The Castagna Manifesto

[liane]

While I would not want Mike bantering back and forth every day with the likes of SA posters, an occasional well worded reply is good.

[sweedee79]

One of the things I like about Mike is his accessibility. He is involved on every level and it seems with passion and faith. I like it that he takes the time to not only join this board, but Twitter... and then he speaks out on SA. To me this shows he has a personal stake in this.. and cares very much about the outcome. Yet, he is also very professional. I like it.

[airfrtman]

No response Yet.

[myocat]

Aug 30, 2016 10:36:49 GMT -5 rockstarrick said:

Aug 30, 2016 10:20:33 GMT -5 myocat said:

Could you re post the link?

seekingalpha.com/article/4002856-mannkind-curtain-drawn-microphone-place

Thanks but no thanks...

I was looking for this  (http://tinyurl.com/zvs...).  Wonder if centralcoastinvestor could provide the link again...

[sportsrancho]

Aug 30, 2016 13:01:19 GMT -5 sweedee79 said:

One of the things I like about Mike is his accessibility. He is involved on every level and it seems with passion and faith. I like it that he takes the time to not only join this board, but Twitter... and then he speaks out on SA. To me this shows he has a personal stake in this.. and cares very much about the outcome. He is also very professional. I like it.

Yes! In essence he is standing up to the bullies! And that's what they are doing, bulling us and beating us down. You have to fight back with pride. It shows respect for himself and the company! Thank you Mike!

[centralcoastinvestor]

Aug 30, 2016 14:08:03 GMT -5 myocat said:

Aug 30, 2016 10:36:49 GMT -5 rockstarrick said:

seekingalpha.com/article/4002856-mannkind-curtain-drawn-microphone-place

Thanks but no thanks...

I was looking for this  (http://tinyurl.com/zvs...).  Wonder if centralcoastinvestor could provide the link again...

That is the correct link.  What Mike wrote is in the comments section.

[myocat]

I can't find it. It redirects me to www.bizboom.com/leveraged_discounts/

Thanks

[compound26]

Here is my cash projection for Mannkind. It appears we do have sufficient cash to last through March 2017, assuming:

(a)    Matt and Mike tries everything to keep the cash burn flat (10 million per month), which I believe they do intend to;

(b)    Mannkind gets another 10 million under insulin put (while still maintaining the 10 million cash burn, i.e., with increase expenditure on insulin purchase) in the third and fourth quarters combined; and

(c)     Mannkind gets a 10 million milestone from RLS by year end of 2016.

Month	TRx	Cash	Available under Mann Loan Facility	Available under ATM	Comment
June	N/A	63.7	30	50
July	250	53.7	30	50
August	350	43.7	30	50
September	450	38.7	30	50	5 from insulin put
October	550	33.7	30	50	5 from insulin put
November	650	33.7	20	50	10 draw under Mann credit line.
December	750	33.7	20	50	10 from RLS
January	850	33.7	10	50	10 draw under Mann credit line.
February	950	33.7	0	50	10 draw under Mann credit line.
March	1050	28.7	0	50	5 from Afrezza sales since August 2016.

Based on the above projection, Mannkind will have 28.7 million cash and 50 million under ATM at the end of March 2017, with an expected TRx around 1,000.  If during any time from now and through March 2017, SP goes above 2, I would think Mannkind will probably use some of the ATM and therefore preserve some of its cash.  

Based on such progress, I think each of the following events will be likely to occur within a few months (i.e., second quarter of 2017), which will further extend Mannkind's runway much longer:

1.    Settlement payment from Sanofi (even if just forgiveness of existing debt + release of Sanofi's lien on the Mannkind headquarter building, which is worth 20 million+ if sold, will be helpful);

2.    an international deal with some upfront fee;

3.    a label change (beneficial for SP and further increase of TRx);

4.    a partnership for epinephrine;

5.    Use of ATM on better SP (with a renewal of ATM registration for future use).   

[Deleted]

Aug 30, 2016 13:04:07 GMT -5 airfrtman said:

No response Yet.

LFD has a lot riding on his response. He is used to only arguing with the MNKD fanatics. Now he has to dig in, and I hope he fails miserably.

[esstan2001]

You laid out a very plausible case that gets the company through the hoop- it provides enough time to see whether Afrezza will leave a real mark on our world or will remain a nice but unremarkable niche product (all instincts point to the former).

[cjm18]

Let's hope the rls milestone payment is more than 10m.

[wmdhunt]

It would also be very nice to diversify our product line at MNKD. Oxycontin, Med Marijuana, epinephrine, caffeine, albuterol, pulmocort, others? So much potential in Technosphere, so little time. Bought more today. IMHOP.

[mnholdem]

A little over a year ago, many shareholders voiced their disgust that MannKind would never respond to Wall Street pundits who, it seemed, could publish misleading statements and outright falsehoods with impunity.  Many blamed the slide of share price on management's silence. Today, management is publicly defending the merits of Afrezza...and the share price is still completely unaffected.

