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Post by fiddler on Oct 13, 2016 11:07:55 GMT -5
That's sort of the whole point. What do the diabetics really care about and how does afrezza address those issues? If hypoglycemia isn't high on their list, then it doesn't seem to make much sense spending a lot of money advertising that aspect of afrezza. it does make sense... it seems to me at this point that is all they can say without label change and I'm surprised they can even claim less hypos.. it all depends on how educated the PWD patient is.... many have accepted their present situation as it is(brainwashing by docs and standard of care) .. they don't know there is something better .. I noticed this with my dad.. but these ads catch peoples attention .. is it going to be the BIG THING that we need? NO .. but it will help .. and yes this situation is nerve racking.. its going to take time .... time and money ... Mnkd is going to have to get more money from someplace... work on insurance issues .. etc etc .. and it seems to me that the SNY debacle did some damage that we have to catch up on .. I'm not looking at the script counts right now, becuz I think that its going to take TV ads to really get this thing rolling.. I believe it will be patient driven... and the insurance coverage and doc education needs to be there when the patients come ... even if the docs aren't totally in the game at least they will have heard of it.. But it does have one strong point that can be advertised and that's convenience -- easy to take on trips, easy to keep one in pocket for a spike, etc. A good advertising agency could then weave into that other information that might lead the diabetic to seek more info. Insurance coverage is definitely the biggest issue. Why can't they do something along the lines of Medtronic did with its artificial pancreas -- negotiate with just a single large insurer like UHC to get the drug covered at a price that offers both a decent profit margin? Also, I've never seen anyone using one. Is there a video with sound showing afrezza being used from start to finish. I posted earlier asking about the sound it makes but the thread was locked for some reason. It never occurred to me that patients might be put off by the sound it makes, but could that be a factor? Mike Hoskins seemed to worry about it so it seems like a question worth investigating.
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Post by fiddler on Oct 13, 2016 11:12:58 GMT -5
That's sort of the whole point. What do the diabetics really care about and how does afrezza address those issues? If hypoglycemia isn't high on their list, then it doesn't seem to make much sense spending a lot of money advertising that aspect of afrezza. I think you are missing the point by mannmade. Hypoglycemia is definitely high on the list for things that you do not want to see happen to PWDs which is more the reason why 7.0 and 8.0 A1Cs are "acceptable". If you mis-dose your prandial there is a high likely hood of being hypo because of the long tail. With Afrezza that risk is virtually gone (evidence of patients taking Afrezza WITHOUT a meal just to see how low they would really go). I have a friend who is an endo and when I told him about the A1Cs that patients on Afrezza were achieving the first response was not "Wow that is great"...it was actually "Whoa, thats dangerous, they should be cautious of hypos". I was confused because my introduction to diabetes started with learning about Afrezza so that was my standard. I was not until I realized what target A1Cs SHOULD be versus what they currently are. If the target A1C for patients was actually to achieve non-diabetic numbers...hypos would have been the highest on the list of reasons to use Afrezza.. While it might be high on your own list, is it high on diabetics' lists? I don't see the sense of trying to promote fast out to prevent hypoglycemia if diabetics don't particularly care about hypoglycemia. Have they done market research to determine the percentage of diabetics concerned about the problem?
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Post by mnkdfann on Oct 13, 2016 11:21:30 GMT -5
Also, I've never seen anyone using one. Is there a video with sound showing afrezza being used from start to finish. I posted earlier asking about the sound it makes but the thread was locked for some reason. It never occurred to me that patients might be put off by the sound it makes, but could that be a factor? Mike Hoskins seemed to worry about it so it seems like a question worth investigating. See / listen here: youtu.be/CbixFksNU48?t=1m51s
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Post by sportsrancho on Oct 13, 2016 12:06:06 GMT -5
Fiddler, put your lips almost all the way together and suck in. That's what it sounds like. Not a lot of noise. Lol. I just sat at a table with a bunch of doctors and a man from MNKD eating a meal and taking Afrezza. All were impressed with his results and the convenience of it!
