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Post by tripoley on Nov 18, 2016 7:29:21 GMT -5
Adam Feuerstein's new line of attack is the cost of raw insulin citing NVO dropping oral insulin because it requires 50x the insulin as injectable. Afrezza requires 2.5-3x as injectable. Walmart sells Novolin (RHI) at $25 for 1000 units or $0.025/unit. A four unit cartridge has 10 units of RHI so 90 carts = 900 units of RHI = $22.50 at retail. Does anyone know what MNKD actually pays for a unit of RHI?
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Post by peppy on Nov 18, 2016 8:08:34 GMT -5
I suspect that is why mnannkind didn't proceed on oral insulin as well.
no matter how well buffered, oral required more insulin.
I do not know the answer to your question.
My take is the reason afrezza users get a larger dose of insulin is the phase one insulin reaction, that analogue users do not get. analog users, go high before coming down.
afrezza users big hit, keeps them from going high in the first place.
Adam is correct, oral insulin will use more insulin, and being dropped, ok.
If afrezza requires more insulin, it is because it is more effective.
you could write the book tripoley, what is your take? afrezza uses regular, to it's advantage?
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Post by Deleted on Nov 18, 2016 9:15:45 GMT -5
AF is trying to obfuscate the real issue, efficacy. Afrezza mimics the effects insulin the pancreas produces; analogues do not.
That is big pharmaceuticals' fear.
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Post by tripoley on Nov 18, 2016 12:23:05 GMT -5
I suspect that is why mnannkind didn't proceed on oral insulin as well.
no matter how well buffered, oral required more insulin.
I do not know the answer to your question.
My take is the reason afrezza users get a larger dose of insulin is the phase one insulin reaction, that analogue users do not get. analog users, go high before coming down.
afrezza users big hit, keeps them from going high in the first place.
Adam is correct, oral insulin will use more insulin, and being dropped, ok.
If afrezza requires more insulin, it is because it is more effective.
you could write the book tripoley, what is your take? afrezza uses regular, to it's advantage?
Afrezza uses more insulin because of all that is lost in the mouth, throat and larger airways until it is deposited in the deep lung where it gets absorbed into the blood. They use regular insulin in monomers (as opposed to hexamers) for the rapid onset and shorter duration of action. My take is RHI is cheap to produce in bulk. I saw where LLY produces 20x the RHI they used to produce from the same plant by tweaking the formula. Also they can produce RHI from safflower, 25 square miles of which could produce enough insulin to supply the entire world in 2010. Links: www.indystar.com/story/money/2013/11/14/eli-lilly-spending-700m-on-insulin-production-to-meet-growing-global-threat-of-diabetes/3524293/www.popsci.com/science/article/2010-02/first-pigs-then-bacteria-now-insulin-flowers |
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Post by mnkdfann on Nov 20, 2016 1:27:57 GMT -5
Your claim about RHI from flowers is a bit of a (actually, a huge) stretch. The 2010 article merely said that some University of Calgary scientists proved it could be done. The article did NOT say that it was in commercial use at the time, or that it would ever make it to widespread commercial use. In fact, the Calgary company that tried doing this went bankrupt in 2012. www.intlcorn.com/seedsiteblog/?p=505"SemBioSys has announced that it is winding down the company and ceasing operations after delisting from the Toronto Stock Exchange ... SemBioSys is located in Calgary and associated with the University of Calgary. Safflower was easy to transform and has no weedy relatives in North America ... One of the major products which SemBioSys targeted was human insulin. With insulin there was no way to avoid the purification issue. SemBioSys started clinical trials with their insulin in 2008." |
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Post by LosingMyBullishness on Nov 20, 2016 5:42:09 GMT -5
MNKD has, as I recall, lots of surplus insulin already bought. these are sunk costs. So this will not an issue for some time. When they have used it up it will not be an issue because they will not face direct competition and price wars because they are in a separate category.
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Post by cjm18 on Nov 20, 2016 9:39:14 GMT -5
Adams hit piece also said afrezza was expensive to make. Not just the cost of insulin. Is that true. He also said the gross to net discount of 32% was high. I read that is average for the industry.
