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Post by sportsrancho on Nov 4, 2016 12:42:32 GMT -5
The only thing that will drive script numbers is demand from PWD telling their doctor they want Afrezza. I did it with Bydureon. They aren't going to suggest a new drug. Patients must demand them. Bydureon had a black box warning. My doctor advised me of it and I said I wanted it anyway. She wrote the script. Doctors rarely argue with patients over risk of losing the patient. Unfortunately, MNKD does not have the money for a real DTC ad campaign. The way I see it we have a big problem. I run into PWD all the time and not one knows about Afrezza! This above post is the truth!! We need to somehow create a movement fast. I don't as a personal trainer suggest new diets. I think I know what's best for my clients. I don't read up on new routines either because I think I've seen them all. Very wrong but true. But if two or three people ask me about the same diet or they insist on a different routine then I change it. Because you see...I work for them.
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Post by rockstarrick on Nov 4, 2016 14:45:59 GMT -5
From what I've seen posted here, there are quite a few problems: 1. black box with spirometry requirement 2. insurance coverage still a major problem 3. endos and diabetics wonder whether MNKD will survive so why start something only to have toi give it up if the company goes under 4. price is still expensive relative to humalog and novolog 5. afrezza appears to have a learning curve which is a more complicated than previously anticipated 6. long term use health concerns Those stand out to me at the moment. What I'd really like to know is whether MNKD has actually done any sort of patient and/or endo survey to determine whether the level of interest in having an inhaled version of insulin -- hard to sell ice to Eskimos and all that. Don't forget the biggest obstacle: Sanofi reps poisoning Afrezza !! ( OH we took Afrezza off market Doc try our new and approved Toujo ) And they have many more then 70 Toujeo and Afrezza are not the same type of Insulin, Toujeo is a highly concentrated 24 hour time released Insulin, (basal). Afrezza is a ultra rapid acting mealtime Insulin, (prandial). but I do agree that the reps may have been down playing Afrezza.
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Post by radgray68 on Nov 4, 2016 16:53:39 GMT -5
The only thing that will drive script numbers is demand from PWD telling their doctor they want Afrezza. I did it with Bydureon. They aren't going to suggest a new drug. Patients must demand them. Bydureon had a black box warning. My doctor advised me of it and I said I wanted it anyway. She wrote the script. Doctors rarely argue with patients over risk of losing the patient. Unfortunately, MNKD does not have the money for a real DTC ad campaign. The way I see it we have a big problem. I run into PWD all the time and not one knows about Afrezza! This above post is the truth!! We need to somehow create a movement fast. I don't as a personal trainer suggest new diets. I think I know what's best for my clients. I don't read up on new routines either because I think I've seen them all. Very wrong but true. But if two or three people ask me about the same diet or they insist on a different routine then I change it. Because you see...I work for them. The one thing not tried yet is what I would call a patient pull marketing strategy. As we discussed over at ST, diabetics just don't know about Afrezza. DAMN FRUSTRATING, IF YOU WANT TO KNOW THE TRUTH. Sorry for yelling, but the sentiment is real. So, let the doctors have it. Screw their pride and prejudices. Having worked with them personally, I can tell you they are just human beings. Sometimes we humans need to be led to what's good for us, like children.
I don't believe many doctors went out of their way to get informed about Viagra until wave after wave of patients came into the office demanding it. WAVE AFTER WAVE AFTER WAVE Ya' follow my meaning?
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Post by agedhippie on Nov 4, 2016 17:09:14 GMT -5
The way I see it we have a big problem. I run into PWD all the time and not one knows about Afrezza! This above post is the truth!! We need to somehow create a movement fast. I don't as a personal trainer suggest new diets. I think I know what's best for my clients. I don't read up on new routines either because I think I've seen them all. Very wrong but true. But if two or three people ask me about the same diet or they insist on a different routine then I change it. Because you see...I work for them. The one thing not tried yet is what I would call a patient pull marketing strategy. As we discussed over at ST, diabetics just don't know about Afrezza. DAMN FRUSTRATING, IF YOU WANT TO KNOW THE TRUTH. Sorry for yelling, but the sentiment is real. So, let the doctors have it. Screw their pride and prejudices. Having worked with them personally, I can tell you they are just human beings. Sometimes we humans need to be led to what's good for us, like children.
I don't believe many doctors went out of their way to get informed about Viagra until wave after wave of patients came into the office demanding it. WAVE AFTER WAVE AFTER WAVE Ya' follow my meaning?
That is never going to happen. I'm a Type 1 and I ignore any diabetes advertising I see on TV (in fairness I ignore all drug advertising I see on TV except out of morbid fascination as to the side effects which leave me thinking ****!!! People swallow that voluntarily?). Oddly I think I would be more likely to read the game advertising that in the campaign that is currently being run because it contains information whereas something like the Tresiba TV ads... I get OK results on RAA and I have been injecting forever and now you want me to gamble all that on an inhaled insulin? That is a lifestyle change and those are notoriously difficult sells. It's going to take way more than TV to sell that, it's going to take my endo telling be I can get better results because when he says that to me he is spending his political capital with me to get me to change.
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Post by sayhey24 on Nov 4, 2016 17:52:42 GMT -5
I thought this was a great article especially since it was written by a cancer biologist. It's articles like this and the Atlanta Fox 5 newscast which provide hope. But, until the Vdex's and Onduo's can overcome Endo inertia its going to be an uphill battle. It would sure be nice to have 1000 Vdex's open right now. Tuesday's going to be a big day in determining the future direction of U.S. healthcare.
