|
|
Post by centralcoastinvestor on Sept 21, 2016 8:44:13 GMT -5
Normally I would place a Twitter post in the Social Media section but thought this recent Twitter post was worth its own thread because of what it represents. Here it is:
Mark
10h10 hours ago
Mark @mpg5454
@mhoskins2179 @kcphaeton Agreed, if more are not using it soon it wont be a choice much longer. Share yr success, get the word out #Afrezza
i don't know who Mark is and that is a very encouraging sign to me. He is not one of the "regular" supporters of Afrezza but someone new who understands what is at stake here. Choice. I have wondered when more PWD would start to understand that there is a different kind of drug war going on out there. It involves choice and money. I truly don't think BP wants Afrezza to survive. So it will be up to PWD to stand up and be heard. In fact, it's bigger than that. I believe that if the diabetic community wants to retain Afrezza as a choice, then JDRF and the ADA cannot stay neutral when it comes to Afrezza. They need to take a strong stand in support of the inhalation choice. Otherwise it is possible that the Afrezza choice may not be there in the future.
I will end with this story about transportation in Los Angeles. Long ago Los Angeles had an extensive inner city rail system, not a subway system but similar. It doesn't exist now because big auto bought up the rail system and removed the tracks. Now you have a freeway system that is gridlocked most of the time. Big business kills new ideas all of the time. I sure hope that Twitter post from Mark shows that PWD will fight back now.
|
|
|
|
Post by dictatorsaurus on Sept 21, 2016 9:20:47 GMT -5
From my limited experience with diabetics, the few I am aware of that I reached out to didn't show any interest in the drug. Neither the delivery method nor the results. I was surprised by the lazy nonchalant reaction.
As time goes by things are starting to make more sense.
|
|
|
|
Post by cjm18 on Sept 21, 2016 9:44:38 GMT -5
From my limited experience with diabetics, the few I am aware of that I reached out to didn't show any interest in the drug. Neither the delivery method nor the results. I was surprised by the lazy nonchalant reaction. As time goes by things are starting to make more sense. Not good. Were they on prandial insulin? |
|
|
|
Post by silentknight on Sept 21, 2016 9:50:00 GMT -5
I haven't given up hope just yet, but as the weeks go by and we see no growth in script numbers, I think we have to at least entertain the possibility that Afrezza just won't/can't penetrate the market in the way we all had hoped and envisioned. I think Mike C and the MNKD team are doing the best they can, but doctors are still reluctant to prescribe the drug and patients are having a hard time convincing not only doctors, but also their insuarance companies to allow them to use Afrezza. Posters here have attested to the difficulty in convincing doctors and insurance companies to allow them access to Afrezza. Their stories are probably more widespread than we know.
It's a fact that Afrezza is more effective than anything else on the market currently in the treatment of diabetes. It's a fact that many patients using Afrezza have better control over their blood glucose than ever before and have shown incredible improvements in A1C levels and have documented how they can eat freely with Afrezza and live as close to a "normal" life as possible while using Afrezza at meal times. It's a fact that Afrezza is less intrusive, faster acting, and quicker to leave resulting in less hypos and more peace of mind for diabetics using it. Those are undisputable facts and the poo-pooers and skeptical doctors can try and dispute them as much as they want, but you won't be able to, ever. Just because they choose to believe something that isn't true doesn't suddenly make it so.
However, it's also an undisputable fact that considerable headwinds exist for the drug in penetrating the pre-concieved and possibly outdated standard of care paradigm for diabetic treatment currently employed by physicians and in dispelling widely held belief by doctors and endos that the drug is less effective or inferior to existing treatments. We can thank the label for that and I'm glad that MNKD has plans to fix it, hopefully with a label change request to the FDA this month. But, as evidenced by tepid and weak script numbers every week, doctors just aren't sold on the drug like we (and MNKD) probably once thought. Trying to stand 75 years of medicine on it's head and do things differently has proven to be much more difficult than any of us ( or the great Al Mann) imagined. It certainly has been for me in seeing how resistant doctors are to the drug.
Granted, there are some doctors nationwide who see the benefits of Afrezza and their patients are healthier and better for it. It is those doctors that truly are revolutionary in embracing new technologies to improve patients' lives. They, unfortunately, seem to be the exception rather than the norm as the majority of their counterparts seem to be stuck in 1975 in how they approach their profession. It's sad and a disservice to patients who deserve the highest standard of care available.
