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Post by therealisaching on Jun 17, 2016 14:12:39 GMT -5
That's the bottom line. They are already working with about 100 NRx today and with a dedicated sales force and proper support channels if they can't ramp up quicker than those early Sanofi numbers by October it is not going to be pretty. Oddly that wouldn't bother me as I don't expect the sales to ramp up that fast. Getting in front of endos may prove to be problematic for the sales force. There are a limited number of time slots and the competition are both a known quantity and have multiple drugs to show in a slot. Mannkind is the new kid on the block and has only one product but still takes up a slot so there may be some reluctance to schedule them. I am not sure what the impact of using a contract sales force will be either as they probably don't have the relationships in place that the dedicated sales force do (I have no idea if this is a real issue but I guess others do). All in all I think this takes time and I'm looking towards mid to late 2018 to see serious progress. I would have agreed with the contract salesforce barrier issue, but Mannkind did reap a bit of good fortune. AstraZeneca laid off approx 1600 contract workers largely in the diabetes space. These contract employees were with Touchpoints. Many of the new hires should have contacts.
www.fiercepharma.com/pharma/astrazeneca-cuts-1-600-contract-reps-house-force-drive-to-save-1-1b-sources
Mike C alluded to this in a tweet, that seems to have been deleted.
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Post by tayl5 on Jun 17, 2016 19:47:23 GMT -5
Another thing to keep in mind is that the longer the saga goes on, the more touches there are between MannKind/Afrezza and the doctors. It's not just rep contacts, it's conference contacts, patient contacts, colleague contacts, social media mentions and, God help us, investor news and contacts. Even if these contacts aren't all positive, they build familiarity and lower the perceived novelty risk for the doctor.
There was a famous experiment where researchers published a different nonsense word each day on the front page of a college newspaper. No one knew who the researchers were or what was happening. The researchers varied the frequency with which the words appeared and, at the end of the experiment, they surveyed people at the university on their perception of how positive specific words were. There should have been no difference, but there was a clear correlation between how often a word was published and how positively it was perceived. If we're lucky we'll see a similar effect for Afrezza.
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Post by capnbob on Jun 17, 2016 21:24:45 GMT -5
The thing that I'm most curious about is what the new salespeolple will say to endos that will make any difference from what Sanofi salespeople said. The label remains unchanged from what the Sanofi people used, so how will new reps make any more impact? Also, I recall Sanofi allegedly subcontracted some sales to Quintiles sometime last year. Was that just a rumor? Has Mannkind ever contacted them? Perhaps Quintiles already has experienced reps and contacts available.
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Post by nylefty on Jun 17, 2016 22:24:18 GMT -5
The thing that I'm most curious about is what the new salespeolple will say to endos that will make any difference from what Sanofi salespeople said. The label remains unchanged from what the Sanofi people used, so how will new reps make any more impact? Also, I recall Sanofi allegedly subcontracted some sales to Quintiles sometime last year. Was that just a rumor? Has Mannkind ever contacted them? Perhaps Quintiles already has experienced reps and contacts available. Maybe their attitude will be different. Sanofi rep: I'm getting the strong impression that the new boss wants to sandbag Afrezza and have us plug our other diabetes drugs instead. Mannkind rep: Mike is pushing us hard and giving us the resources to make Afrezza a success. If it is, I'm a success. If it isn't, I'll need to find another job.
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Post by mnkdnut on Jun 17, 2016 23:57:00 GMT -5
The thing that I'm most curious about is what the new salespeolple will say to endos that will make any difference from what Sanofi salespeople said. The label remains unchanged from what the Sanofi people used, so how will new reps make any more impact? Also, I recall Sanofi allegedly subcontracted some sales to Quintiles sometime last year. Was that just a rumor? Has Mannkind ever contacted them? Perhaps Quintiles already has experienced reps and contacts available. Same label, same non-inferior clinical trial data, but totally different approach to doctors. SNY reps would have to back off at any sign of resistance to Afrezza because they couldn't risk losing the other/main business they did with him/her. A MNKD rep cannot afford to leave any stone un-turned in getting the message across to the doc or solving any barriers in the way, and has nothing to lose (and everything to gain) by being insistent and persistent. The SNY rep acts like a distributor and order taker, the MNKD rep is an evangelist. The MNKD rep has to have credible relationships with endos he/she can tap, or they should not have been hired for this position. Go get'em reps. All that being said, eventually and ultimately they will need better outcomes data - the kind that says superior to RAAs. Mike mentioned a "time in range" study. That would be a good start. I hope it's underway.