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Post by dreamboatcruise on Oct 13, 2016 12:17:06 GMT -5
I think you are missing the point by mannmade. Hypoglycemia is definitely high on the list for things that you do not want to see happen to PWDs which is more the reason why 7.0 and 8.0 A1Cs are "acceptable". If you mis-dose your prandial there is a high likely hood of being hypo because of the long tail. With Afrezza that risk is virtually gone (evidence of patients taking Afrezza WITHOUT a meal just to see how low they would really go). I have a friend who is an endo and when I told him about the A1Cs that patients on Afrezza were achieving the first response was not "Wow that is great"...it was actually "Whoa, thats dangerous, they should be cautious of hypos". I was confused because my introduction to diabetes started with learning about Afrezza so that was my standard. I was not until I realized what target A1Cs SHOULD be versus what they currently are. If the target A1C for patients was actually to achieve non-diabetic numbers...hypos would have been the highest on the list of reasons to use Afrezza.. when was that conversation with your endo friend ? 3 months? 1 yr? is he well versed with Afrezza now ? any of his patients on Afrezza with the same unbelievable results ? he must be familiar with the CGM range of his current patients on injectables. Did he ever attempt to look around on Afrezza and all the anecdotal time in zone cgm shots? Turning to the internet for anecdotal evidence flies in the face of their medical training. I know it isn't a fair comparison, but google diabetes and you'll find countless anecdotal claims of cures, many involving some herb. Doctors are very skeptical of anything from the interweb. Afrezza is the real deal, but don't expect posts on the tweet machine to sway large numbers of doctors. It will take a concerted, thoughtful and more traditional marketing effort.
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Post by brentie on Oct 13, 2016 12:20:01 GMT -5
Fiddler, put your lips almost all the way together and suck in. That's what it sounds like. Not a lot of noise. Lol. I just sat at a table with a bunch of doctors and a man from MNKD eating a meal and taking Afrezza. All were impressed with his results and the convenience of it!
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Post by lsl428 on Oct 13, 2016 12:34:27 GMT -5
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Post by kbrion77 on Oct 13, 2016 12:37:18 GMT -5
What if she left Afrezza in her check in bag?
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Post by mnkdfann on Oct 13, 2016 12:50:12 GMT -5
What if she left Afrezza in her check in bag? Technosphere's remote-teleport feature! Everyone knows this. Peddle your FUD elsewhere, shorty. Just kidding.
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Post by compound26 on Oct 13, 2016 12:51:40 GMT -5
The sound of inhaling afrezza was noticed by early users long time ago. See this video at around 4:30". But it is a very minor issue (as the video indicates, only if you want to inhale Afrezza during a meeting or lecture and you want to be discreet, then that may be an issue, but imagine you want to inject yourself during such occasion). www.youtube.com/watch?v=CbixFksNU48
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Post by cathode on Oct 13, 2016 13:03:52 GMT -5
I think the biggest problem to prescription growth is that doctors and PWD remain fearful of the long-term health implications related to the respiratory system. This is in part tainted by the exubera recall/abandonment and misinformation swirling around that. Two of my partner's endos have explicitly stated this concern. One had actively turned down samples during the early Sanofi launch period, and the other hasn't prescribed Afrezza. The second (current) endo was instrumental in getting her a CGM and is aware of the diversity of treatment options. He stated that he wouldn't prescribe Afrezza until his colleagues had vetted it and there was sufficient data on its long-term safety, so maybe 2+ years down the road. He did think it would be a good option for the extremely needle-phobic who have associated poor glucose control.
We could debate the validity of their concerns and their motives, but these are the anecdotal facts I have encountered in the past 1.5 years. These are concerns that will exist regardless of who is doing the marketing and education. Exubera has left a bad taste in people's mouths and Afrezza is being hurt by it. You can't point all the blame to Exubera, but there is certainly a predisposition now.