I guess I'm having a hard time reconciling that something as amazingly effective and ground shattering like Afrezza could fail because of doctors' and insurance companies' ignorance. That's basically what it boils down to: a refusal on the part of medical professionals and insurance companies to improve patient's health due to insistence in keeping both feet planted firmly in the past.
I'm just venting I suppose, but as each week passes seeing miniscule adoption of Afrezza, the dying light of hope within gets just a little bit dimmer. I'm not sure what the answer is, but I hope Mike C has it. If he does, I'll treat him to the greatest dinner of his life on behalf of my fellow longs to say thank you.
|
|
|
|
Post by dictatorsaurus on Sept 21, 2016 9:50:04 GMT -5
Yes. Spoke with both T1 and T2. Same sentiment.
|
|
|
|
Post by kbrion77 on Sept 21, 2016 9:58:02 GMT -5
From my limited experience with diabetics, the few I am aware of that I reached out to didn't show any interest in the drug. Neither the delivery method nor the results. I was surprised by the lazy nonchalant reaction. As time goes by things are starting to make more sense. Not good. Were they on prandial insulin? I'll be interested in the answer to this question. I can see if it's a type 2 currently on metaformin and ok with their numbers. But when the time comes for insulin and they have the choice between the pen or Afrezza and they are going the pen well that spells trouble. |
|
|
|
Post by sophie on Sept 21, 2016 10:07:46 GMT -5
I haven't given up hope just yet, but as the weeks go by and we see no growth in script numbers, I think we have to at least entertain the possibility that Afrezza just won't/can't penetrate the market in the way we all had hoped and envisioned. I think Mike C and the MNKD team are doing the best they can, but doctors are still reluctant to prescribe the drug and patients are having a hard time convincing not only doctors, but also their insuarance companies to allow them to use Afrezza. Posters here have attested to the difficulty in convincing doctors and insurance companies to allow them access to Afrezza. Their stories are probably more widespread than we know. I'm not saying I agree with what he's saying, but I decided to post an email I recently received from a PCP that I know. I have heard about Afrezza.
Let’s see what happens with this drug. There have been prior inhaled insulin’s, Exubera, that did not make it. I couldn’t remember the name but I looked it up. Several years ago we did some studies with it to see if it affected lung function. I am not sure of the results. It was pulled from the market. Patient’s with underlying lung disease were excluded from using it.
If I were diabetic, I would not use it until it was thoroughly tested and trialed for years. I would like to see if there are any long term pulmonary effects. It’s one thing to inhale meds to help lung function, but I am not a fan of inhaling anything else. The large and small airways as well as the alveolar membranes are susceptible to irritants. The mucociliary cascade can only protect so much.
Irregular absorption could be a problem.
I've seen this discussed a bunch already in the time I've been here. More time is needed to convince doctors that Afrezza is safe and superior. (I think) the reason Afrezza has had a slow uptake is because medicine is conservative. I know this isn't new. I've seen it discussed on here. Based on my discussions with the above PCP and others that I know, they don't perceive that the risks outweigh the benefits. PWD can live 5-6 decades with the disease. Not saying that there won't be limb loss or sight/hearing losses involved as well as a myriad of other secondary diseases, but they don't feel any urgency to shake things up considering the "success" of the current system. To them, causing lung diseases would cause a much more rapid decline than the complications associated with diabetes. Why create a more severe problem to solve a lesser one is their rationale.