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Post by Deleted on Jun 18, 2016 0:03:22 GMT -5
The thing that I'm most curious about is what the new salespeolple will say to endos that will make any difference from what Sanofi salespeople said. The label remains unchanged from what the Sanofi people used, so how will new reps make any more impact? Also, I recall Sanofi allegedly subcontracted some sales to Quintiles sometime last year. Was that just a rumor? Has Mannkind ever contacted them? Perhaps Quintiles already has experienced reps and contacts available. Family medicine providors also very frequently prescribe diabetes medications, and help manage their condition. Sometimes tweaking their regimen based on a number of factors (most often because of insurance issues and/or the wait time to see an endocrinologist, or what they are on is not sufficient). At least in my state it is pretty common. Also, in the hosptial setting, hospitalists prescribe diabetes medications everyday.
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Post by brotherm1 on Jun 18, 2016 0:51:21 GMT -5
"Maybe their attitude will be different.
Sanofi rep: I'm getting the strong impression that the new boss wants to sandbag Afrezza and have us plug our other diabetes drugs instead.
Mannkind rep: Mike is pushing us hard and giving us the resources to make Afrezza a success. If it is, I'm a success. If it isn't, I'll need to find another job."
Lefty that statement appears short and simple but runs totally profound in my book. You just hit a line drive out of the park with that one. And again, the reps will be 100% committed to selling only one product. m
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Post by babaoriley on Jun 18, 2016 1:25:45 GMT -5
Lefty, nice post, just one thought: "'If it is, I'm a success. If it isn't, I'll need to find another job.'" Is more accurately, unfortunately, "'If it is, I'm a success. If it isn't, I'll need to find yet another new job."
I'm not sayin' our new sales force is exactly the Dirty Dozen (remember that movie?), but they are folk who recently got laid off. Perhaps Mike can motivate them to show their ex-employer what king of salesperson they lost.
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Post by LosingMyBullishness on Jun 18, 2016 5:14:01 GMT -5
That's the bottom line. They are already working with about 100 NRx today and with a dedicated sales force and proper support channels if they can't ramp up quicker than those early Sanofi numbers by October it is not going to be pretty. Oddly that wouldn't bother me as I don't expect the sales to ramp up that fast. Getting in front of endos may prove to be problematic for the sales force. There are a limited number of time slots and the competition are both a known quantity and have multiple drugs to show in a slot. Mannkind is the new kid on the block and has only one product but still takes up a slot so there may be some reluctance to schedule them. I am not sure what the impact of using a contract sales force will be either as they probably don't have the relationships in place that the dedicated sales force do (I have no idea if this is a real issue but I guess others do). All in all I think this takes time and I'm looking towards mid to late 2018 to see serious progress. Aged, This is odd. How can it not bother you if MNKD fails in generating positive cashflow? They will run out of money and since the last financing was already pretty bad for shareholder the next one will be a disaster. Mnkd will become the pennystock JO and others had wished for. Even if you are not invested it right now this can not be what you want.
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Post by brotherm1 on Jun 18, 2016 8:18:03 GMT -5
Lefty, nice post, just one thought: "'If it is, I'm a success. If it isn't, I'll need to find another job.'" Is more accurately, unfortunately, "'If it is, I'm a success. If it isn't, I'll need to find yet another new job." I'm not sayin' our new sales force is exactly the Dirty Dozen (remember that movie?), but they are folk who recently got laid off. Perhaps Mike can motivate them to show their ex-employer what king of salesperson they lost. I would think these reps are also greatly incentivized to succeed with the likelihood of advancement within this company that is poised to expand. This is what most good sales reps thrive on, a promising future. And Afrezza is a terrific product a sales person will believe whole heartedly in. Sincerely believing in what one is selling makes the job much less of a job and much more of a pleasure. That should put bright smiles on the reps that the docs/endos would be glad to open their doors to. The product and company holds a lot of promise. It's got to be very exciting for the employees.
