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Post by factspls88 on May 11, 2016 11:34:39 GMT -5
I have to believe that an announcement by Mannkind of a price drop for Afrezza would be a postive catalyst for the stock price. However, it would have to be parity pricing to Novolog and Humalog for it to have any impact.
If premium pricing is going to be maintained it has to be accompanied by meaningful superiority claims backed by hard data to get better insurance coverage. Could the abstracts to be presented in June fit that bill?
I would prefer the latter but barring that, Mannkind needs to drop the price.
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Post by rockstarrick on May 11, 2016 12:00:09 GMT -5
If Mannkind is expecting to see profits from this sales force and marketing team they have assembled they better drop the price enough to represent the "noninferior" label we have.
Mannkind needs across the board, complete coverage, with very reasonable copays, and they need to make sure any confusion, or hurdles PWD have to negotiate to get a script are gone !!! All of this should be done now !!! Not after the sales force starts pushing Afrezza.
We have been selling Afrezza long enough to know the problem areas, Mike needs to make the Afrezza shopping experience a pleasant one, no pre authorization, no high copays, the spirometry process needs to be evaluated and the spiro instructions to Healthcare providers and the patients need to be concise and consistant !!
I have faith in both Mike and Matt, but there are huge hurdles in the process of getting a prescription of Afrezza, these need to be gone immediately or sooner IMO.
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Post by therealisaching on May 11, 2016 12:09:50 GMT -5
www.activatethecard.com/7055/#
It's been mentioned on the board a few times now. MNKD has issued an Afrezza patient savings card. First fill $0, refills no more than $30 |
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Post by sluggobear on May 11, 2016 12:17:13 GMT -5
I keep beating this drum but I'm afraid poor insurance coverage and the PA process are real barriers. Yes drop the price - but can they price it for patients to buy without needing insurance completely? If they can take out the insurance/PA etc. barriers for 6 months then at least we can see if it will sell.
Announce a program of cut-rate insulin for all diabetics on Medicaid. Get national news attention. One decent headline (David vs. Goliath BP, anti-Shkreli approach) could go viral.
And the clinical trials were small safety trials, not powered for demonstration of better efficacy or even less hypos. I assume they met the basic primary endpoints which were safety in nature.
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Post by rockstarrick on May 11, 2016 12:23:09 GMT -5
www.activatethecard.com/7055/#
It's been mentioned on the board a few times now. MNKD has issued an Afrezza patient savings card. First fill $0, refills no more than $30 Yes I know, I have one. There are many other issues that need to be dealt with other than the savings card, and even though I had no trouble getting one, there are a few people posting that after several attempts they were unsuccessful at getting the discount card. Please don't get me wrong, I'm not a basher, never !!! but MNKD needs to make the process easier for both the prescribers and the patients. getting a prescription of afrezza is far from easy at this time, I really hope this changes before the sales force hits the road, we need happy customers, not frustrated customers, right ?? Good Luck |
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Post by therealisaching on May 11, 2016 12:28:01 GMT -5
Correct, we need happy customers.
Wasnt criticizing. Just didnt know if you were aware.