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Post by dreamboatcruise on Nov 4, 2016 17:57:18 GMT -5
It sure would be nice to hear an explanation for and a plan for a solution for these less-than-explosive sales numbers at the CC. What are the biggest obstacles and challenges that the sales team is facing, and what is the solution plan (with or without a BP)? It seems insurance is being addressed well enough – good job, Mike. An established sales team didn’t do the job for Sanofi. Top-down advertising is not working … maybe we need bottom-up. The doctors don't seem to be getting onboard with this obviously best diabetic tool. So, maybe the "Ask your doctor if Afrezza would be right for you" approach is what is needed. Would an ad in game 7 have made the needed sales turnaround and saved MNKD? MNKD does not have the cash necessary for advertising, but a new BP will have to. Or, would doctors just answer “No, Afrezza is not right for you”? It just makes no sense for Afrezza to be doomed. What to heck is the real problem and solution here, anyway? I'm not suggesting they aren't doing their job well, since I have no understanding of the dynamics behind the scenes in getting payers to cover. However, I do believe that is still slowing adoption by docs considerably. Based on the following numbers (hot off formularylookup.com) it is still the case that a sizable chunk of patients have no coverage of Afrezza and of the ones that do many have to jump through hoops. You can see that in comparison to Tresiba (also introduced around the same time), Afrezza coverage looks meaningfully less... and of course it is night and day to coverage of Lantus. % NOT COVERED (higher is worse) Afrezza Tresiba Lantus Commercial Insurance 33% 16% 0% Exchange 44% 36% 0% Medicare 85% 42% 6% State Medicaid 0% 2% 0% Managed Medicaid 16% 44% 0%
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Post by nadathing on Nov 4, 2016 18:50:25 GMT -5
I thought this was a great article especially since it was written by a cancer biologist. It's articles like this and the Atlanta Fox 5 newscast which provide hope. But, until the Vdex's and Onduo's can overcome Endo inertia its going to be an uphill battle. It would sure be nice to have 1000 Vdex's open right now. Tuesday's going to be a big day in determining the future direction of U.S. healthcare. Given the amount of DTC advertising it is obviously driving people to ask their doctors for the medication.
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Post by broncolife on Nov 4, 2016 20:14:17 GMT -5
Don't forget the biggest obstacle: Sanofi reps poisoning Afrezza !! ( OH we took Afrezza off market Doc try our new and approved Toujo ) And they have many more then 70 Really? Our biggest problems stem from Sanofi reps bad mouthing Afrezza? What a load of bull. There's a massive list of major issues here, and I can tell you Sanofi being the culprit is not one of them. We need to stop blaming Sanofi for Mannkind's failures. Afterall, no one forced them to sign with them in the first place. They've had 11 months to make a difference. And here we are, averaging 2 scripts per rep. How is that even remotely close to being acceptable??? Dict, do you actually think about what your spewing. Let's take it point by point. Sanofi- do you think they lived up to their agreement? How was Al supposed to know the CEO would change, how was he supposed to know they would give up so easily. When you sign a contract that you believe is the best available for you and is presented as such, is it your fault if the other party doesn't live up to expectations? Second- It has not been 11 mos, listen to the CC and they will clearly tell you when they got up and moving (late Aug, early Sept.) They didn't even get the rights back until July 4th. Third -Sanofi has not caused MNKD to fail, but I think we can agree they sure didn't help them succeed. Yes, we need better script numbers, yes we need more reps, yes we need DTC, yes the stock price sucks, but with limited cash fixing that will not be easy. How about we look at the positive side. Afrezza is now back in our control (100% profit). We have a great advocate in Mike. Whom I believe is the best thing to happen at MNKD in a long time. The script numbers aren't where we want them but we stopped the free fall. We have had some good exposure, we have had some decent ad placement. We know based on the Insulin and Outsulin they are working on DTC. Most of all we have all the proof that Afrezza is a superior Diabetes medication. It takes way more time and energy to be negative, so be positive. If we can extend the runway, I have know doubt Afrezza will be the blockbuster Al always said it would be. GL! 😀
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Post by peppy on Nov 4, 2016 21:23:56 GMT -5
Peppy's words. Good article harry. He loves her with all his heart. I am glad she feels better.
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Post by radgray68 on Nov 4, 2016 23:04:40 GMT -5
Agedhippie is exactly right on here. I've received the same responses from my patients. Diabetics are bombarded with ads so much that they tune it out. We all do after a while, I guess. Something about sensory adaptation comes to mind. I don't know if i get that term from biology or psychology classes but it exists just the same. I don't know what will finally get this product into the forefront of diabetics minds. I made up my mind a while ago to give Mannkind a couple years to gain some traction. That's what it's going to take. That's probably why the naysayers hang their hat on the financials until we actually get enough cash.
After re-reading my prior post, I feel I must clarify that I know management is doing their dead level best to succeed. I'm still optimistic they can gain some percentage of market share and save this treatment for future study. Given the numerous obstacles, I'm glad I only have a small stake in the stock, enough to feel like I didn't miss out completely. However, that frees me up to really just be pissed that I might have been wrong about something that I was soooo sure of. I hate it when I'm wrong.
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