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Post by kball on Jun 18, 2016 10:00:36 GMT -5
Lefty, nice post, just one thought: "'If it is, I'm a success. If it isn't, I'll need to find another job.'" Is more accurately, unfortunately, "'If it is, I'm a success. If it isn't, I'll need to find yet another new job." I'm not sayin' our new sales force is exactly the Dirty Dozen (remember that movie?), but they are folk who recently got laid off. Perhaps Mike can motivate them to show their ex-employer what king of salesperson they lost. I would think these reps are also greatly incentivized to succeed with the likelihood of advancement within this company that is poised to expand. This is what most good sales reps thrive on, a promising future. And Afrezza is a terrific product a sales person will believe whole heartedly in. Sincerely believing in what one is selling makes the job much less of a job and much more of a pleasure. That should put bright smiles on the reps that the docs/endos would be glad to open their doors to. The product and company holds a lot of promise. It's got to be very exciting for the employees. First rep to 1000 scripts gets to run the company!
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Post by LosingMyBullishness on Jun 18, 2016 10:56:47 GMT -5
I wondered why the institutional shorts are covering now. My assumption is that the benchmark of 100 scripts per week is so low right now that the chances for a significant increase are high. And this might send an impulse to investors and traders to buy a stock in turnaround. This could be the buying shorts could not mitigate with the present control mechanisms. And is could even trigger some media coverage that would amplify this notion. Even stories about Sanofi sandbagging Afrezza to improve profit vs quality of life for patients could get more into headlines. In a nutshell: the benchmark is so pathetically low that Mike's team might have little problem to reach multiples. Still too low for cashflow but significant for media and investors.
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Post by rravis1914 on Jun 18, 2016 11:05:51 GMT -5
In my mind the greatest obstacle is cost. I am a 78 yr. old T2. I would love to be on Afrezza but I can't afford $300/month cost. United Health Care in Fl. does not cover. When it does, I will be first in line. I don't know how our cost of goods compares to other insulin products. When a Doc rxs something, he is concerned about Rx costs, otherwise patient will not fill script. Our first objective is to become competitive with the competition. Nothing will be more discouraging to a rep than to hear "I like your product but it is too expensive for my patients. Let me know when Insurance will cover it".
I was a rep for 30 years and I know how that will hurt.
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Post by Deleted on Jun 18, 2016 11:25:49 GMT -5
In my mind the greatest obstacle is cost. I am a 78 yr. old T2. I would love to be on Afrezza but I can't afford $300/month cost. United Health Care in Fl. does not cover. When it does, I will be first in line. I don't know how our cost of goods compares to other insulin products. When a Doc rxs something, he is concerned about Rx costs, otherwise patient will not fill script. Our first objective is to become competitive with the competition. Nothing will be more discouraging to a rep than to hear "I like your product but it is too expensive for my patients. Let me know when Insurance will cover it". I was a rep for 30 years and I know how that will hurt. Did u reach out to Mike at freedom@mannkindcorp.com and tell him about this? If not you should right away and let us know the progress
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Post by Deleted on Jun 18, 2016 12:26:30 GMT -5
The thing that I'm most curious about is what the new salespeolple will say to endos that will make any difference from what Sanofi salespeople said. The label remains unchanged from what the Sanofi people used, so how will new reps make any more impact? Also, I recall Sanofi allegedly subcontracted some sales to Quintiles sometime last year. Was that just a rumor? Has Mannkind ever contacted them? Perhaps Quintiles already has experienced reps and contacts available. Maybe their attitude will be different. Sanofi rep: I'm getting the strong impression that the new boss wants to sandbag Afrezza and have us plug our other diabetes drugs instead. Mannkind rep: Mike is pushing us hard and giving us the resources to make Afrezza a success. If it is, I'm a success. If it isn't, I'll need to find another job. Capnbob aka Fragslap To add to Ny Leftys response- Dr's and Sales reps probably have off the record conversations all the time. There are plenty of Dr's aware that the FDA plays games and while its illegal to mention otherwise its completely naive to think conversations dont take place.
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