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Post by straightly on Jul 19, 2016 1:19:50 GMT -5
Our rep to the doctor: "Afrezza is a miracle drug". Doctor: "WOW! Wonderful. I will definitely try it when I get the chance and the right patient comes around.".
When doctor sees a patient, however, unless the patient has some indications that beg changes, the doctor will ask "How things are going? Everything under control? Oh, right, let me extend your prescription before I forget." In fact, he forget and the nurse/assistant actually end up sending the renewal to the pharmacy.
I fail to see where Afrezza will be jammed into the conversation.
Reality is that prescriptions get renewed through call in or even through pharmacy, UNLESS the patients required changes.
So, of all the diabetes patients, we are down to only new patients and/or patients whose situations has significantly changed, which is a very small portion.
Educating the providers works for DIFFERENT treatments. "You mean this indication has a new treatment? You mean this thing can apply to that indication?" For replacement or improved treatments like Afrezza, I still believe we needs the patients to push the providers over the hump.
But no TV commercials please. Too expensive and too nowhere. OTOH, social media is beaconing for opportunities like Afrezza. Anybody know how to create a new type of Pokémon for Afrezza, just in case?
JMHO.
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Post by bioexec25 on Jul 19, 2016 5:50:12 GMT -5
Straightly, you may be slightly underestimating the number of patients interested in reducing needles, gaining freedom and reducing risk. If you're right the script growth will likely be insufficient to sustain operations. Not that that is what you were implying.
Btw, I ike the concept of a guest Pokemon like Outsulin albeit not sure how many pwd play phone apps. :-))
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Post by straightly on Jul 19, 2016 20:30:31 GMT -5
Straightly, you may be slightly underestimating the number of patients interested in reducing needles, gaining freedom and reducing risk. If you're right the script growth will likely be insufficient to sustain operations. Not that that is what you were implying. Btw, I ike the concept of a guest Pokemon like Outsulin albeit not sure how many pwd play phone apps. :-)) "you may be slightly underestimating the number of patients interested in reducing needles."
I am not. In fact, I invested in MNKD because I believe in the number of patients interested in reducing needles AND lowering A1C.
I am concerned, however, that the providers, while interested in and maybe even excited about Afrezza, do not have the trigger, "the kick", to venture off their beaten path. I believe we need something to lure them out and I believe the luring needs to come from the patients.
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Post by sportsrancho on Jul 20, 2016 7:16:42 GMT -5
I am concerned, however, that the providers, while interested in and maybe even excited about Afrezza, do not have the trigger, "the kick", to venture off their beaten path. I believe we need something to lure them out and I believe the luring needs to come from the patients.
I believe this to be true. Some doctors will. But we need to hit the patients with just as much gusto! JMHO
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Post by agedhippie on Jul 20, 2016 7:47:24 GMT -5
I am concerned, however, that the providers, while interested in and maybe even excited about Afrezza, do not have the trigger, "the kick", to venture off their beaten path. I believe we need something to lure them out and I believe the luring needs to come from the patients. I believe this to be true. Some doctors will. But we need to hit the patients with just as much gusto! JMHO If their current approach works for them then I think moving patients or doctors will be extremely difficult. The people to go after is those who are compliant but whose their current approach is not working - they will be open to trying new things. That is a fairly large group and reasonably aware and proactive. No needles is not going to move more than a tiny number of people although it may be popular with newly diagnosed diabetics.
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Post by sweedee79 on Jul 20, 2016 8:40:50 GMT -5
Our rep to the doctor: "Afrezza is a miracle drug". Doctor: "WOW! Wonderful. I will definitely try it when I get the chance and the right patient comes around.".
When doctor sees a patient, however, unless the patient has some indications that beg changes, the doctor will ask "How things are going? Everything under control? Oh, right, let me extend your prescription before I forget." In fact, he forget and the nurse/assistant actually end up sending the renewal to the pharmacy.
I fail to see where Afrezza will be jammed into the conversation.
Reality is that prescriptions get renewed through call in or even through pharmacy, UNLESS the patients required changes.
So, of all the diabetes patients, we are down to only new patients and/or patients whose situations has significantly changed, which is a very small portion.
Educating the providers works for DIFFERENT treatments. "You mean this indication has a new treatment? You mean this thing can apply to that indication?" For replacement or improved treatments like Afrezza, I still believe we needs the patients to push the providers over the hump.
But no TV commercials please. Too expensive and too nowhere. OTOH, social media is beaconing for opportunities like Afrezza. Anybody know how to create a new type of Pokémon for Afrezza, just in case?
