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Post by brotherm1 on Dec 9, 2016 19:25:19 GMT -5
madog stated, "As CGM continue to gain insurance coverage and market penetration i think we will see much larger afrezza growth. I was trying to see what percentage of PWD currently use CGM - I believe this is the real target market the Mannkind should be marketing to." MNKD is targeting type ones and I would not at all doubt they are targeting CGM users - at least at the current time while its difficult to get insurance to cover Aftezza (Mike did recently say it works best with CGM's). I would think Mike is also showing insurance companies the results obtained from patients on Afrezza and CGM's to get insurance companies to better cover Afrezza. I don't remember the name of the cloud based database MNKD implemented this year, but I would think that in addition to having the data on it for the patients, the data is also there for the insurance companies. In fact, now that I think about it, the main reason for the database is probably to show the Afrezza related data to insurance companies in the effort to gain better coverage. Excellent post brotherm1. Thank you brotherm1. In fact I just had an epiphany. The focus, especially the past several months, has not been to increase sales - as evidenced by the reduction of our sales personnel - but rather to continue to obtain data from CGM's monitoring patients on Afrezza to provide it to the iinsurance companies to examine and hopefully increase the insurance coverage. Who needs extensive and expensive trials to show insurance companies how well Afrezza works when we have users on CGM's and a cloud based database (correction: web based and I believe it's through Asembia) with the results. |
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Post by sportsrancho on Dec 9, 2016 19:31:53 GMT -5
Nice thread Madog. Though you said: "One similarity i have noticed between all of the successful afrezza users was that they have a CGM". How many successful users are you talking about? I would not doubt that at least most successful users of Afrezza have a CGM, but I also would not doubt that many do not such as Hillsave and his son. Would love to hear from or about other successful users without CGM's Spiro does not use a CGM. Sam in the tudiabetes.org does not user a CGM. Robyn Jarrell does not seem to use a CGM. And I think there are other members in Sam Finta's report group that does not use a CGM. The teenagers do not use one. The boy got the hang of Afrezza faster because he had never used anything else. One of my friends is talking to Vdex about a script for his son:-)). I'll let you know in a week or so how that went. |
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Post by sportsrancho on Dec 9, 2016 19:42:19 GMT -5
In the US there are 1.25 million Type 1 diabetics. Globally Dexcom have 140,000 users and on the basis of no information at all I would guess that about 100,000 of those are in the US. Medtronics probably has a few less (a lot of Medtronics pump users have Dexcom CGMs because they are better than Medtronics CGM) so say a generous 200,000 CGM users in the US total. Of the Type 1 population you lose CGM coverage when you go onto Medicare so the numbers age out and you need to be continually recruiting new users. Wasn't there a panel recently to have dexcom covered by medicare for t1? To me this is the group/ market mnkd should be targeting. They will see the benefits of afrezza immediately , they have already shown to be early adopters , actively manage their diabetes, and probably have good coverage. I saw this on Twitter... |
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Post by sayhey24 on Dec 9, 2016 19:52:52 GMT -5
Vdex has been open for over a week. I was wondering how they were doing. I hope they are doing great. For T2's the general thought is about 2 months is all they need a CGM for when they first start on afrezza. Then they pretty much have the hang of it and how to dose. However, if Google/Onduo can provide a non-invasive CGM then its game on for everyone using a CGM. Right now the price of a Dexcom is too much if its only needed 2 months. A rental or loaner program might work for the Onduo type services. At the same time Abbott with the freestyle and San Meditech may one day enter the US market. Lets hope sooner than later and it looks like Abbott is getting close. San Meditech has a very nice unit which would sell for pennies on the dollar to Dexcom. It will be interesting to see the direction IBM Watson takes with their offering.