I truly believe that time is all that is needed for Afrezza to prove itself. I know that there were only about 2-4 issues with lung cancer out of all the people who were involved in Afrezza trials. For those who like links, here ya go. That article was written by a physician. Good or bad, right or wrong, the reality is that there appears to be risk involved with Afrezza. And those risks appear to docs to be more significant than the benefits. I can't say for sure that all doctors think this way- obviously some do prescribe. To say that doctors haven't heard of Afrezza is not an accurate statement, though. The ratio of docs who have heard of Afrezza to those who prescribe it is just very, very low. If there was interest in prescribing, it would be evident by now. The majority of docs who know about Afrezza have chosen not to. We might be able to find a few more who will if we look for them, but the assumption based on the current trend is that it's more similar to finding a needle in a haystack. This won't turn into a blockbuster overnight. It will take a long time to prove itself, then there may be an inflection point. Who knows how long that amount of time will be... |
|
|
|
Post by sophie on Sept 21, 2016 10:15:36 GMT -5
Normally I would place a Twitter post in the Social Media section but thought this recent Twitter post was worth its own thread because of what it represents. Here it is: How do we measure patient demand? How do we measure Dr reluctance to prescribe? While not perfect because there may still be other/different barriers in place (what they are I don't know) All you have to do is measure script growth vs insurance coverage. The biggest reason patients wouldn't have access to a drug they want is because they can't afford it. The slope isn't linear when comparing script growth vs coverage. This probably tells us that PWD don't really have much interest in Afrezza and/or docs aren't wanting to prescribe it. I don't think BP is doing much to suppress Afrezza at this point. The data suggests it's more of a doctor/patient issue at this point. |
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Sept 21, 2016 10:21:36 GMT -5
I haven't given up hope just yet, but as the weeks go by and we see no growth in script numbers, I think we have to at least entertain the possibility that Afrezza just won't/can't penetrate the market in the way we all had hoped and envisioned. I think Mike C and the MNKD team are doing the best they can, but doctors are still reluctant to prescribe the drug and patients are having a hard time convincing not only doctors, but also their insuarance companies to allow them to use Afrezza. Posters here have attested to the difficulty in convincing doctors and insurance companies to allow them access to Afrezza. Their stories are probably more widespread than we know. I'm not saying I agree with what he's saying, but I decided to post an email I recently received from a PCP that I know. I have heard about Afrezza.
Let’s see what happens with this drug. There have been prior inhaled insulin’s, Exubera, that did not make it. I couldn’t remember the name but I looked it up. Several years ago we did some studies with it to see if it affected lung function. I am not sure of the results. It was pulled from the market. Patient’s with underlying lung disease were excluded from using it.
If I were diabetic, I would not use it until it was thoroughly tested and trialed for years. I would like to see if there are any long term pulmonary effects. It’s one thing to inhale meds to help lung function, but I am not a fan of inhaling anything else. The large and small airways as well as the alveolar membranes are susceptible to irritants. The mucociliary cascade can only protect so much.
Irregular absorption could be a problem.
I've seen this discussed a bunch already in the time I've been here. More time is needed to convince doctors that Afrezza is safe and superior. (I think) the reason Afrezza has had a slow uptake is because medicine is conservative. I know this isn't new. I've seen it discussed on here. Based on my discussions with the above PCP and others that I know, they don't perceive that the risks outweigh the benefits. PWD can live 5-6 decades with the disease. Not saying that there won't be limb loss or sight/hearing losses involved as well as a myriad of other secondary diseases, but they don't feel any urgency to shake things up considering the "success" of the current system. To them, causing lung diseases would cause a much more rapid decline than the complications associated with diabetes. Why create a more severe problem to solve a lesser one is their rationale.
I truly believe that time is all that is needed for Afrezza to prove itself. I know that there were only about 2-4 issues with lung cancer out of all the people who were involved in Afrezza trials. For those who like links, here ya go. That article was written by a physician. Good or bad, right or wrong, the reality is that there appears to be risk involved with Afrezza. And those risks appear to docs to be more significant than the benefits. I can't say for sure that all doctors think this way- obviously some do prescribe. To say that doctors haven't heard of Afrezza is not an accurate statement, though. The ratio of docs who have heard of Afrezza to those who prescribe it is just very, very low. If there was interest in prescribing, it would be evident by now. The majority of docs who know about Afrezza have chosen not to. We might be able to find a few more who will if we look for them, but the assumption based on the current trend is that it's more similar to finding a needle in a haystack. This won't turn into a blockbuster overnight. It will take a long time to prove itself, then there may be an inflection point. Who knows how long that amount of time will be...the pcp is uneducated.It was tested 4 many years now.there were studies done for irregular absorption too..unfortunately, its the docs that have to rx. This is where marketing helps. |
|
|
|
Post by peppy on Sept 21, 2016 10:30:09 GMT -5
I haven't given up hope just yet, but as the weeks go by and we see no growth in script numbers, I think we have to at least entertain the possibility that Afrezza just won't/can't penetrate the market in the way we all had hoped and envisioned. I think Mike C and the MNKD team are doing the best they can, but doctors are still reluctant to prescribe the drug and patients are having a hard time convincing not only doctors, but also their insuarance companies to allow them to use Afrezza. Posters here have attested to the difficulty in convincing doctors and insurance companies to allow them access to Afrezza. Their stories are probably more widespread than we know. I'm not saying I agree with what he's saying, but I decided to post an email I recently received from a PCP that I know. I have heard about Afrezza.