JMHO.
I agree with your scenario .. this is exactly what it was like when my dad and I were seeking to change his novolog to Afrezza... the docs said.. "Why do you want to change? Your numbers are good." .. However, the numbers were an average A1C of 7 .. This is what is "acceptable" .. I knew we could do better on Afrezza.. docs are reluctant to change..
We finally got our wish, dad started on Afrezza without much doctor enthusiasm.. he was never prescribed the right dose.. and eventually had to go off of Afrezza becuz the insurance removed it from the formulary.. His numbers were still "acceptable" on Afrezza even without the proper dose .. didn't lower his A1C much, but he felt better and lost a lot of weight... Novolog makes him feel lethargic..
Anyway, the point being... docs have to be educated first, then the patients... I believe Matt and Mike are taking the right approach.. We have label constraints... things we cant say in an advertisement.. Most T1s don't mind the needles.. The new needles are so small they cause very little pain and patients adjust well, so I don't think that is a blockbuster selling point... The real selling points for Afrezza are its speed and the fact that it more closely mimics normal insulin release and vastly reduces the risk of hypo. No needles could be a huge selling point to the pediatric population if we can get approved for that.
We have to address all of the issues related to marketing this drug very carefully.. we wont get a 3rd chance... The sales force is out there... and it sounds like they are good .. the company is also pursuing a label change with the clamp study.. then we can do TV ads and drive the patients to the docs.. Time consuming??? YES .. that is my only concern with this investment, the time and money it will take.. I have total faith in Afrezza .. Matt and Mike have to know what they are up against and I believe they are handling it very well so far..
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Post by sportsrancho on Jul 20, 2016 8:59:05 GMT -5
Our rep to the doctor: "Afrezza is a miracle drug". Doctor: "WOW! Wonderful. I will definitely try it when I get the chance and the right patient comes around.".
When doctor sees a patient, however, unless the patient has some indications that beg changes, the doctor will ask "How things are going? Everything under control? Oh, right, let me extend your prescription before I forget." In fact, he forget and the nurse/assistant actually end up sending the renewal to the pharmacy.
I fail to see where Afrezza will be jammed into the conversation.
Reality is that prescriptions get renewed through call in or even through pharmacy, UNLESS the patients required changes.
So, of all the diabetes patients, we are down to only new patients and/or patients whose situations has significantly changed, which is a very small portion.
Educating the providers works for DIFFERENT treatments. "You mean this indication has a new treatment? You mean this thing can apply to that indication?" For replacement or improved treatments like Afrezza, I still believe we needs the patients to push the providers over the hump.
But no TV commercials please. Too expensive and too nowhere. OTOH, social media is beaconing for opportunities like Afrezza. Anybody know how to create a new type of Pokémon for Afrezza, just in case?
JMHO.
I agree with your scenario .. this is exactly what it was like when my dad and I were seeking to change his novolog to Afrezza... the docs said.. "Why do you want to change? Your numbers are good." .. However, the numbers were an average A1C of 7 .. This is what is "acceptable" .. I knew we could do better on Afrezza.. docs are reluctant to change..
We finally got our wish, dad started on Afrezza without much doctor enthusiasm.. he was never prescribed the right dose.. and eventually had to go off of Afrezza becuz the insurance removed it from the formulary.. His numbers were still "acceptable" on Afrezza even without the proper dose .. didn't lower his A1C much, but he felt better and lost a lot of weight... Novolog makes him feel lethargic..
Anyway, the point being... docs have to be educated first, then the patients... I believe Matt and Mike are taking the right approach.. We have label constraints... things we cant say in an advertisement.. Most T1s don't mind the needles.. The new needles are so small they cause very little pain and patients adjust well, so I don't think that is a blockbuster selling point... The real selling points for Afrezza are its speed and the fact that it more closely mimics normal insulin release and vastly reduces the risk of hypo. No needles could be a huge selling point to the pediatric population if we can get approved for that.
We have to address all of the issues related to marketing this drug very carefully.. we wont get a 3rd chance... The sales force is out there... and it sounds like they are good .. the company is also pursuing a label change with the clamp study.. then we can do TV ads and drive the patients to the docs.. Time consuming??? YES .. that is my only concern with this investment, the time and money it will take.. I have total faith in Afrezza .. Matt and Mike have to know what they are up against and I believe they are handling it very well so far..
