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Post by nylefty on Oct 28, 2016 23:39:35 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand.
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Post by lakon on Oct 29, 2016 3:13:12 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand. Great point! That's why I believe that MNKD must (and are) focus on their proven prescribers. These doctors must see anecdotal evidence in their patients at a statistically significant amount for them to say, I'm pulling the trigger to switch my patients to Afrezza because I know Al Mann was correct. Until a doctor sees it enough with his/her own eyes, it will not be enough. If they can get some big practices convinced over 6 months, the following 6 months should allow them to make progress with another set. It will be slow and hopefully steady at some point before the tipping point. Meanwhile, the sales reps keep trying to crack open new doors to build a pipeline of practices. CEO finds a way to finance until 4th of July 2017. Who would plan a second commercialization effort without at least a runway of 1 year, besides SNY? If the answer is Matt P, he's never going to work again at this level. I think he plans to succeed, which only means giving it a fair shot before walking away. |
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Post by saxcmann on Oct 29, 2016 7:22:59 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand. Yes, so true. Also PWD usually see docs twice per year. 90% have never heard of afrezza at this point. 10% might ask "I heard about inhaled insulin from my friend, what do you think?" Endo says might have lung issues, is there a problem with your pump?" Patient say "no not really" ...end of conversation. Unless patient demands it or endo suggest trying it, its simply not gonna happen. Better label will change conversation slightly but in my opinion we need 2 things mostly...endos telling other endos about results and educating them how to dose afrezza thru presentations and we need mass DTC marketing campaign from television. If we get more cash to extend runway and to promote afrezza mnkd can still be a successful drug. |
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Post by sportsrancho on Oct 29, 2016 8:06:47 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand. Yes, so true. Also PWD usually see docs twice per year. 90% have never heard of afrezza at this point. 10% might ask "I heard about inhaled insulin from my friend, what do you think?" Endo says might have lung issues, is there a problem with your pump?" Patient say "no not really" ...end of conversation. Unless patient demands it or endo suggest trying it, its simply not gonna happen. Better label will change conversation slightly but in my opinion we need 2 things mostly...endos telling other endos about results and educating them how to dose afrezza thru presentations and we need mass DTC marketing campaign from television. If we get more cash to extend runway and to promote afrezza mnkd can still be a successful drug. 10 Thumbs Up Sax! I can't tell you how accurate I feel every word in your post is. And how important! |
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Post by twibs66 on Oct 29, 2016 10:14:39 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand. enter vdex they obviously know the long waits pwd's deal with to see their endos . |
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Post by slugworth008 on Oct 29, 2016 10:40:14 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand. enter vdex they obviously know the long waits pwd's deal with to see their endos . Good call on vdex but do they have any locations up and running yet? |
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Post by agedhippie on Oct 29, 2016 10:40:34 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand. Yes, so true. Also PWD usually see docs twice per year. 90% have never heard of afrezza at this point. 10% might ask "I heard about inhaled insulin from my friend, what do you think?" Endo says might have lung issues, is there a problem with your pump?" Patient say "no not really" ...end of conversation. Unless patient demands it or endo suggest trying it, its simply not gonna happen. Better label will change conversation slightly but in my opinion we need 2 things mostly...endos telling other endos about results and educating them how to dose afrezza thru presentations and we need mass DTC marketing campaign from television. If we get more cash to extend runway and to promote afrezza mnkd can still be a successful drug. According to my endo endocrinology is not a popular option with doctors because you don't have high cost procedures to perform so you are never going to make the big bucks. Consequently there is a shortage and these huge lead times. The operative phrase in the reply is "or endo suggest trying it". There was an earlier post that talked about and an endo pulling the trigger and switching their patients to Afrezza - it doesn't work like that, suggest is about as strong as it gets. People are very touchy about their insulin, I hated getting switched from Novolog to Humalog by my insurance and they are extremely close, so getting people to move from injected to inhaled will be a delicate operation. The endo is going to have to invest time in selling Afrezza to his patients. |
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Post by slugworth008 on Oct 29, 2016 10:41:34 GMT -5
