their doc for creeping A1c. As for bold... thank goodness no human organs are square  |
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Post by stevil on Feb 4, 2016 18:16:46 GMT -5
I can see emarketing being really successful in the future, but I'm not sure its time has come yet. I'm not nearly as tech-savvy as some of my classmates. They're able to organize all of their notes onto their ipads. The best I can do is use a stylus to write on mine. Anyway, the reason I see emarketing being successful in the future- even apart from the billions of dollars it would save- is that the younger generations don't want printed paper anymore. It's clutter. Even for the books that I read, I use digital copies. you can use search functions and other handy things... It's just quicker than having to go to an index, thumb through the alphabet, find that page number, go back, you get the point. If there's one thing I've learned since starting medical school it's how to be more efficient in everything that I do. I almost make a game out of cutting corners.Ok, sorry... rambling... So why I think emarketing will be the wave of the future, if done properly, is that it allows physicians to have some control over what they research. They can be given lists of pathologies and click on the ones that interest them and have a whole slew of drugs and their mechanisms pop up. I guess I'm not there yet, but I imagine I'll need a brief refresher on some of the mechanisms when I get to that point. All that information would be accessible right at the hands of the doctor. If the marketing company does it right, they should be able to add visual effects (but nothing elaborate that will waste time or distract) to keep things vivid and interesting. So everything would be in one place as well as allowing the physician to peek at his/her own leisure. I'm pretty sure I'd be more interested in drugs if I had a digital catalogue that had charts and graphs and empirical data that was easy to find and access. I'd want to stay up on the "latest and greatest". Anyway, just my opinion... yes... people are consuming things online or electronically, but that doesn't translate into some miracle new cheap way of marketing drugs. I for one, no longer subscribe to any paper magazines... I read them all on a tablet. To whatever extent I paid attention to ads in the print edition I suppose I now do with the electronic versions... and I suspect the publishers get roughly the same ad revenue based on the number of distributed copies. That isn't some revolution, and really is just a minor tweak to the ad model. Are banner ads going to be the revolutionary emarketing that changes things? I've seen them here. It appears that the site Tudiabetes only uses googleads for placement so presumably Afrezza ads might pop up there occasionally... but even if somehow ads targeting for those kind of sites is improved and shown more often, what percentage of PWD population really participates in those on a regular basis. I would think the articles they've written would have already done about as much for awareness as would be possible with ads. As for as catalogs of drugs for doctors... I believe that already exists as apps for tablets and phones. I'm sure Afrezza is included. I can see where perhaps there is some cost savings to be had via electronic marketing to docs... such as targeting professional endo organizations with webiners vs free lunch talks... but the reason the free lunch is given is that the food and the networking opportunity makes it more likely a busy doc will bother sitting through the talk. Personally I liked the idea of an Afrezza bus going to various diabetes events. Marketing in the real world and targeted at people that aren't treating their diabetes like something they only think about once every 6 months when they have to go and get scolded once again by their doc for creeping A1c. As for bold... thank goodness no human organs are square haha! that was funny  No surgery in my future... I don't have the stamina or time for that. I want to still have a somewhat "normal" life. So don't worry, I won't be cutting any of your corners Anyway, the kind of marketing I was talking about was somehow having all of the drug companies agree to have all of the drugs in one place... There are already catalogues with all of that stuff. I just tried logging into my epocrates account, but I can't remember my info because I haven't used it on my new phone yet. There are databases that have all of that stuff like you said. And they give contraindications and brief descriptions of mechanisms of action. Unless they've updated it or it's available on the paid version, it doesn't really offer any data as far as efficacy (doesn't make claims like Lipitor lowers cholesterol better than Zocor or Pravachol, etc) or speed of onset for pain meds, etc... like graphs and charts would be really helpful to see those things as would a more detailed mechanism that would show why a certain drug is more specific to a particular ailment and would cause fewer side effects, etc. None of that information is listed in epocrates. I completely agree with you regarding banner ads and internet ads for targeting customers. I feel like their best bet is to make videos on youtube and somehow find a way to attract viewers that way. Even though I usually skip ads, youtube and other sites make you wait 5 seconds before you can and every now and then I find myself watching one without knowing it. But it's that damn label again that will prevent us from making a good video that can capture attention quickly. We can't make claims yet that will pique interest. |
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Post by dreamboatcruise on Feb 4, 2016 18:53:38 GMT -5