I'm very happy you feel this way, and I respect your opinion so much. Even though I believe it's patient driven those people have to be willing to not take no for a answer and there are not many of those. So Mike's path is the one we go with:-)
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Post by centralcoastinvestor on Jul 20, 2016 9:10:59 GMT -5
Our rep to the doctor: "Afrezza is a miracle drug". Doctor: "WOW! Wonderful. I will definitely try it when I get the chance and the right patient comes around.".
When doctor sees a patient, however, unless the patient has some indications that beg changes, the doctor will ask "How things are going? Everything under control? Oh, right, let me extend your prescription before I forget." In fact, he forget and the nurse/assistant actually end up sending the renewal to the pharmacy.
I fail to see where Afrezza will be jammed into the conversation.
Reality is that prescriptions get renewed through call in or even through pharmacy, UNLESS the patients required changes.
So, of all the diabetes patients, we are down to only new patients and/or patients whose situations has significantly changed, which is a very small portion.
Educating the providers works for DIFFERENT treatments. "You mean this indication has a new treatment? You mean this thing can apply to that indication?" For replacement or improved treatments like Afrezza, I still believe we needs the patients to push the providers over the hump.
But no TV commercials please. Too expensive and too nowhere. OTOH, social media is beaconing for opportunities like Afrezza. Anybody know how to create a new type of Pokémon for Afrezza, just in case?
JMHO.
I agree with your scenario .. this is exactly what it was like when my dad and I were seeking to change his novolog to Afrezza... the docs said.. "Why do you want to change? Your numbers are good." .. However, the numbers were an average A1C of 7 .. This is what is "acceptable" .. I knew we could do better on Afrezza.. docs are reluctant to change..
We finally got our wish, dad started on Afrezza without much doctor enthusiasm.. he was never prescribed the right dose.. and eventually had to go off of Afrezza becuz the insurance removed it from the formulary.. His numbers were still "acceptable" on Afrezza even without the proper dose .. didn't lower his A1C much, but he felt better and lost a lot of weight... Novolog makes him feel lethargic..
Anyway, the point being... docs have to be educated first, then the patients... I believe Matt and Mike are taking the right approach.. We have label constraints... things we cant say in an advertisement.. Most T1s don't mind the needles.. The new needles are so small they cause very little pain and patients adjust well, so I don't think that is a blockbuster selling point... The real selling points for Afrezza are its speed and the fact that it more closely mimics normal insulin release and vastly reduces the risk of hypo. No needles could be a huge selling point to the pediatric population if we can get approved for that.
We have to address all of the issues related to marketing this drug very carefully.. we wont get a 3rd chance... The sales force is out there... and it sounds like they are good .. the company is also pursuing a label change with the clamp study.. then we can do TV ads and drive the patients to the docs.. Time consuming??? YES .. that is my only concern with this investment, the time and money it will take.. I have total faith in Afrezza .. Matt and Mike have to know what they are up against and I believe they are handling it very well so far..
Well stated. There are no easy paths to success here. Selling Afrezza is going to take intense determination and a rebel spirit. I think Matt and Mike have got that.
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Post by mnholdem on Jul 20, 2016 9:49:53 GMT -5
What little we know about Mike's sales & marketing plan comes from this interview with Fierce Pharma:
Link: www.fiercepharma.com/marketing/mannkind-refocuses-on-endocrinologists-to-give-afrezza-launch-a-jolt
Excerpt:
Castagna, now a month into the job, has hired the advertising agency precisioneffect--which recently changed its name from LehmanMillet--and begun mapping out the new marketing direction for Afrezza.
First up are endocrinologists. While Castagna said he wouldn't critique Sanofi's strategy, he noted that its main target audience was primary care physicians treating Type 2 diabetics. MannKind's plan instead is to go directly to the 5,000 endocrinologists in the U.S. who care for both Type 1 and Type 2 diabetes patients.
Many endocrinologists weren't specifically detailed on Afrezza, he said, so getting doctors up to speed on usage is important before launching any broader DTC campaign. But consumer ads are coming, likely within the next 12 months, he said.
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I find myself agreeing with my fellow Minnesotan sweedee79 when she writes that for, "treatments like Afrezza, I still believe we need the patients to push the providers over the hump." In his interview, Mike indicated that educating the doctors is important BEFORE launching a DTC campaign but, as he clearly states, the ads are coming...
Wasn't it Castagna who said (I don't have a link handy) that he thinks that any significant increase in prescriptions for Afrezza will be patient-driven?
I also think that a digital campaign makes a lot more sense initially than TV ads... just don't wait too long.
