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Post by hillsave on Dec 10, 2016 14:45:14 GMT -5
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. Mike said that because some people only want to follow what their Dr tells them to do. Some Dr's still have no clue. Even my Endo wrote the script for me 30(4)60(8) yet the script reads "Take 4 units with Meals" how does the Box:) know what I'm having for dinner, when I don't even know what I'm having. Maybe I'll have a Veal Parm Hero with a Large Baked potatoes w/sour cream and a side order of veggies. Maybe I'll decide to go light and have scrimp scampi with angel hair pasta. Or maybe I'll just have a big tossed salad with lemon grilled chicken. Does the box of Afrezza know how many units I should take? I don't think so. Some people think like a box!!!! They don't. |
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Post by brotherm1 on Dec 10, 2016 18:49:25 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 . I'm thinking this is probably already being done. I'm thinking the main reason - albeit not the only reason - MNKD contracted with Asembia four months ago was to use Asembia to gather data - A1C's, glucose levels -from Afrezza patients for insurance coverage purposes. In addition to educating doctors, working to get better insurance coverage has been and still is prioritized over sales. How would Asembia be collecting this data? Do doctors monitor the patients' glucose levels and report them to insurers? Are there not already many patients using Affezza on CGM's? Is Asembia capable of collecting this data? I would think so. finance.yahoo.com/news/asembia-hub-patient-support-services-150000650.html |
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Post by agedhippie on Dec 10, 2016 22:49:51 GMT -5
I'm thinking this is probably already being done. I'm thinking the main reason - albeit not the only reason - MNKD contracted with Asembia four months ago was to use Asembia to gather data - A1C's, glucose levels -from Afrezza patients for insurance coverage purposes. In addition to educating doctors, working to get better insurance coverage has been and still is prioritized over sales. How would Asembia be collecting this data? Do doctors monitor the patients' glucose levels and report them to insurers? Are there not already many patients using Affezza on CGM's? Is Asembia capable of collecting this data? I would think so They contracted to outsource the follow up work needed on a patient by patient basis to get Afrezza prescribed as I understood it. I do not believe doctors would be allowed to routinely pass out patient data, HIPAA should preclude that. Maybe I ought to read all those papers doctors have me sign... |
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Post by brotherm1 on Dec 11, 2016 4:51:57 GMT -5
After further ado agedhippie, I believe you are correct about asembias's purpose to MNKD Perhaps its function is just underlying support for the Mannkind Cares platform
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Regarding CGM-Afrezza related data, I would hope by now there is plenty of it being accessed and analyzed by individual large insurance companies that currently support CGM's and Aftezza to some extent.
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Post by goyocafe on Dec 14, 2016 18:02:14 GMT -5
After further ado agedhippie, I believe you are correct about asembias's purpose to MNKD Perhaps its function is just underlying support for the Mannkind Cares platform ] Regarding CGM-Afrezza related data, I would hope by now there is plenty of it being accessed and analyzed by individual large insurance companies that currently support CGM's and Aftezza to some extent. I was following links from another thread and stumbled on " The Nightscout Project", "an open-source website for people or relatives of those with diabetes, was started by patients who wanted to remotely monitor CGM data. It started specifically for the Dexcom G4, and now integrates with the Share feature of the G4, G5 and Medtronic devices for both iOS and Android". It would be great to see patient agnostic data inclusive of current medication/dosing regimen in a separate section of this website. What a marketing tool that would be for the best performing drug or combination of drugs and a way of centralizing this information so other PWDs can benefit from all of this information. |
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Post by agedhippie on Dec 14, 2016 18:46:20 GMT -5
After further ado agedhippie, I believe you are correct about asembias's purpose to MNKD Perhaps its function is just underlying support for the Mannkind Cares platform ] Regarding CGM-Afrezza related data, I would hope by now there is plenty of it being accessed and analyzed by individual large insurance companies that currently support CGM's and Aftezza to some extent. I was following links from another thread and stumbled on " The Nightscout Project", "an open-source website for people or relatives of those with diabetes, was started by patients who wanted to remotely monitor CGM data. It started specifically for the Dexcom G4, and now integrates with the Share feature of the G4, G5 and Medtronic devices for both iOS and Android". It would be great to see patient agnostic data inclusive of current medication/dosing regimen in a separate section of this website. What a marketing tool that would be for the best performing drug or combination of drugs and a way of centralizing this information so other PWDs can benefit from all of this information. There are a few projects in the open source space like Nightscout, openAPS and xDrip spring to mind. Nightscout predated the G4 Share feature and Share was atleasy partly a response by Dexcom to Nightscout. As to sharing data as proposed; I am all in favor, how much are the marketeers going to pay me for my data? Pharmas want the data for free, but until I get my diabetic suppliers for free as well they can pay. |
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Post by sayhey24 on Dec 15, 2016 20:01:41 GMT -5
So we know we have a number of companies developing 24/7 monitoring services. Two of them - Onduo and IBM are pretty big players. A few others are also good sized. If I were one of these companies I would cut a deal with the CGM OEM and provide the CGM as part of the service with no direct cost to the patient if insurance is an issue. It looks like Onduo may already have a deal with Dexcom although I have never seen any formal announcement but Dexcom is pretty expensive. If I were one of the other companies I would be talking with San Meditech who can make them for pennies on the Dexcom dollar and work the approval through the FDA. If I could buy a unit from them for $50 providing them free as part of the service is little cost.