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Post by sweedee79 on Oct 13, 2016 13:16:40 GMT -5
I think you are missing the point by mannmade. Hypoglycemia is definitely high on the list for things that you do not want to see happen to PWDs which is more the reason why 7.0 and 8.0 A1Cs are "acceptable". If you mis-dose your prandial there is a high likely hood of being hypo because of the long tail. With Afrezza that risk is virtually gone (evidence of patients taking Afrezza WITHOUT a meal just to see how low they would really go). I have a friend who is an endo and when I told him about the A1Cs that patients on Afrezza were achieving the first response was not "Wow that is great"...it was actually "Whoa, thats dangerous, they should be cautious of hypos". I was confused because my introduction to diabetes started with learning about Afrezza so that was my standard. I was not until I realized what target A1Cs SHOULD be versus what they currently are. If the target A1C for patients was actually to achieve non-diabetic numbers...hypos would have been the highest on the list of reasons to use Afrezza.. While it might be high on your own list, is it high on diabetics' lists? I don't see the sense of trying to promote fast out to prevent hypoglycemia if diabetics don't particularly care about hypoglycemia. Have they done market research to determine the percentage of diabetics concerned about the problem? Hypoglycemia is a problem and also a restraint.... If you have an insulin where you can take a higher dose without the worry of having a hypo event you then have better control ... the question is how knowledgeable is the person with diabetes.... many aren't.. the are robotic .. following everything the doc says without question, therefore never really questioning or taking responsibility for their own disease .. or realizing that there is something else out there.. I know that is what my dad was doing.. he really doesn't understand his own disease.. he left that up to someone else.. makes me wonder how many people there are out there like him ...
My dad is on Novolog.... because there is ALWAYS a worry about a hypo event with this insulin, especially in elderly people .. the docs HAVE TO keep the dose low enuff to prevent this from happening as it can be fatal.. With Novolog there is a much larger risk of hypo .. so patients CANNOT take a dose that is too large.. Afrezza is much more forgiving because its in and out fast.. this one of the things that makes Afrezza remarkable .. so YES ... less risk of hypo is a huge
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Post by compound26 on Oct 13, 2016 13:21:02 GMT -5
I think the biggest problem to prescription growth is that doctors and PWD remain fearful of the long-term health implications related to the respiratory system. This is in part tainted by the exubera recall/abandonment and misinformation swirling around that. Two of my partner's endos have explicitly stated this concern. One had actively turned down samples during the early Sanofi launch period, and the other hasn't prescribed Afrezza. The second (current) endo was instrumental in getting her a CGM and is aware of the diversity of treatment options. He stated that he wouldn't prescribe Afrezza until his colleagues had vetted it and there was sufficient data on its long-term safety, so maybe 2+ years down the road. He did think it would be a good option for the extremely needle-phobic who have associated poor glucose control. We could debate the validity of their concerns and their motives, but these are the anecdotal facts I have encountered in the past 1.5 years. These are concerns that will exist regardless of who is doing the marketing and education. Exubera has left a bad taste in people's mouths and Afrezza is being hurt by it. You can't point all the blame to Exubera, but there is certainly a predisposition now. That sounds rights. The following comments following Haynes'a Afrezza video illustrate this: Roy L Flush 10 months ago Why is the stock so low? I would have thought by now it would have soared. Who turned you on to this drug? Hayes Fejer 6 months ago My husband's endocrinologist actually mentioned it, but I had to ask my endo for it. Since it is so new I think many endocrinologists are hesitant to suggest it because of the lack of data published on it. I just got my second lung function tests done in order to get the prior approval my insurance requires. Roy L Flush 6 months ago It's really not that new. At least 5 years I think. Hayes Fejer 6 months ago It's my understanding that Afrezza didn't receive FDA approval until mid 2014 and wasn't widely distributed until January 2015.