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Post by madog365 on Dec 9, 2016 20:02:21 GMT -5
Vdex has been open for over a week. I was wondering how they were doing. I hope they are doing great. For T2's the general thought is about 2 months is all they need a CGM for when they first start on afrezza. Then they pretty much have the hang of it and how to dose. However, if Google/Onduo can provide a non-invasive CGM then its game on for everyone using a CGM. Right now the price of a Dexcom is too much if its only needed 2 months. A rental or loaner program might work for the Onduo type services. At the same time Abbott with the freestyle and San Meditech may one day enter the US market. Lets hope sooner than later and it looks like Abbott is getting close. San Meditech has a very nice unit which would sell for pennies on the dollar to Dexcom. It will be interesting to see the direction IBM Watson takes with their offering. Could be interesting Mannkind had a co-marketing partnership to subsidize a short term rental of a cgm with each script of afrezza. Maybe one of the smaller cgm developers would do it to break into the market. |
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Post by hillsave on Dec 9, 2016 20:25:35 GMT -5
Madog, how long will you be with us till you have to head to the Pentagon? You must have me confused with THE mad dog, I am but a simple og although also mad (mostly about our lack of scripts to date) Hill, happy for you and your son and thanks for being a great advocate for afrezza. I have no quantitative proof that majority of successful users are also cgm users at this time but I do see this correlation quite often. I have no doubt afrezza works in either case but I'm worried many users without cgm do not see The benefits right away and drop off. Hill you did say "once you get the hang of it" how long does that take? Not everyone may be as dedicated as you to stick around and find out. Question asked: How long does it take to get the Hang of it with Afrezza? Answer: Depends on your level of intelligence. If you have passed 5th grade you're good to go and you will get the hang of it in a week as long as you are not afraid to take a follow up dose. No need to count Carbs. Just use your common sense. |
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Post by hillsave on Dec 9, 2016 21:50:29 GMT -5
Nice thread Madog. Though you said: "One similarity i have noticed between all of the successful afrezza users was that they have a CGM". How many successful users are you talking about? I would not doubt that at least most successful users of Afrezza have a CGM, but I also would not doubt that many do not such as Hillsave and his son. Would love to hear from or about other successful users without CGM's Spiro does not use a CGM. Sam in the tudiabetes.org does not user a CGM. Robyn Jarrell does not seem to use a CGM. And I think there are other members in Sam Finta's report group that does not use a CGM. You are wrong about Sam. He uses a Dexcom |
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Post by compound26 on Dec 9, 2016 22:31:37 GMT -5
Spiro does not use a CGM. Sam in the tudiabetes.org does not user a CGM. Robyn Jarrell does not seem to use a CGM. And I think there are other members in Sam Finta's report group that does not use a CGM. You are wrong about Sam. He uses a Dexcom I am not referring to Sam Fanta. I am referring to another Sam (Sam19), who is very active in tudiabete.org. |
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Post by cjm18 on Dec 9, 2016 23:32:57 GMT -5
You must have me confused with THE mad dog, I am but a simple og although also mad (mostly about our lack of scripts to date) Hill, happy for you and your son and thanks for being a great advocate for afrezza. I have no quantitative proof that majority of successful users are also cgm users at this time but I do see this correlation quite often. I have no doubt afrezza works in either case but I'm worried many users without cgm do not see The benefits right away and drop off. Hill you did say "once you get the hang of it" how long does that take? Not everyone may be as dedicated as you to stick around and find out. Question asked: How long does it take to get the Hang of it with Afrezza? Answer: Depends on your level of intelligence. If you have passed 5th grade you're good to go and you will get the hang of it in a week as long as you are not afraid to take a follow up dose. No need to count Carbs. Just use your common sense. Then why did mike say titration was a barrier on the last conference call? Some people are having issues. |
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Post by slapshot on Dec 9, 2016 23:40:22 GMT -5
ok, this was from a while backin another thread, but if i remember correctly, once Mike came on board he said something similar...
Jan 11, 2016 19:32:37 GMT -5 slapshot said:
Im beginning to think that Afrezza needs the use of CGMs to appeal to diabetics in general and T2s particularly. I think maybe the reason why Afrezza has appealed to T1s it that they have CGMs and could see the real time needs and benefits and therefore were able to dynamically adjust their dosages and timing to maximize their results. The T1s willing to adjust their habits and dosage protocols (with real time feedback from the CGM) have gotten incredible results, while perhaps those less willing or able could take or leave it (Afrezza) as their results are mixed or relatively similar to other products.
T2s (or those without a CGM) are taking Afrezza in the dark as they cant see the real time feedback and thus cant optimize the dosage or timing and therefore aren't necessarily getting good results. On top of that, the label and perhaps instructions from doctors may not offer the best timing / dosage information to begin with.
Just my 2 cents based on what i have read here.
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Post by stocker on Dec 9, 2016 23:44:32 GMT -5
Abbotts Freestyle Libre Pro is on the market now.
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Post by sweedee79 on Dec 10, 2016 0:40:46 GMT -5
My dad didn't have a CGM and I doubt he would ever use one.. I have a hard time just getting him to check his BG levels once a day... his numbers were only slightly better on Afrezza because he wasn't on a high enough dose... but he felt so much better .. and he lost weight .. my point being you can have success with Afrezza even without getting the A1C numbers in the 5s and having a CGM .. his lowest was 6.6 on Afrezza .. It all depends on the person and what their goals are. I personally believe that Afrezza very often requires a larger dose ..
Most people who use a CGM are very serious about managing their disease ... consequently have a CGM .. So I'm not sure the common denominater is a CGM but rather PWDs who are more dedicated to managing and learning about their disease and also have cooperative docs willing to try something new. I also believe that you can get the low A1Cs without a CGM if you are dedicated to doing that .. Afrezzauser says you don't have to have a CGM to achieve success with Afrezza..