Let’s see what happens with this drug. There have been prior inhaled insulin’s, Exubera, that did not make it. I couldn’t remember the name but I looked it up. Several years ago we did some studies with it to see if it affected lung function. I am not sure of the results. It was pulled from the market. Patient’s with underlying lung disease were excluded from using it.
If I were diabetic, I would not use it until it was thoroughly tested and trialed for years. I would like to see if there are any long term pulmonary effects. It’s one thing to inhale meds to help lung function, but I am not a fan of inhaling anything else. The large and small airways as well as the alveolar membranes are susceptible to irritants. The mucociliary cascade can only protect so much.
Irregular absorption could be a problem.
I've seen this discussed a bunch already in the time I've been here. More time is needed to convince doctors that Afrezza is safe and superior. (I think) the reason Afrezza has had a slow uptake is because medicine is conservative. I know this isn't new. I've seen it discussed on here. Based on my discussions with the above PCP and others that I know, they don't perceive that the risks outweigh the benefits. PWD can live 5-6 decades with the disease. Not saying that there won't be limb loss or sight/hearing losses involved as well as a myriad of other secondary diseases, but they don't feel any urgency to shake things up considering the "success" of the current system. To them, causing lung diseases would cause a much more rapid decline than the complications associated with diabetes. Why create a more severe problem to solve a lesser one is their rationale.
I truly believe that time is all that is needed for Afrezza to prove itself. I know that there were only about 2-4 issues with lung cancer out of all the people who were involved in Afrezza trials. For those who like links, here ya go. That article was written by a physician. Good or bad, right or wrong, the reality is that there appears to be risk involved with Afrezza. And those risks appear to docs to be more significant than the benefits. I can't say for sure that all doctors think this way- obviously some do prescribe. To say that doctors haven't heard of Afrezza is not an accurate statement, though. The ratio of docs who have heard of Afrezza to those who prescribe it is just very, very low. If there was interest in prescribing, it would be evident by now. The majority of docs who know about Afrezza have chosen not to. We might be able to find a few more who will if we look for them, but the assumption based on the current trend is that it's more similar to finding a needle in a haystack. This won't turn into a blockbuster overnight. It will take a long time to prove itself, then there may be an inflection point. Who knows how long that amount of time will be...The physician sited had heard the name. The physician compared afrezza to exubera and had to google the exubera name. Exubera a hexamer. Afrezza a monmer. Exubera no phase one. Afrezza phase one stops the liver from putting out glucose. Very different. This physician was not aware of the difference.
Regarding will more PWD fight for Afrezza? Consider, the objective, to keep us dumbed down and dying.
Pep
|
|
|
|
Post by cjm18 on Sept 21, 2016 10:41:12 GMT -5
I'm not saying I agree with what he's saying, but I decided to post an email I recently received from a PCP that I know. I have heard about Afrezza.
Let’s see what happens with this drug. There have been prior inhaled insulin’s, Exubera, that did not make it. I couldn’t remember the name but I looked it up. Several years ago we did some studies with it to see if it affected lung function. I am not sure of the results. It was pulled from the market. Patient’s with underlying lung disease were excluded from using it.
If I were diabetic, I would not use it until it was thoroughly tested and trialed for years. I would like to see if there are any long term pulmonary effects. It’s one thing to inhale meds to help lung function, but I am not a fan of inhaling anything else. The large and small airways as well as the alveolar membranes are susceptible to irritants. The mucociliary cascade can only protect so much.
Irregular absorption could be a problem.
I've seen this discussed a bunch already in the time I've been here. More time is needed to convince doctors that Afrezza is safe and superior. (I think) the reason Afrezza has had a slow uptake is because medicine is conservative. I know this isn't new. I've seen it discussed on here. Based on my discussions with the above PCP and others that I know, they don't perceive that the risks outweigh the benefits. PWD can live 5-6 decades with the disease. Not saying that there won't be limb loss or sight/hearing losses involved as well as a myriad of other secondary diseases, but they don't feel any urgency to shake things up considering the "success" of the current system. To them, causing lung diseases would cause a much more rapid decline than the complications associated with diabetes. Why create a more severe problem to solve a lesser one is their rationale.