I think the validity of management publishing corrections and clarifications - on occasion and for very specific topics - lies in the fact that the Direct-to-Patient (DTP) marketing has not begun and it's important at this stage to protect Afrezza from pundits who would mislead the public.  Once the DTP campaign begins, it will be much easier to direct patients with diabetes to places online where they can get very accurate information. Yes, it's true that Afrezza currently has a website and while there are some useful changes that have been made to it until the new site is ready to launch the site remains as Sanofi designed it "Surprise! It's Insulin!"

Everyday, I Google the word "Afrezza" to see if there's anything interesting that's hit the web in the past 24 hours. The pundits' articles regularly show up at the top of the list. When an author proclaims that MannKind faces bankruptcy or proclaims that the launch of Afrezza is a failure, it's an image problem. 99% of the stuff can be ignored, but I think that sometimes there are some misleading or false statement about Afrezza that should be corrected in a public forum.  I also agree with many here that Castagna should do this selectively and sparingly... and only if it's believed that Afrezza's image may be damaged by saying nothing. Such efforts may not stop the pundits, but putting it out there that you believe in your product and that it will fulfill many unmet needs for patients with diabetes is not a bad thing. It would be better to arrange an interview with a major publisher rather than to post your comments in replies sections, though.

---

The DTP campaign for Afrezza cannot come soon enough for me. It's one area where I disagree with management on the timeline, but the delay (intentional or otherwise) may have more to do with the ad agency and the timelines related to those publications where the Afrezza ads will be initially placed. I wholeheartedly agree with recent comments by MannKind's CEO and CCO that a record amount of transitioning has been accomplished in a short amount of time. I agree that it's critical to bring the endos up to speed, especially on how to titrate for success. However, I also believe that the sales of Afrezza will not blossom until after the DTP campaign begins. 

Monday's FDA conference revealed that patients want to control this disease rather than for the disease to control them.  Building patient awareness of the many benefits of Afrezza and how it can help the patient regain their FREEDOM will create public awareness and once patient demand increases, both the physicians and the 3rd party payers will get on board. Perhaps that little OUTsulin character will play a big part in building awareness of the REAL benefits of this TS-insulin. We'll see when MannKind brings on the marketing campaign. Bring it, Mr. Castagna, and the sooner the better for ALL stakeholders, especially the patients.

[sophie]

Aug 30, 2016 17:01:30 GMT -5 mnholdem said:

 However, I also believe that the sales of Afrezza will not blossom until after the DTP campaign begins. 

Monday's FDA conference revealed that patients want to control this disease rather than for the disease to control them.  Building patient awareness of the many benefits of Afrezza and how it can help the patient regain their FREEDOM will create public awareness and once patient demand increases, both the physicians and the 3rd party payers will get on board. Perhaps that little OUTsulin character will play a big part in building awareness of the REAL benefits of this TS-insulin. We'll see when MannKind brings on the marketing campaign. Bring it, Mr. Castagna, and the sooner the better for ALL stakeholders, especially the patients.

I agree with almost everything you've said. I just don't want to fall into the camp that keeps kicking the can down the road. Every step along the way I've had faith in "X", then when "X" happened and didn't fulfill expectations, "Y" carried the burden. 

First it was FDA approval. Then it was a partner. Then it was insurance. Then spirometry. Now the baton is being passed from (hesitant?) prescribers to the very last thing that can save us. We are now at "Z", the patients. 

I think if we're having trouble selling Afrezza to the docs then we're going to have just as much trouble selling it to the patients who then have the burden of trying to sell it to their doctors. 

If we don't make it, it wasn't for lack of trying. If Mannkind Cares can't fix script count by straightening out the issues from the time the doctor hands the prescription to the patient til they get it filled at the pharmacy, the drug was never meant to succeed due to low demand and it will be a very expensive lesson for all of us. 

It's hard for me to see reality through the dream of this becoming what I thought it should be. Just because I think there's no way this drug can't be a blockbuster doesn't mean it is so. It's not my opinion that matters. Maybe my discouragement is sinking in and I'm becoming irrational. I wasn't that worried about the script count yesterday. By itself it's not that big of a problem. But when I keep seeing the share price drop 5-7% a day with no reprieve and no near term catalyst to change its course, it becomes a lot bigger of a deal. We simply don't have time to wait for DTP campaigns unless they somehow create exponential growth. I'd rather not put my hope in such rapid growth, especially after this has been on the market for a year and a half and it has yet to get above what, 700 Trx a week? If the diabetics who have heard about it, and I'm sure there are well over 2800 diabetics who have (700x4), they would have been watching and waiting for their insurance to cover Afrezza and our script count should reflect that. I have seen stories of this happening, so I know it does. 

The truth is that the shorts don't have reason to exit at this point, not even if the script counts do increase, unless they increase so much that we no longer need additional funding. Neither appear to be much of a possibility at this point.

[sophie]

I do hope that there is a way to find all the health conscious diabetics. There appears to be a growing market for organic foods. I wonder if the same exists in the type 1 diabetic community. It'd be a good sell. 100% human insulin with as few other ingredients as possible. And the other ingredients pass through your urine.