My dad doesn't want his disease.. he wants to be free of it.. and that means he wants to be free of all of the hassle.. including poking his finger umpteen times a day to check his blood sugar.. A set dose 3 Xs a day did that for him... but more importantly he felt so much better.. lost weight and achieved better numbers as well..
I wish I could get him to do all of the things he suppose to do... but he doesn't want to.. as long as he is happy and he feels better we have achieved some success.. I think that if he were able to be on Afrezza again and for a longer length of time with the support of a positive doc perhaps we could get him to follow things more closely if he could see the benefits such as being able to eat more of what he wants to eat, take a dose of Afrezza and then not feel guilty about it or suffer high blood sugar ..
There are a whole range of things that could cause Afrezza to not work for some people .. and especially at this stage in the game with docs or patients not fully understanding the drug.. But certainly for those dedicated enough to managing their disease and willing to put in the extra effort a CGM is a great tool, tho not necessary..
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Post by sayhey24 on Dec 10, 2016 8:40:18 GMT -5
Abbotts Freestyle Libre Pro is on the market now. yes but only in a "clinical" setting. I can plunk down $1100 and buy a G5 today and hook it up to my phone. With the Libre Pro I would have to go back to the doctor every 2 weeks and have it read. This does not provide the real time feedback new afrezza users need. And, this won't work for Ondou and IBM 24/7 monitoring. My hope is Google can get to the market sooner than later with their non-invasive CGM. San Meditech tells me they have one now but I have never seen it and its their regular CGM which is cloud based is not in the US. |
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Post by hillsave on Dec 10, 2016 10:45:34 GMT -5
madog stated, "As CGM continue to gain insurance coverage and market penetration i think we will see much larger afrezza growth. I was trying to see what percentage of PWD currently use CGM - I believe this is the real target market the Mannkind should be marketing to." MNKD is targeting type ones and I would not at all doubt they are targeting CGM users - at least at the current time while its difficult to get insurance to cover Aftezza (Mike did recently say it works best with CGM's). I would think Mike is also showing insurance companies the results obtained from patients on Afrezza and CGM's to get insurance companies to better cover Afrezza. I don't remember the name of the cloud based database MNKD implemented this year, but I would think that in addition to having the data on it for the patients, the data is also there for the insurance companies. In fact, now that I think about it, the main reason for the database is probably to show the Afrezza related data to insurance companies in the effort to gain better coverage. Excellent post brotherm1. Thank you brotherm1. In fact I just had an epiphany. The focus, especially the past several months, has not been to increase sales - as evidenced by the reduction of our sales personnel - but rather to continue to obtain data from CGM's monitoring patients on Afrezza to provide it to the iinsurance companies to examine and hopefully increase the insurance coverage. Who needs extensive and expensive trials to show insurance companies how well Afrezza works when we have users on CGM's and a cloud based database (correction: web based and I believe it's through Asembia) with the results. The Mannkind sales staff was at 44 last count and increasing to 70+ after the first of the year. It has nothing to do with collecting data from CGM users. IMHO. As the Great results from Patients and doctors get more coverage the top sales people in the industry will be easier to attract. |
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Post by Deleted on Dec 10, 2016 11:16:21 GMT -5
Part of Novos strategy to hold pricing on insulin products is that they will attempt to demonstrate better patient outcomes and premium pricing for their product based on that. The time is rapidly coming where fee for service is replaced by fee for improved patient health so Novo will help he cause and they will need CGM to do so.
What was said earlier and what I had mentioned for some time now is that Mike C needs to go to a few big insurance cos and get 100 or so patients in a program so they get a CGM and go on Afrezza for 3-6 mos and do an A1C every 6 weeks during the process. The data will demonstrate without a doubt that patients on Afrezza will have better control of glucose levels (less volatility) and it will further demonstrate how much information the A1C fails to capture (intraday volatility of glucose levels of which, it is the hypoglycemia that is the main culprit in long term health complications). With this data, neither Mike C, MNKD or the insurance cos will need to run any trial as the data will glaringly demonstrate all of this. Why would the medical community initial resist Afrezza and to some extent CGMs - the risk of a new product / litigation and also the CGM data for many patients would reveal just how poorly many are controlling their diabetes (not mean to insult, without timely data, patient does not know what is really happening with their body).
Dexcom G5 sends data right to patient smartphone. Dexcom has deal w Google Health (Is name Verily now). This data is worth a lot of money to insurers, Rx manufactures and patients. The CGM initiative will pick up steam. Of course, we need to hope MNKD has enough cash to ride this all out.
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