Several people have posted about four month waiting times for endo appointments and until yesterday I took those claims with the proverbial grain of salt. I'm not a diabetic, but I may have osteoporosis, so my primary care doc referred me to an endo. Yesterday I called to make an appointment and was told that the first slot available was on February 27th -- exactly four months away. The lesson I take from this is that when it comes to getting a Rx for Afrezza or any other drug from an endo, "demanding it" may or may not work, but be prepared for a l-o-n-g wait to get the chance to make that demand. Yes, so true. Also PWD usually see docs twice per year. 90% have never heard of afrezza at this point. 10% might ask "I heard about inhaled insulin from my friend, what do you think?" Endo says might have lung issues, is there a problem with your pump?" Patient say "no not really" ...end of conversation. Unless patient demands it or endo suggest trying it, its simply not gonna happen. Better label will change conversation slightly but in my opinion we need 2 things mostly...endos telling other endos about results and educating them how to dose afrezza thru presentations and we need mass DTC marketing campaign from television. If we get more cash to extend runway and to promote afrezza mnkd can still be a successful drug. I second sports post. My pipe dream is we get an arbitration settlement from SNY and a chunk of that money for DTC television ads. |
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Post by broncolife on Oct 29, 2016 10:53:40 GMT -5
enter vdex they obviously know the long waits pwd's deal with to see their endos . Good call on vdex but do they have any locations up and running yet? Yes, in California. Opened a wk or so ago. |
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Post by broncolife on Oct 29, 2016 11:08:15 GMT -5
Yes, so true. Also PWD usually see docs twice per year. 90% have never heard of afrezza at this point. 10% might ask "I heard about inhaled insulin from my friend, what do you think?" Endo says might have lung issues, is there a problem with your pump?" Patient say "no not really" ...end of conversation. Unless patient demands it or endo suggest trying it, its simply not gonna happen. Better label will change conversation slightly but in my opinion we need 2 things mostly...endos telling other endos about results and educating them how to dose afrezza thru presentations and we need mass DTC marketing campaign from television. If we get more cash to extend runway and to promote afrezza mnkd can still be a successful drug. According to my endo endocrinology is not a popular option with doctors because you don't have high cost procedures to perform so you are never going to make the big bucks. Consequently there is a shortage and these huge lead times. The operative phrase in the reply is "or endo suggest trying it". There was an earlier post that talked about and an endo pulling the trigger and switching their patients to Afrezza - it doesn't work like that, suggest is about as strong as it gets. People are very touchy about their insulin, I hated getting switched from Novolog to Humalog by my insurance and they are extremely close, so getting people to move from injected to inhaled will be a delicate operation. The endo is going to have to invest time in selling Afrezza to his patients. I also wonder if the first failed launch along with other drug reps could be hurting adoption. Let me explain, the last launch saw Doctors not writing scripts because they believed MNKD/Afrezza was done. Now we have 2.0, but what is the growing concern we all have, not enough cash. So if I'm a competing drug rep, and I notice the doctor is or is thinking about Afrezza what do I say. I would say just in case you weren't aware they are pretty cash strapped and not sure how much longer it will be available. Don't believe me check it out yourself. So then the doctor either checks it out himself or becomes hesitant to write the prescription for fear of it going away. Just a thought! |
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Post by saxcmann on Oct 29, 2016 11:39:35 GMT -5
According to my endo endocrinology is not a popular option with doctors because you don't have high cost procedures to perform so you are never going to make the big bucks. Consequently there is a shortage and these huge lead times. The operative phrase in the reply is "or endo suggest trying it". There was an earlier post that talked about and an endo pulling the trigger and switching their patients to Afrezza - it doesn't work like that, suggest is about as strong as it gets. People are very touchy about their insulin, I hated getting switched from Novolog to Humalog by my insurance and they are extremely close, so getting people to move from injected to inhaled will be a delicate operation. The endo is going to have to invest time in selling Afrezza to his patients. I also wonder if the first failed launch along with other drug reps could be hurting adoption. Let me explain, the last launch saw Doctors not writing scripts because they believed MNKD/Afrezza was done. Now we have 2.0, but what is the growing concern we all have, not enough cash. So if I'm a competing drug rep, and I notice the doctor is or is thinking about Afrezza what do I say. I would say just in case you weren't aware they are pretty cash strapped and not sure how much longer it will be available. Don't believe me check it out yourself. So then the doctor either checks it out himself or becomes hesitant to write the prescription for fear of it going away. Just a thought! Yes, there is some truth to this. We'll need clarity soon how they expect to proceed with no cash. |
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Post by surplusvalue on Oct 29, 2016 12:53:11 GMT -5