I truly believe that time is all that is needed for Afrezza to prove itself. I know that there were only about 2-4 issues with lung cancer out of all the people who were involved in Afrezza trials. For those who like links, here ya go. That article was written by a physician. Good or bad, right or wrong, the reality is that there appears to be risk involved with Afrezza. And those risks appear to docs to be more significant than the benefits. I can't say for sure that all doctors think this way- obviously some do prescribe. To say that doctors haven't heard of Afrezza is not an accurate statement, though. The ratio of docs who have heard of Afrezza to those who prescribe it is just very, very low. If there was interest in prescribing, it would be evident by now. The majority of docs who know about Afrezza have chosen not to. We might be able to find a few more who will if we look for them, but the assumption based on the current trend is that it's more similar to finding a needle in a haystack. This won't turn into a blockbuster overnight. It will take a long time to prove itself, then there may be an inflection point. Who knows how long that amount of time will be...the pcp is uneducated.It was tested 4 many years now.there were studies done for irregular absorption too..unfortunately, its the docs that have to rx. This is where marketing helps. That link speaks to decreased lung function which contradicts the recent Ada paper on the topic. Exuberas failure is definitely hurting doctors perception of afrezza. I don't expect a doctor to prescribe afrezza if a1c is below 7 (if it ain't broke don't fix it) but there are plenty of people not at goal. That's the niche afrezza needs to go after. |
|
|
|
Post by sophie on Sept 21, 2016 10:48:07 GMT -5
The physician sited had heard the name. The physician compared afrezza to exubera and had to google the exubera name. Exubera a hexamer. Afrezza a monmer. Exubera no phase one. Afrezza phase one stops the liver from putting out glucose. Very different. This physician was not aware of the difference.
Regarding will more PWD fight for Afrezza? Consider, the objective, to keep us dumbed down and dying.
Pep
You missed the point of his email. It wasn't to compare the qualities of Exubera to Afrezza. It was that both were inhaled insulins and how that affects lung function. Has nothing to do with metabolism. |
|
|
|
Post by sophie on Sept 21, 2016 10:51:16 GMT -5
the pcp is uneducated.It was tested 4 many years now.there were studies done for irregular absorption too..unfortunately, its the docs that have to rx. This is where marketing helps. Correct. He is uneducated. So many on here think that doctors have available to them all the hours we as investors do to research. That's not the case. Unless a physician has supreme interest in a product, are they going to look past 1 source? Who knows... That's why I say that there have to be conclusive studies that really wow the physicians into prescribing. Otherwise it's just one more drug in a very large arsenal, and the thing that distinguishes it (inhaled) may actually be what's hurting it at the moment. |
|
|
|
Post by applogic on Sept 21, 2016 11:05:25 GMT -5
I talked about Afrezza with my sister *after* I bought into it. She warned me that the uptake would be slow until it was adopted by pediatrics and to stay away from the stock until then. I should have sold back then but I figured it was just a matter of time. She believe it could be a block buster and accepted by PCP after it was accepted by pediatricians but until then doctors would be reluctant to prescribe. By way of credentials she was on the President's council, a hospital director, an RN, a regular author to the NEJM, editor of the physcians desk reference and has enough other credentials to fill this page.
We don't know the situation with RLS but if there's a milestone payment coming, my hope is that we can survive and complete the pediatrics testing. In the meantime, the only way scripts are going to increase is if patient's ask for it. I've been following Mannkind's & Mike's Twitter but a few posts here and there don't make the social media campaign Matt promised. I was really expecting that Matt would follow up on the Israeli opportunity and at least have some international such as Teva and Shire lined up for some R&D pipeline.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Sept 21, 2016 11:05:28 GMT -5
the pcp is uneducated.It was tested 4 many years now.there were studies done for irregular absorption too..unfortunately, its the docs that have to rx. This is where marketing helps. Correct. He is uneducated. So many on here think that doctors have available to them all the hours we as investors do to research. That's not the case. Unless a physician has supreme interest in a product, are they going to look past 1 source? Who knows... That's why I say that there have to be conclusive studies that really wow the physicians into prescribing. Otherwise it's just one more drug in a very large arsenal, and the thing that distinguishes it (inhaled) may actually be what's hurting it at the moment. send him some reading material. They may read up at their convenience. |
|
