|
Post by sophie on Sept 21, 2016 15:42:25 GMT -5
Peppy, the data you quoted is just what is says it is: non-clinical toxicology. While these are acceptable tests for FDA approval, both 104 week and especially 26 week studies on carcinogenicity are extremely short periods. A lot of smokers die of lung cancer, but only after long periods of usage. Most smokers start in their teens, but there are very few smoking related cancer deaths in the under 20 population. If a physician does not prescribe Afrezza out of an abundance of caution, you cannot quarrel with that because it is a reasonable professional judgment. However, if the patient decamps to a different physician, you cannot quarrel with that either. Overall type 1 life expectancy 12.2 years less than general population www.diabetesincontrol.com/life-expectancy-for-type-1-diabetes/
Cigarette smoking causes premature death: Life expectancy for smokers is at least 10 years shorter than for nonsmokers. Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by about 90%.Aug 18, 2015 www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/
a lot of meat, fish and eggs, = heart attack .
A physician can not be sued when a diabetic has a heart attack.
what to do, what to do. screencast.com/t/O4E1NxGdWKvt
You bring up a good point, but it's not necessarily valid. You have to remember that the life expectancy in each of those studies was due to the old formulations of insulin that are no longer prescribed because they were much less effective- slower onset for prandials, shorter duration of control for basals. It probably isn't a fair comparison. To be fair, the same can also be said for smoking, although who knows how much modern medicine will prolong the lives of either category. The effects of smoking have been reduced slightly by better inhaled steroids for ephysema, better hypertensives for BP control, statins, etc- better overall available surgery/healthcare. The part where your point falls short -even if we were to compare smoking cigarettes to inhaling medication and call it similar, the gap is so small that you sort of answered your own question- there isn't much difference in the quantity of life, so it becomes difficult to really say one is better than the other. Quality of life associated with injections/Afrezza might contain a measurable difference, and that's what should be focused on. Obviously many diabetics on social media are passionate enough about how they feel for us to hear about it. I've heard that's what doctors want to see, sometimes more than how effectively a drug works. If it's safe to prescribe and it makes people happy, doctors love prescribing- it's good business for all parties involved. It's the reason why Viagra has been so successful. Viagra can cause hypotensive shock and atrial fibrillation and all sorts of other goodies, yet I think it's the best selling drug of all time (certainly among the highest) because men are horny and would risk dying in order to be able to have a relatively normal sex life. I think I argued before with mnholdem about demand needing to come from doctors and not patients. I can't remember exactly what I said, but I think I agree more with him now after thinking through things a little more. I still think that docs are going to need to be convinced to prescribe. It'll be interesting to see how far people are willing to travel to get their Afrezza rx. Call me wrong if you'd like, but I see this drug as a grassroots movement. Slow and steady will win the race. Let's hope there's enough money to get us to the finish line. Forgot to add that modifiable risk factors are additive with diabetes. Meaning, smoking and being diabetic is potentially an extremely harmful combination. So if Afrezza is prescribed to someone who is non adherent and has high glucose, it may be worse for them to be on Afrezza than injectable insulin. This, of course, is under the assumption that Afrezza is similar to smoking, which I am not claiming or disclaiming.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Sept 21, 2016 15:43:54 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. I got my college roommate on it. He looked into for 9 months had no idea what a CGM was, and that the technology had improved so much. Which is interesting because he works in computers where technology is always evolving. My wife's co worker type two eats KFC every day, is obese and takes nothing. My sister in law is type 1 drinks and smokes cigarettes and has poor control. My cousin is type 1 and had his foot amputated I under estimated that people do not take care of themselves. Which hindsight really shouldn't be a shock. Most people are severely over weight. Most people hate going to the Dr. did you mean Afrezza or a CGM? If Afrezza, how is he doing?
|
|
|
Post by rravis1914 on Sept 21, 2016 15:44:30 GMT -5
The education process of a primary care physician: New rep calls at office. "Dr. only sees reps by appointment. Next apt is 3 months away." Rep leaves some literature. (Almost useless). Asks to see nurse, endeavors to educate nurse. Leaves sample if Dr. will sign for them. Asks nurse if she knows any tough T1 or T2 cases. Details and leaves articles for her. Visits office every cycle and tries to start a relationship with staff.
Rep finally gets in to se Doc. Hopefully the office staff has generated some interest in Afrezza. Doc listens and says he has one tough T1 to try it on. rep follows up next cycle with nurse to see what happened with T1 patient. Offers to help educate patient. Etc., Etc.
Some docs will jump on Afrezza right away, some will wait a while to see other docs response, some will not use it ever. (these ones are dangerous to patients and the entire medical community.
Rep keeps plugging and hope that direct advertising will stimulate interest.
Bottom line, it takes time.
|
|
|
Post by mannmade on Sept 21, 2016 15:52:35 GMT -5
rravis I think your description is fairly spot on. I have actively been working to help pwd get on AFREZZA and also working with doctors to educate them when I can and it seems appropriate. I just received a call today from a friend back east who has a 15 yr old son who is a T1. I have been working with her since last November to find a doctor willing to prescribe off label.