I also wonder if the first failed launch along with other drug reps could be hurting adoption. Let me explain, the last launch saw Doctors not writing scripts because they believed MNKD/Afrezza was done. Now we have 2.0, but what is the growing concern we all have, not enough cash. So if I'm a competing drug rep, and I notice the doctor is or is thinking about Afrezza what do I say. I would say just in case you weren't aware they are pretty cash strapped and not sure how much longer it will be available. Don't believe me check it out yourself. So then the doctor either checks it out himself or becomes hesitant to write the prescription for fear of it going away. Just a thought! Bingo. I have been stating in repeated posts that MNKD needed to take care of the cash/finance issue from the beginning of 2.0. Everyone knew that cash would be an issue at the beginning. In the second last large diabetes meeting that MNKD attended what did they discover and report?; that docs (everyone) thought that Afrezza was no longer available ...MNKD out of business. So if MNKD knew this they needed to insure that that perception would be eliminated. How to do this?; by making sure that MNKD was not in danger of falling in to possible bankruptcy by shoring up cash reserves. If not dilution in January 2016 then at least right after that meeting. But no, and even now MNKD is SILENT on this issue. I have said before that this CEO/CFO does NOT know how to interact with the market , know how to present MNKD to the market. So in effect, they have hobbled 2.0 by their own lack of action on this matter. This is the same problem in the CEO's inability to see the importance of his presence for instance on the health show circuit or have Laura K on this circuit as a spokesperson which has been discussed on another thread; the same problem of not knowing how to present to the market and the public as part of DTC efforts. The cash issue is in fact part and parcel of the DTC/market issue. All this is important since the endo education portion of 2.0 is only HALF of the process for all the reasons in this thread and others about endo resistance, endos' still lack of knowledge, endo conservatism etc. Along with the cash issue and its effects, t he DTC efforts are crucial here to help drive demand and so far these efforts have been extremely sparse and limited. People (including endos and the public) have to know about it and not under the assumption that it will disappear soon before the public can demand it, if that demand is going to have any merit or audience at all. nylefty's point is well taken but there has to be demand in the first place and then a willingness to prescribe; these both are just not there for the reasons suggested here. |
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Post by sayhey24 on Oct 30, 2016 18:20:51 GMT -5
Yes, so true. Also PWD usually see docs twice per year. 90% have never heard of afrezza at this point. 10% might ask "I heard about inhaled insulin from my friend, what do you think?" Endo says might have lung issues, is there a problem with your pump?" Patient say "no not really" ...end of conversation. Unless patient demands it or endo suggest trying it, its simply not gonna happen. Better label will change conversation slightly but in my opinion we need 2 things mostly...endos telling other endos about results and educating them how to dose afrezza thru presentations and we need mass DTC marketing campaign from television. If we get more cash to extend runway and to promote afrezza mnkd can still be a successful drug. I second sports post. My pipe dream is we get an arbitration settlement from SNY and a chunk of that money for DTC television ads. I agree with you on the SNY settlement but I am not convinced they are fully gone. Call me crazy but I think Stefan Schwarz realized early on there was too much inertia selling to the endo's and the PCPs wanted to write scripts for pills. I think he also realized that if he could develop a full service business model utilizing CGMs, the cloud, afrezza and toujeo/treshiba for 24/7 monitoring through drug delivery there was much more money to be made. I suspect we will find out soon but on one side we have Mike tweeting we will thank him soon and we have Matt awhile back predicting the greatest turn-around in history while at the same time the Vanguards, Blackrocks and Mann Foundation keep buying and all you read about is how MNKD is going bankrupt. One thing we do know is afrezza in the real world is performing much better than in the trials and better than almost everyone predicted. |
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Post by pengiep on Oct 30, 2016 18:26:50 GMT -5
Hmmm. Here's hoping you are right!
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Post by mannmade on Oct 30, 2016 18:35:10 GMT -5
I second sports post. My pipe dream is we get an arbitration settlement from SNY and a chunk of that money for DTC television ads. I agree with you on the SNY settlement but I am not convinced they are fully gone. Call me crazy but I think Stefan Schwarz realized early on there was too much inertia selling to the endo's and the PCPs wanted to write scripts for pills. I think he also realized that if he could develop a full service business model utilizing CGMs, the cloud, afrezza and toujeo/treshiba for 24/7 monitoring through drug delivery there was much more money to be made. I suspect we will find out soon but on one side we have Mike tweeting we will thank him soon and we have Matt awhile back predicting the greatest turn-around in history while at the same time the Vanguards, Blackrocks and Mann Foundation keep buying and all you read about is how MNKD is going bankrupt. One thing we do know is afrezza in the real world is performing much better than in the trials and better than almost everyone predicted. Check out the article from the Fool I just posted regarding pay for performance... I bolded your last line as it is spot on with a new drug revenue/payor system being experimented with according to The Motley Fool. |
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