Best |
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Post by tripoley on May 11, 2016 12:40:05 GMT -5
I have to believe that an announcement by Mannkind of a price drop for Afrezza would be a postive catalyst for the stock price. However, it would have to be parity pricing to Novolog and Humalog for it to have any impact. If premium pricing is going to be maintained it has to be accompanied by meaningful superiority claims backed by hard data to get better insurance coverage. Could the abstracts to be presented in June fit that bill? I would prefer the latter but barring that, Mannkind needs to drop the price. Really they just need to negotiate with payors to get preferred status so patients have low co-pays. I think they're working on that now. |
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Post by factspls88 on May 11, 2016 12:45:59 GMT -5
The discount card is great for temporarily lowering the price and for trial generation but it has an expiration date and max benefit. It can also be very costly. Mannkind needs to make a bold statement that it means business for the long term. Do what it takes to get the label improved/achieve superior product claims asap or lower the price. Lowering the price may be the only feasible option near term unless they can afford to keep the discount card in place on an ongoing basis until testing is complete and superiority claims are approved by the FDA. It might require a $100 million milestone payment to fund, though  . |
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Post by factspls88 on May 11, 2016 12:51:40 GMT -5
I have to believe that an announcement by Mannkind of a price drop for Afrezza would be a postive catalyst for the stock price. However, it would have to be parity pricing to Novolog and Humalog for it to have any impact. If premium pricing is going to be maintained it has to be accompanied by meaningful superiority claims backed by hard data to get better insurance coverage. Could the abstracts to be presented in June fit that bill? I would prefer the latter but barring that, Mannkind needs to drop the price. Really they just need to negotiate with payors to get preferred status so patients have low co-pays. I think they're working on that now. That, of course, would be ideal. Not sure what kind of leverage they have unless Sanofi did squat to make it happen and the payors really weren't the problem. |
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Post by nylefty on May 11, 2016 14:38:17 GMT -5
Really they just need to negotiate with payors to get preferred status so patients have low co-pays. I think they're working on that now. That, of course, would be ideal. Not sure what kind of leverage they have unless Sanofi did squat to make it happen and the payors really weren't the problem. Is there any doubt? What the bashers either don't realize or choose to ignore is the fact that the Sanofi CEO at the time the deal was signed was enthusiastic about Afrezza but then was succeeded by somebody who chose to sandbag it. It's as simple as that. |
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Post by ilovekauai on May 11, 2016 15:35:45 GMT -5
True, and I failed to recognize what was going on last summer, being in complete denial that the new CEO could even remotely view Afrezza as a threat, which IMO he did. I thought we had a solid partnership! What a bitter pill for me. I defended Sanofi to the end too. I suspect senior management at MNKD were shocked too. Sanofi set us back by at least 18 months, and makes it really tough going now, but I remain long and hope for future success.
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Post by rockstarrick on May 11, 2016 16:00:11 GMT -5
Correct, we need happy customers.
Wasnt criticizing. Just didnt know if you were aware.
Best Thank you !! |
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Post by agedhippie on May 11, 2016 18:10:17 GMT -5
True, and I failed to recognize what was going on last summer, being in complete denial that the new CEO could even remotely view Afrezza as a threat, which IMO he did. I thought we had a solid partnership! What a bitter pill for me. I defended Sanofi to the end too. I suspect senior management at MNKD were shocked too. Sanofi set us back by at least 18 months, and makes it really tough going now, but I remain long and hope for future success. I'm going to say something that will be fairly unpopular at this point. I seriously doubt any of the big pharmas saw Afrezza as any sort of risk at all. The trial data said it was equivalent to analogs in which case the USP was that it was inhaled and the big pharmas did not see that as a huge benefit (I think rightly). Sanofi knew going into this that the label was bad and so getting it broadly accepted by insurers was going to be a stretch without having to drop the price. To mitigate that they bumped the price up to compensate (the price to the Sanofi is set by Mannkind in the Supply Agreement) to try and make it a low volume/high value product. By now it was becoming clear that the doctors were also a problem because the label was worse than for the insulin analogs together with the lung test requirement. Enter the new CEO who wants to review everything the diabetes division is doing to find cost savings because they are his most dysfunctional division. With costs probably running an order of magnitude higher than revenue Afrezza must have stood out like a sore thumb - high expense/low revenue. On the other hand they were tied into a contract until January so they adhered to the letter of the contract and did the bare minimum required to meet the contract. In the short term, and maybe medium term Afrezza did not threaten the established insulins, in the longer term it did but nobody looks that far out as to much can change. The only insulin at risk was Apidra which was the runt of the analog litter, Sanofi would have happily killed that if Afrezza took off. There was no serious threat to Lantus/Toujeo as they have different roles. Afrezza may have reduced the Lantus use by patients, but that is because they were using to much Lantus all along. Simple basal testing would have given substantially the same result - you see the same thing when people move to pumps, their basal requirement drops because their meal time insulin is properly covered (basal is partially used to cover meals which is bad practice) This is all 20:20 hindsight, I never saw any of this at the time and was caught completely flat-footed when Sanofi exited! I would like to think it was all a massive conspiracy but I seriously doubt it was - the truth is usually mundane. |