She just told me today that she met with a doctor who does have patients on AFREZZA most of whom like it very much. However, the doctor was unwilling to prescribe AFREZZA for her son because of her concern about unknown long term health effects. The doctor told her that she would do so if her son were able to give his own consent but unfortunately he is not. So we are on to the next doctor...
|
|
|
Post by factspls88 on Sept 21, 2016 15:53:39 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. While this is a great story and I am sincerely glad to see that there are PWD's willing to fight for Afrezza, but we are going to need a lot more than a handful of PWD's to make a difference. Given that there is no national TV advertising in the mix right now to drive patient demand (for budgetary reasons), the push has to come from Mannkind to get formulary approval at the best tiers possible, get doctors educated and enthusiastic about prescribing Afrezza, and ensure that new triers have a positive product experience that leads to repurchase. This is a tall order despite the fact that Mannkind management is pushing on all fronts as best it can. The clock is ticking for Mannkind given it's burn rate and cash position, and I grow more and more concerned and frustrated as the clock ticks away. I would like to hear some good news soon - either with respect to scripts -- or at least regarding additional funding to lengthen the runway for patient uptake. As many of you may know I have been in this stock for several years and like so many others I am deeply in the red. I strongly believe in the product (which is why I continue to hold) and I am supportive of management but we need some kind of positive breakthrough soon.
|
|
|
Post by kball on Sept 21, 2016 16:57:46 GMT -5
Anyone else past red at this point? I'm more purple
|
|
|
Post by agedhippie on Sept 21, 2016 17:12:50 GMT -5
If a physician does not prescribe Afrezza out of an abundance of caution, you cannot quarrel with that because it is a reasonable professional judgment. However, if the patient decamps to a different physician, you cannot quarrel with that either. I got through four endos before I reached my current one. It's not that the others were bad, it's just that their style and attitude didn't work for me. This is a long term relationship - you need an endo you are compatible with.
|
|
|
Post by slugworth008 on Sept 21, 2016 18:04:09 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. While this is a great story and I am sincerely glad to see that there are PWD's willing to fight for Afrezza, but we are going to need a lot more than a handful of PWD's to make a difference. Given that there is no national TV advertising in the mix right now to drive patient demand (for budgetary reasons), the push has to come from Mannkind to get formulary approval at the best tiers possible, get doctors educated and enthusiastic about prescribing Afrezza, and ensure that new triers have a positive product experience that leads to repurchase. This is a tall order despite the fact that Mannkind management is pushing on all fronts as best it can. The clock is ticking for Mannkind given it's burn rate and cash position, and I grow more and more concerned and frustrated as the clock ticks away. I would like to hear some good news soon - either with respect to scripts -- or at least regarding additional funding to lengthen the runway for patient uptake. As many of you may know I have been in this stock for several years and like so many others I am deeply in the red. I strongly believe in the product (which is why I continue to hold) and I am supportive of management but we need some kind of positive breakthrough soon. Amen to that !!! We need a bone !!! Teva, RLS or something while I'm still relatively young already
|
|
|
Post by bioexec25 on Sept 21, 2016 18:48:27 GMT -5
Lol. Sports, well said. Although youth is a relative term I suppose. Was tempted to quote a Pink Floyd lyric but hey. The Wall comes to mind. Hehe.
|
|
|
Post by bioexec25 on Sept 21, 2016 18:50:35 GMT -5
Anyone else past red at this point? I'm more purple "And once you're gone you can't ever come back, when you're out of the blue and into the black". Ok settled for Neil Young Kball.
|
|
|
Post by mnholdem on Sept 21, 2016 19:32:18 GMT -5
Lol. Sports, well said. Although youth is a relative term I suppose. Was tempted to quote a Pink Floyd lyric but hey. The Wall comes to mind. Hehe. Time Lyrics
Mason, Waters, Wright, Gilmour The Dark Side of The Moon
Ticking away the moments that make up a dull day You fritter and waste the hours in an offhand way. Kicking around on a piece of ground in your home town Waiting for someone or something to show you the way.
Tired of lying in the sunshine staying home to watch the rain. You are young and life is long and there is time to kill today. And then one day you find ten years have got behind you. No one told you when to run, you missed the starting gun.
So you run and you run to catch up with the sun but it's sinking Racing around to come up behind you again. The sun is the same in a relative way but you're older, Shorter of breath and one day closer to death.
Every year is getting shorter never seem to find the time. Plans that either come to naught or half a page of scribbled lines Hanging on in quiet desperation is the English way The time is gone, the song is over, Thought I'd something more to say.
|
|
|
Post by peppy on Sept 21, 2016 19:57:21 GMT -5
Anyone else past red at this point? I'm more purple I have lost all my clotting factors and am in DIC (disseminated intravascular coagulation.) I am in need of a total blood volume transfusion. Too bad for me I am AB negative. On the bright side, I am too ill to sell.
(I am fine. I know what you mean.)
Every picture tells a story don't it.
|
|
|
Post by bioexec25 on Sept 21, 2016 21:21:29 GMT -5
Mnholdem, we need to have a jam session. Lol.
Btw, Us and Them comes to mind tonight. Ugh.
|
|