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Post by agedhippie on Nov 20, 2016 14:11:54 GMT -5
Adams hit piece also said afrezza was expensive to make. Not just the cost of insulin. Is that true. He also said the gross to net discount of 32% was high. I read that is average for the industry. I suspect it's a wash at the end of the day. Undoubtedly RHI is cheaper to produce than the analogs however there are extra manufacturing steps in converting it from liquid RHI to Technosphere powder capsules. Right now there is probably extra cost because the manufacturing is going to be running at sub-optimal volumes. |
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Post by mannmade on Nov 20, 2016 16:18:30 GMT -5
At what cost good health? None of this matters, imho, once the medical community truly understands how far ahead and superior AFREZZA is to current prandials.
Cost then will not be an issue. And the difference right now is not huge. If Gilead could get 80k for Harvoni/Solvadi then this should be a no brainer.
Not to mention the cost savings to the insurance companies and the gov't.
Just my opinion.
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Post by agedhippie on Nov 20, 2016 17:27:55 GMT -5
At what cost good health? None of this matters, imho, once the medical community truly understands how far ahead and superior AFREZZA is to current prandials. Cost then will not be an issue. And the difference right now is not huge. If Gilead could get 80k for Harvoni/Solvadi then this should be a no brainer. Not to mention the cost savings to the insurance companies and the gov't. Just my opinion. It's a not unreasonable position - looking at the old human insulins vs. the analogs. The analogs are an order of magnitude more expensive. But, and it's a big but, their superiority was supported by trial data and their introduction pre-dated a lot of the health concerns the FDA now routinely check for. Even then uptake is not certain - in Europe the health services use NPH rather than slow acting analogs like Lantus for Type 2 on basal only because the trial data did not prove long term superiority in that role (for MDI they do use Lantus though). |
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Post by tripoley on Nov 20, 2016 18:06:25 GMT -5
Your claim about RHI from flowers is a bit of a (actually, a huge) stretch. The 2010 article merely said that some University of Calgary scientists proved it could be done. The article did NOT say that it was in commercial use at the time, or that it would ever make it to widespread commercial use. In fact, the Calgary company that tried doing this went bankrupt in 2012. www.intlcorn.com/seedsiteblog/?p=505"SemBioSys has announced that it is winding down the company and ceasing operations after delisting from the Toronto Stock Exchange ... SemBioSys is located in Calgary and associated with the University of Calgary. Safflower was easy to transform and has no weedy relatives in North America ... One of the major products which SemBioSys targeted was human insulin. With insulin there was no way to avoid the purification issue. SemBioSys started clinical trials with their insulin in 2008." Not my claim. I just quoted the article. The concentrations they saw shows the possibility but it still would require harvesting, collecting, concentrating, purifying, etc. I assume they would have to go through some sort of FDA certificaRion as well. Doesn't change my opinion since LLY seems to produce it in large quantities. |
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Post by anderson on Nov 20, 2016 18:55:25 GMT -5
Adams hit piece also said afrezza was expensive to make. Not just the cost of insulin. Is that true. He also said the gross to net discount of 32% was high. I read that is average for the industry. Mannkind has said Afrezza per unit is expensive now due to the overhead cost of running the factory at such low volumes. Keeping the lights on has a fixed price cost, as well as under utilizing the staff, so as volume picks up the price per unit will actually go down till the cost of insulin is the largest factor. |
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Post by lakon on Nov 21, 2016 11:44:50 GMT -5
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Post by LosingMyBullishness on Nov 21, 2016 12:00:07 GMT -5
Today could be a reminder that a tweet by AF always comes with some short attack. Concerning AF: His job is to serve his customers by publishing biased, distorted and something that is called in German "Teilwahrheit" (A term for using some true elements to give credibility to the lie).
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Post by slugworth008 on Nov 21, 2016 12:04:55 GMT -5
AF is trying to obfuscate the real issue, efficacy. Afrezza mimics the effects insulin the pancreas produces; analogues do not. That is big pharmaceuticals' fear. BINGO!! And that IS exactly why Afrezza should be / will be a frontline treatment assuming we have the funds to get there. IMO |
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