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Post by anderson on May 11, 2016 19:07:11 GMT -5
Big pharmas may not have seen Afrezza as a threat, but what about the delivery platform......Aspirin on TS is patentable. Any drug about to go off patent is a target. Till TS is proven though you cant go OTC and have to stick to prescription drugs. If Afrezza gains a foot hold, even a small one MNKD will start to advance other products, that is the threat. I think Chris Viehbacher saw this but the board didnt want to go along and got rid of him and got someone who would sandbag Afrezza.(note TS is perfect for immunizations: Sanofi 2015 aggregate sales by business areas: Diabetes €7,580M, Vaccines €4,743M )
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Post by rockstarrick on May 11, 2016 19:42:46 GMT -5
True, and I failed to recognize what was going on last summer, being in complete denial that the new CEO could even remotely view Afrezza as a threat, which IMO he did. I thought we had a solid partnership! What a bitter pill for me. I defended Sanofi to the end too. I suspect senior management at MNKD were shocked too. Sanofi set us back by at least 18 months, and makes it really tough going now, but I remain long and hope for future success. I'm going to say something that will be fairly unpopular at this point. I seriously doubt any of the big pharmas saw Afrezza as any sort of risk at all. The trial data said it was equivalent to analogs in which case the USP was that it was inhaled and the big pharmas did not see that as a huge benefit (I think rightly). Sanofi knew going into this that the label was bad and so getting it broadly accepted by insurers was going to be a stretch without having to drop the price. To mitigate that they bumped the price up to compensate (the price to the Sanofi is set by Mannkind in the Supply Agreement) to try and make it a low volume/high value product. By now it was becoming clear that the doctors were also a problem because the label was worse than for the insulin analogs together with the lung test requirement. Enter the new CEO who wants to review everything the diabetes division is doing to find cost savings because they are his most dysfunctional division. With costs probably running an order of magnitude higher than revenue Afrezza must have stood out like a sore thumb - high expense/low revenue. On the other hand they were tied into a contract until January so they adhered to the letter of the contract and did the bare minimum required to meet the contract. In the short term, and maybe medium term Afrezza did not threaten the established insulins, in the longer term it did but nobody looks that far out as to much can change. The only insulin at risk was Apidra which was the runt of the analog litter, Sanofi would have happily killed that if Afrezza took off. There was no serious threat to Lantus/Toujeo as they have different roles. Afrezza may have reduced the Lantus use by patients, but that is because they were using to much Lantus all along. Simple basal testing would have given substantially the same result - you see the same thing when people move to pumps, their basal requirement drops because their meal time insulin is properly covered (basal is partially used to cover meals which is bad practice) This is all 20:20 hindsight, I never saw any of this at the time and was caught completely flat-footed when Sanofi exited! I would like to think it was all a massive conspiracy but I seriously doubt it was - the truth is usually mundane. I can see your point, but I can't help thinking that if the CEO that actually signed the deal with MNKD would've still been there, things would've played out completely different. Brandicourt has single handedly destroyed sanofis diabetes franchise in my opinion, when the FDA does the post approval safety profile on Toujeo, Sanofi could be hit with tougher label restrictions for Toujeo. I have read numerous testimonials from PWD using Toujeo claiming it doesn't last 24 hours, and due to the concentration, some are building up a resistance to it quickly. Then I keep reflecting on the testimonies from the many Healthcare Professionals that spoke at the afrezza FDA ADCOM, unanimously they all agreed that afrezza, in combination with current therapies, would positively enhance the treatment programs for at least some PWD. So yes, I agree, afrezza was no threat to the basal insulin market and should've been viewed as a tool that would enhance insulin therapy, and as an alternative option to those who don't like injections at mealtime. I guess the thing that bothers me the most, is there are people using afrezza that claim they are no longer held hostage from their diabetes, and if afrezza had been aggressively marketed, how many more would experience this new found freedom ?? What a complete shame it would be if they now, because of Sanofi, lost it. How long until somebody has the funds and tenacity of Al Mann to bring inhaled insulin back to the market ?? All the "big boys" tapped out after Exhubra, they aren't willing to risk the possibility of failing even though they know current therapies, as good as they are, still aren't good enough, they're on cruise control. Nearly every advancement in Diabetes care in the last 20 years has Al Manns hard earned money and his time deeply invested in it, he cared, he was trying to make life better for these people. You would think a leader in Diabetes therapy like Sanofi would've put a little more effort into it, 3 or 4 months of doing just enough to satisfy their obligation, then pull the plug. Disgusting in my opinion, Sanofi doesn't care about PWD, they care about capitolizing on their disease. I hope they sink to the bottom, they disgust me. Sorry for the rant, this is just the way I see it. Good Luck |
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