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Post by cjm18 on Oct 13, 2016 13:30:07 GMT -5
While it might be high on your own list, is it high on diabetics' lists? I don't see the sense of trying to promote fast out to prevent hypoglycemia if diabetics don't particularly care about hypoglycemia. Have they done market research to determine the percentage of diabetics concerned about the problem? Hypoglycemia is a problem and also a restraint.... If you have an insulin where you can take a higher dose without the worry of having a hypo event you then have better control ... the question is how knowledgeable is the person with diabetes.... many aren't.. the are robotic .. following everything the doc says without question, therefore never really questioning or taking responsibility for their own disease .. or realizing that there is something else out there.. I know that is what my dad was doing.. he really doesn't understand his own disease.. he left that up to someone else.. makes me wonder how many people there are out there like him ...
My dad is on Novolog.... because there is ALWAYS a worry about a hypo event with this insulin, especially in elderly people .. the docs HAVE TO keep the dose low enuff to prevent this from happening as it can be fatal.. With Novolog there is a much larger risk of hypo .. so patients CANNOT take a dose that is too large.. Afrezza is much more forgiving because its in and out fast.. this one of the things that makes Afrezza remarkable .. so YES ... less risk of hypo is a huge
It's frustrating that docs and insurers can't put two and two together and realize there's less risk of hypo. The fast in and out mentioned in the ada paper from march should have been a stepping stone.
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Post by silentknight on Oct 13, 2016 13:34:43 GMT -5
I think the biggest problem to prescription growth is that doctors and PWD remain fearful of the long-term health implications related to the respiratory system. This is in part tainted by the exubera recall/abandonment and misinformation swirling around that. Two of my partner's endos have explicitly stated this concern. One had actively turned down samples during the early Sanofi launch period, and the other hasn't prescribed Afrezza. The second (current) endo was instrumental in getting her a CGM and is aware of the diversity of treatment options. He stated that he wouldn't prescribe Afrezza until his colleagues had vetted it and there was sufficient data on its long-term safety, so maybe 2+ years down the road. He did think it would be a good option for the extremely needle-phobic who have associated poor glucose control. We could debate the validity of their concerns and their motives, but these are the anecdotal facts I have encountered in the past 1.5 years. These are concerns that will exist regardless of who is doing the marketing and education. Exubera has left a bad taste in people's mouths and Afrezza is being hurt by it. You can't point all the blame to Exubera, but there is certainly a predisposition now. I think the approach described here is probably the norm rather than the exception. New technology and advancement in drug therapies often see difficulty in penetrating the paradigm of treatment options for doctors. I can understand why they might adopt such a philosophy but in my view, it's extremely short-sighted and close minded, to the detriment of their patients. In an effort to protect them, they are ultimately harming them. You can use the A1C levels of Afrezza users and the tight glucose control that most have as evidence of this. Afrezza gives them their lives back. When I hear of doctors being hesitant to try new drugs or ways to treat disease, I can't help but feel sorry for the thousands of people being forced to continue to use outdated and less effective therapies because of a doctor unwilling to be forward thinking and do some research. With innovations in drug therapies and incredible advances in anti-virals, carriers of HIV can now live long, healthy lives. Take Magic Johnson as a prime example. But think of how long that took to become the standard of care, and think about how many people died before it came to pass. What we saw in the treatment of HIV now exists for those with diabetes through the availability of Afrezza. I'm sure my late uncle would have loved to try Afrezza before he had to have limbs amputated and became debilitated as a result of the effects of diabetes. Afrezza is different than what endos and physicians have tried before, and there in lies the fear on the part of doctors to use it. We naturally fear what we don't understand. Fear is overcome through education and experience and I'd encourage your partners to seek out both before writing off something that could fundamentally improve the lives of their patients. The "first do no harm" part of their oath shouldn't be a shield to excuse resistance to FDA approved and demonstrably evidenced improvements in medicine. I'll put away the soap box now.
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