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Post by surplusvalue on Jul 20, 2016 10:05:06 GMT -5
I am concerned, however, that the providers, while interested in and maybe even excited about Afrezza, do not have the trigger, "the kick", to venture off their beaten path. I believe we need something to lure them out and I believe the luring needs to come from the patients. I believe this to be true. Some doctors will. But we need to hit the patients with just as much gusto! JMHO If their current approach works for them then I think moving patients or doctors will be extremely difficult. The people to go after is those who are compliant but whose their current approach is not working - they will be open to trying new things. That is a fairly large group and reasonably aware and proactive. No needles is not going to move more than a tiny number of people although it may be popular with newly diagnosed diabetics. As I said in another thread, the targeted (endos) like most doctors are conservative and the endos need a push (demand side) from patients to seriously consider using Afrezza instead of the status quo. But whether new patients or existing ones public awareness of the product by diabetics is almost non existent. This is a main roadblock. From a strategy standpoint and limited finances, DTC by Precision is slated for later. However public awareness might be improved earlier if MNKD enlisted a dynamic speaker (CEO- not very dynamic, Mike-who has too much on his plate already or?) at limited cost by doing the circuit. 60 minutes is unlikely, but Dr. Oz, The Doctors (Medical info show), the View, Ellen or anything with a large viewership might help alleviate the awareness problem. You would be surprised how many people watch this stuff or who don't (myself) but who are aware of these programs.
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Post by peppy on Jul 20, 2016 10:21:27 GMT -5
If their current approach works for them then I think moving patients or doctors will be extremely difficult. The people to go after is those who are compliant but whose their current approach is not working - they will be open to trying new things. That is a fairly large group and reasonably aware and proactive. No needles is not going to move more than a tiny number of people although it may be popular with newly diagnosed diabetics. As I said in another thread, the targeted (endos) like most doctors are conservative and the endos need a push (demand side) from patients to seriously consider using Afrezza instead of the status quo. But whether new patients or existing ones public awareness of the product by diabetics is almost non existent. This is a main roadblock. From a strategy standpoint and limited finances, DTC by Precision is slated for later. However public awareness might be improved earlier if MNKD enlisted a dynamic speaker (CEO- not very dynamic, Mike-who has too much on his plate already or?) at limited cost by doing the circuit. 60 minutes is unlikely, but Dr. Oz, The Doctors (Medical info show), the View, Ellen or anything with a large viewership might help alleviate the awareness problem. You would be surprised how many people watch this stuff or who don't (myself) but who are aware of these programs. Sam and Eric meet Dr. OZ and The Doctors. Exactly what we need. Perfect idea.
The Doctors meet afrezza users team.
screencast.com/t/vYtJCrf1HX
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Post by therealisaching on Jul 20, 2016 10:40:57 GMT -5
What little we know about Mike's sales & marketing plan comes from this interview with Fierce Pharma:
Link: www.fiercepharma.com/marketing/mannkind-refocuses-on-endocrinologists-to-give-afrezza-launch-a-jolt
Excerpt:
Castagna, now a month into the job, has hired the advertising agency precisioneffect--which recently changed its name from LehmanMillet--and begun mapping out the new marketing direction for Afrezza.
First up are endocrinologists. While Castagna said he wouldn't critique Sanofi's strategy, he noted that its main target audience was primary care physicians treating Type 2 diabetics. MannKind's plan instead is to go directly to the 5,000 endocrinologists in the U.S. who care for both Type 1 and Type 2 diabetes patients.
Many endocrinologists weren't specifically detailed on Afrezza, he said, so getting doctors up to speed on usage is important before launching any broader DTC campaign. But consumer ads are coming, likely within the next 12 months, he said.
---
I find myself agreeing with my fellow Minnesotan sweedee79 when she writes that for, "treatments like Afrezza, I still believe we need the patients to push the providers over the hump." In his interview, Mike indicated that educating the doctors is important BEFORE launching a DTC campaign but, as he clearly states, the ads are coming...
Wasn't it Castagna who said (I don't have a link handy) that he thinks that any significant increase in prescriptions for Afrezza will be patient-driven?
I also think that a digital campaign makes a lot more sense initially than TV ads... just don't wait too long.
We know a bit more from this June 24th interview:
www.forbes.com/sites/kenkam/2016/06/24/mannkind-will-market-afrezza-better-than-sanofi-ever-did/#3b4fa11286f1
"We need to focus our energy and resources to help doctors who have prescribed the product and had great success in helping their patients achieve their treatment goals."
