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Post by agedhippie on Jul 9, 2016 14:50:08 GMT -5
Thinking about the Nurse Educators and this topic. As they educate the Drs and patients, they must have to help them decide when to take Afrezza and how to interpret the CGM readings after Afrezza is taken. I can imagine the patients following the advice and saying this works great! Why does it say on the label that it's not better than Lispro? I think it's MUCH better, I'm getting better A1Cs and I'm always in range. The nurse might say "I'm not allowed to tell you that because of what's written on the box, but discuss it with the DR". So in a round about way, the nurse educator is able to tell the doctor (and demonstrate at the same time) that Afrezza is superior. The problem is getting people onto Afrezza in the first place. A CDE is unlikely to swap someone to Afrezza without talking with their endo because clinically it's a big move. This is a chicken and egg problem. Once you get good results then the patient will speak up without any prompting. Type 1 diabetics tend to be fairly vocal especially if the doctor may be about to take away something that works.
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Post by rockstarrick on Jul 9, 2016 15:06:27 GMT -5
I think it was said best by someone already on this board (if true and I understood correctly) that reps can send the literature (with off label results from clamp studiers etc...) to each doctor and then follow up and ask if they have read it allowing the reps a legal entry into the off label conversation with the doctors. If this is true then any rep worth his or her job has already mailed out all the literature to all the doctors on their list and is beginning the follow up. They cannot do that. The doctor has to specifically request the literature. This is where raising awareness like the ADA event matters because it lets the doctor know what is out there and they can then ask the rep for the literature. Doesn't everything presented at the ADA get published in the Journal of American Medicine ??
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Post by agedhippie on Jul 9, 2016 15:11:54 GMT -5
They cannot do that. The doctor has to specifically request the literature. This is where raising awareness like the ADA event matters because it lets the doctor know what is out there and they can then ask the rep for the literature. Doesn't everything presented at the ADA get published in the Journal of American Medicine ?? No. More likely in Care Diabetes because that's the ADA research journal. Typically though these are published in the conference proceedings. For the ADA conference they have the presentations on-line (password protected sadly).
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Post by kc on Jul 9, 2016 16:49:29 GMT -5
We just have to have patience and wait for the marketing efforts of the sales team to take effect. I believe we will see traction within 6 to 12 months.
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Post by kball on Jul 9, 2016 17:24:02 GMT -5
We just have to have patience and wait for the marketing efforts of the sales team to take effect. I believe we will see traction within 6 to 12 months. Insurance formularies would seem priority 1A. No hope of big sales jump until then realistically. Drugs are too damn expensive. So maybe 2nd quarter 2017?
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Post by rockstarrick on Jul 9, 2016 17:25:49 GMT -5
Doesn't everything presented at the ADA get published in the Journal of American Medicine ?? No. More likely in Care Diabetes because that's the ADA research journal. Typically though these are published in the conference proceedings. For the ADA conference they have the presentations on-line (password protected sadly). Thanks
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Post by brooklyndoc on Jul 9, 2016 18:10:10 GMT -5
I think it was said best by someone already on this board (if true and I understood correctly) that reps can send the literature (with off label results from clamp studiers etc...) to each doctor and then follow up and ask if they have read it allowing the reps a legal entry into the off label conversation with the doctors. If this is true then any rep worth his or her job has already mailed out all the literature to all the doctors on their list and is beginning the follow up. Sales reps can never have any off label conversation with doctors. Never. Ever. What sales reps can do in response to unsolicited off-label questions is refer the doctor to the company Medical Affairs department (sometimes called Medical Information or Scientific Communication) for carefully scripted, prepared, approved (and narrowly constrained) responses based on the available data and put into the context of the label. If MannKind has a scientific field force (often called Medical Science Liaisons), those people can have data-driven conversations with physicians in response to off-label questions, but they still can't make new claims about efficacy (and I don't know if MannKind does have any MSLs). For example, MSLs would not be able to make a link between the glucose-clamp data and a claim for superior clinical efficacy. And MSLs cannot talk about anecdotal data, such as those folks posting to social media.
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Post by mnholdem on Jul 10, 2016 8:45:08 GMT -5
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Post by uvula on Jul 10, 2016 9:07:39 GMT -5
It almost seems like mnkd should fire the sales reps and put that money into studies that will improve the label. Then afrezza will almost sell itself. If the sales reps are so constrained we can't really blame the sny reps for doing poorly.
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