I completely agree with you regarding banner ads and internet ads for targeting customers. I feel like their best bet is to make videos on youtube and somehow find a way to attract viewers that way. Even though I usually skip ads, youtube and other sites make you wait 5 seconds before you can and every now and then I find myself watching one without knowing it. But it's that damn label again that will prevent us from making a good video that can capture attention quickly. We can't make claims yet that will pique interest. Whether youtube is a cheaper channel on a per eyeball basis is something I don't know. Maybe it provides a mechanism for finer granularity of ad targeting. For instance on TV one could target the metropolitan area where the first Afrezza clinic is located, but with Youtube I'm sure you might be able to get down to zip code... and by demographic, if for instance they find that younger people are more receptive, etc. So there may be some benefit to youtube... but I don't really envision that "attracting viewers" in the traditional sense of youtube is something that would happen. People aren't going to be passing around links of a drug ad as something their friends should view. They basically already have the ads as SNY shot the content. Nothing earth shattering though because of FDA restrictions. Though... if one really wanted to think outside the box... maybe you hire really good comedy writer to come up with sketch that might go viral... based on group of young people sitting at restaurant table... funny part has NOTHING to do with afrezza, but during the over the top fun interaction one of them quickly pops in a cartridge and takes a puff (no focus on them and no one bothers to notice)... at the end of the comedy part the image pops back in time to zoom in on person inhaling and then you start the Afrezza ad voice over saying "The only insulin that doesn't inject itself into your fun"... inhaled, blah, blah, medical stuff, black box, etc. [tell Matt my scene card concept is available for a small fee] Still highly skeptical that you can do something that both attracts viewers and passes FDA muster. |
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Post by falconquest on Feb 4, 2016 18:58:41 GMT -5
The three biggest issues are cash, cash, and cash. Without more of it, and very soon, none of the ideas Matt is working on will ever happen. Matt was clear that he is looking at non-exclusive deals and foreign deals for distribution of Afrezza, something that all but guarantees that no big pharma will participate. I can't remember a single big pharma deal that has gone down since the 1980's where the partner did not have global exclusivity, and part of the reason the small companies can get upfront payments is because they are willing to give global exclusivity. The kind of local or regional deals that may happen now might sell some Afrezza, but it won't come with a big initial chunk of cash and sales will take a while to get going. TS is even more unlikely to generate big up-front chunks of cash. There is just too much uncertainty in drug delivery deals until the formulation work is complete and the regulatory hurdles are identified. There is a big difference between having an idea to use TS and actually having a working formulation to use TS; look how long it took MNKD to get insulin approved. Most of those efforts fail, that is the nature of the R&D business, and why almost all drug delivery deals are backloaded with milestones and royalties that are paid after the drug is approved. Which begs the question of where the cash will come from to keep MNKD alive, and for that I don't have a good answer. The financial markets are not very friendly at the moment, the balance sheet cannot tolerate any more senior debt, and I don't see any quick hits for Afrezza or TS that will generate cash. Unless Al wants to increase his investment, all the sources of cash MNKD can still tap are pretty awful people to deal with. My sense is that they need to partner soon or sell something. It will be real telling if no other BP steps up to offer a partnership for Afrezza in my opinion. Not sure if that means no one wants to touch it because it is not perceived as viable or if it's that we're sitting on the 100 mpg carburetor that big business wants to keep out of the market. I certainly cannot imagine someone stepping up to get involved with the best treatment for diabetes in decades. |
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Post by falconquest on Feb 4, 2016 19:00:08 GMT -5
That last line should read cannot image someone NOT stepping up.....
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Post by jlaw277 on Feb 4, 2016 19:04:55 GMT -5
At the end of the day, one has to wonder what Al Mann will do to protect his investment. If he believes the feedback from early adopters and sees Afrezza fulfilling his expectations, it would seem prudent to loan (in some form) $100mm in order to allow the company to show traction through the various pathways Matt has outlined. Bankruptcy would wipe out his shares and Deerfield would be in control going into BK. Taking it private would still leave him with the Deerfield problem and it would prevent future access to the equity markets in the event things start to improve. At this point, a credit line (or mezzanine debt or preferred) from him would probably move the stock price meaningfully at which point the equity markets might be an option. He would almost certainly have to subordinate any further financing to the Deerfield piece and other remaining debt. I would think that it really comes down to what he thinks is possible and if he still believes as strongly in Afrezza, especially given what they have learned from the SNY experience. It would also probably be the nuclear option meaning that all other options would not be possible.
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Post by jurystillout on Feb 4, 2016 19:11:14 GMT -5
I would be curious how many e-mails Matt received prior to his last CC asking him to layout the plans to fund operation until mnkd products are able to fund operations themselves. I know that was the question that I asked and the issue that concerns me the most, however the question was not even addressed. I appreciate Matts efforts however if he doesn't know the answer to this question, we are in serious trouble and to answer your question "no".
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No surgery in my future... I don't have the stamina or time for that. I want to still have a somewhat "normal" life. So don't worry, I won't be cutting any of your corners 