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Post by sweedee79 on Jul 20, 2016 10:52:10 GMT -5
I cant wait until we are ready for widespread DTC including TV ... of course we need the patients demanding the product. But wouldn't it be better if the docs knew what the patients were demanding and knew how to prescribe the accurate dose? How many patients could we lose to docs who don't know what they are doing or are reluctant? And as a matter of fact because of label constraints and limited advertising as to the true nature of Afrezza the patients wont even know what it really is or what they are asking for. We already have insurance problems... I'm just saying, lets do this right and in some systematic order that makes sense, then hit the streets running with big DTC .. ASAP
I thought this is what SNY was doing.... Not sure what they were doing, but they failed miserably. If we can continue to get financing I don't believe Matt and Mike will fail.. especially if they can work on our label and get the word out. I think they are doing a great job. I love Mike's enthusiasm and positivity .. is what the company needs.... none of it however, is going to be easy.
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Post by surplusvalue on Jul 20, 2016 11:37:32 GMT -5
I cant wait until we are ready for widespread DTC including TV ... of course we need the patients demanding the product. But wouldn't it be better if the docs knew what the patients were demanding and knew how to prescribe the accurate dose? How many patients could we lose to docs who don't know what they are doing or are reluctant? And as a matter of fact because of label constraints and limited advertising as to the true nature of Afrezza the patients wont even know what it really is or what they are asking for. We already have insurance problems... I'm just saying, lets do this right and in some systematic order that makes sense, then hit the streets running with big DTC .. ASAP
I thought this is what SNY was doing.... Not sure what they were doing, but they failed miserably. If we can continue to get financing I don't believe Matt and Mike will fail.. especially if they can work on our label and get the word out. I think they are doing a great job. I love Mike's enthusiasm and positivity .. is what the company needs.... none of it however, is going to be easy. Don't think anyone here is suggesting reversing the strategy or order of approach. Educating the endos is the first leg to be followed by DTC. The crucial thing here is the lag between education and demand created by DTC. Timing is crucial and finances are limited restricting a "big" DTC. In the meantime building awareness as I suggested might be a good supplement preceding the DTC by Precision. Starting this when they are 3/4 or so through the endo education process might be complementary rather than counterproductive.
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Post by straightly on Jul 21, 2016 2:11:34 GMT -5
I agree with your scenario .. this is exactly what it was like when my dad and I were seeking to change his novolog to Afrezza... the docs said.. "Why do you want to change? Your numbers are good." .. However, the numbers were an average A1C of 7 .. This is what is "acceptable" .. I knew we could do better on Afrezza.. docs are reluctant to change..
We finally got our wish, dad started on Afrezza without much doctor enthusiasm.. he was never prescribed the right dose.. and eventually had to go off of Afrezza becuz the insurance removed it from the formulary.. His numbers were still "acceptable" on Afrezza even without the proper dose .. didn't lower his A1C much, but he felt better and lost a lot of weight... Novolog makes him feel lethargic..
Anyway, the point being... docs have to be educated first, then the patients... I believe Matt and Mike are taking the right approach.. We have label constraints... things we cant say in an advertisement.. Most T1s don't mind the needles.. The new needles are so small they cause very little pain and patients adjust well, so I don't think that is a blockbuster selling point... The real selling points for Afrezza are its speed and the fact that it more closely mimics normal insulin release and vastly reduces the risk of hypo. No needles could be a huge selling point to the pediatric population if we can get approved for that.
We have to address all of the issues related to marketing this drug very carefully.. we wont get a 3rd chance... The sales force is out there... and it sounds like they are good .. the company is also pursuing a label change with the clamp study.. then we can do TV ads and drive the patients to the docs.. Time consuming??? YES .. that is my only concern with this investment, the time and money it will take.. I have total faith in Afrezza .. Matt and Mike have to know what they are up against and I believe they are handling it very well so far..
Well stated. There are no easy paths to success here. Selling Afrezza is going to take intense determination and a rebel spirit. I think Matt and Mike have got that. "Selling Afrezza is going to take intense determination and a rebel spirit."
Could not have said it better myself, I will heap on: "Getting Afrezza is going to take intense determination and a rebel spirit also."
Questions are
Who are these kind of patients? Tall or Short? Old or Young? Do not know. But pretty sure they do not watch much TV. How to find them? How to throw them the challenge?
We do NOT have to have a large number of patients either BTW. We need the trail blazers. We must have precision first (pun intended) by focusing on them. We can worry about the herd later.
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