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Post by agedhippie on Dec 15, 2016 20:35:19 GMT -5
These monitoring services already exist. The biggest one is Glooko who have just swallowed Diasend (the one I used to use). However their focus is on enabling your doctor to see your results, not in selling data sets. HIPAA means you need to be very careful sharing peoples data without their express permission as the penalties sting.
The second and bigger issue is that although people happily upload their numbers they are a lot lazier about logging food and doses despite most meters having this function built in (yes I am guilty).
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Post by sayhey24 on Dec 15, 2016 20:56:01 GMT -5
These monitoring services already exist. The biggest one is Glooko who have just swallowed Diasend (the one I used to use). However their focus is on enabling your doctor to see your results, not in selling data sets. HIPAA means you need to be very careful sharing peoples data without their express permission as the penalties sting. The second and bigger issue is that although people happily upload their numbers they are a lot lazier about logging food and doses despite most meters having this function built in (yes I am guilty). The focus of the new services are changing from doctor control to patient "real time" control. Both IBM and Google have extensive "food models". After IBM Watson builds out your personal profile there is no need to upload anything; its Thursday which is often your pizza night; the model knows based on many biometric factors during the day what to expect if you start eating pizza; it sees your BG level rise; and it factors in the 8 units of afrezza which you took and it detected. Maybe it predicts in 1 hour you will need to take another 4 units. The problem has been having something which acts like the pancreas and something which can provide the flatline during fasting. The Tresiba/afrezza combo comes pretty close. For most T2s they should only need afrezza. HIPAA is not an issue as this is all personal and private information. There is NO sharing which would break the doctor/patient relationship. The problem is the endos as this will put most out of business. Endos will not be our friends. |
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Post by agedhippie on Dec 15, 2016 21:07:21 GMT -5
These monitoring services already exist. The biggest one is Glooko who have just swallowed Diasend (the one I used to use). However their focus is on enabling your doctor to see your results, not in selling data sets. HIPAA means you need to be very careful sharing peoples data without their express permission as the penalties sting. The second and bigger issue is that although people happily upload their numbers they are a lot lazier about logging food and doses despite most meters having this function built in (yes I am guilty). The focus of the new services are changing from doctor control to patient "real time" control. Both IBM and Google have extensive "food models". After IBM Watson builds out your personal profile there is no need to upload anything; its Thursday which is often your pizza night; the model knows based on many biometric factors during the day what to expect if you start eating pizza; it sees your BG level rise; and it factors in the 8 units of afrezza which you took and it detected. Maybe it predicts in 1 hour you will need to take another 4 units. The problem has been having something which acts like the pancreas and something which can provide the flatline during fasting. The Tresiba/afrezza combo comes pretty close. For most T2s they should only need afrezza. HIPAA is not an issue as this is all personal and private information. There is NO sharing which would break the doctor/patient relationship. The problem is the endos as this will put most out of business. Endos will not be our friends. That is exactly right. I use Diasend because it stores all my data and lets me see things over time that I suspect but can now prove. An example is the effect of season on my insulin sensitivity. I can then calibrate how much I should change things by to improve the numbers. I would love to use Watson, that service would be awesome and hopefully IBM opens it up more. |
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Post by sayhey24 on Dec 15, 2016 21:29:33 GMT -5
The focus of the new services are changing from doctor control to patient "real time" control. Both IBM and Google have extensive "food models". After IBM Watson builds out your personal profile there is no need to upload anything; its Thursday which is often your pizza night; the model knows based on many biometric factors during the day what to expect if you start eating pizza; it sees your BG level rise; and it factors in the 8 units of afrezza which you took and it detected. Maybe it predicts in 1 hour you will need to take another 4 units. The problem has been having something which acts like the pancreas and something which can provide the flatline during fasting. The Tresiba/afrezza combo comes pretty close. For most T2s they should only need afrezza. HIPAA is not an issue as this is all personal and private information. There is NO sharing which would break the doctor/patient relationship. The problem is the endos as this will put most out of business. Endos will not be our friends. That is exactly right. I use Diasend because it stores all my data and lets me see things over time that I suspect but can now prove. An example is the effect of season on my insulin sensitivity. I can then calibrate how much I should change things by to improve the numbers. I would love to use Watson, that service would be awesome and hopefully IBM opens it up more. Hey - there is nothing wrong with Glooko but they are small potatoes to a company like Onduo which is looking to disrupt diabetes care. Just to open the office up in Boston they got a $248M check from Sanofi. Glooko got really excited when they got $8m from a venture firm. IBM is probably spending $8m on lunch. Now, I sure hope Mike C has been talking with Glooko and others if plan A and plan B don't work out. Right now MNKD is so poor 6 days a week they get potato soup for lunch and on Sundays they get to eat the potato. |
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Post by MnkdWASmyRtrmntPlan on Dec 15, 2016 21:37:20 GMT -5
Good info and insight, SayHey and AgedH (and others). I totally agree with MadDog (and others) that as CGM continue to gain insurance coverage and market penetration, that may be the biggest driver of Afrezza sales.
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