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Post by silentknight on Dec 12, 2016 8:28:12 GMT -5
I'm not sure when or if we'll see scripts pick up. We've been circling around between 250-300 for several weeks now and there isn't anything on the short-term horizon that leads me to believe that there's any reason for it to change. Doctors aren't writing scripts for it and while some patients are getting insurance coverage, some are still left paying out of pocket for Afrezza, which can be quite costly. See some of the Tudiabetes forums and you'll see.
I understand that one of Mike's selling points is that the cost for Afrezza hasn't gone up in two years, but if it was priced exorbitantly high to begin with, that isn't much of a selling point. Insurance coverage revolves around cost, and cost alone. If they lowered the price, more insurance companies would cover it, as it would improve their bottom line. The bottom line is all they care about. You can't expect to charge a premium for Afrezza with so little demand. It's a failed strategy that has demonstrated its flaws since SNY was marketing the drug. Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price. Doing it backwards will kill your sales, as we've seen over the past two years. But that doesn't even begin to address the major issues of doctor awareness or willingness to prescribe, which is something altogether.
Barring a massive improvement in the label or massive adoption by pediatricians for the use in children, I don't think Afrezza sales pick up. The ship has run its course and there simply is no demand, no awareness, and no willingness on the part of doctors to prescribe. Doing what they're doing now will result in the same weekly numbers that we've seen for month after month. After all, the definition of insanity is doing the same thing over and over and expecting different results...
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Post by saxcmann on Dec 12, 2016 9:12:02 GMT -5
I'm not sure when or if we'll see scripts pick up. We've been circling around between 250-300 for several weeks now and there isn't anything on the short-term horizon that leads me to believe that there's any reason for it to change. Doctors aren't writing scripts for it and while some patients are getting insurance coverage, some are still left paying out of pocket for Afrezza, which can be quite costly. See some of the Tudiabetes forums and you'll see. I understand that one of Mike's selling points is that the cost for Afrezza hasn't gone up in two years, but if it was priced exorbitantly high to begin with, that isn't much of a selling point. Insurance coverage revolves around cost, and cost alone. If they lowered the price, more insurance companies would cover it, as it would improve their bottom line. The bottom line is all they care about. You can't expect to charge a premium for Afrezza with so little demand. It's a failed strategy that has demonstrated its flaws since SNY was marketing the drug. Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price. Doing it backwards will kill your sales, as we've seen over the past two years. But that doesn't even begin to address the major issues of doctor awareness or willingness to prescribe, which is something altogether. Barring a massive improvement in the label or massive adoption by pediatricians for the use in children, I don't think Afrezza sales pick up. The ship has run its course and there simply is no demand, no awareness, and no willingness on the part of doctors to prescribe. Doing what they're doing now will result in the same weekly numbers that we've seen for month after month. After all, the definition of insanity is doing the same thing over and over and expecting different results... Knight, things are changing soon. More reps and new marketing strategy beginning 2017. I might be crazy tho?! 😉 |
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Post by silentknight on Dec 12, 2016 9:30:32 GMT -5
I'd love for them to prove me wrong, but I've heard the "good things are coming" for two years now with precious little to show for it. I'm a realist so I'll believe it when I see it.
That being said, I think opportunities exist for improvements, namely the label change and potential juvenile approval, but thus far, all efforts to sell Afrezza have pretty much failed. MNKD reported revenues of less than $1 million from Afrezza during the last quarter. That's not good.
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Post by matt on Dec 12, 2016 9:36:51 GMT -5
Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price. Doing it backwards will kill your sales, as we've seen over the past two years. But that doesn't even begin to address the major issues of doctor awareness or willingness to prescribe, which is something altogether. I partially agree with you, but I wonder if the company can afford to do it. If you look at the actual number of scripts reported for the third quarter and divide that into the sales number, the average revenue per script is just shy of $200 on a net basis and not the $600 gross figure reported by Symphony. This difference exists because Symphony reports gross pharmacy charges and they do not have visibility to the cost of rebates, free samples, or the impact of the co-pay cards which do not impact the pharmacy itself, but which reduce the revenue actually realized by MKND. Co-pay cards and rebates are not free to the company; they are just different words for a price discount. I am not sure you can make a script cheaper than $200 and still afford to run the company even in survival mode. While it is always dangerous to look at a single quarter's data to extrapolate into the future, based on the net sales information we have from third quarter and a recurring quarterly cash burn rate of $22 million the breakeven number of scripts is significantly higher than 4,000 even without a price cut. If the company cannot drive adoption with a $200 net price, will a $100 net price change the story in a meaningful way? |
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Post by silentknight on Dec 12, 2016 9:59:26 GMT -5
Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price. Doing it backwards will kill your sales, as we've seen over the past two years. But that doesn't even begin to address the major issues of doctor awareness or willingness to prescribe, which is something altogether. I partially agree with you, but I wonder if the company can afford to do it. If you look at the actual number of scripts reported for the third quarter and divide that into the sales number, the average revenue per script is just shy of $200 on a net basis and not the $600 gross figure reported by Symphony. This difference exists because Symphony reports gross pharmacy charges and they do not have visibility to the cost of rebates, free samples, or the impact of the co-pay cards which do not impact the pharmacy itself, but which reduce the revenue actually realized by MKND. Co-pay cards and rebates are not free to the company; they are just different words for a price discount. I am not sure you can make a script cheaper than $200 and still afford to run the company even in survival mode. While it is always dangerous to look at a single quarter's data to extrapolate into the future, based on the net sales information we have from third quarter and a recurring quarterly cash burn rate of $22 million the breakeven number of scripts is significantly higher than 4,000 even without a price cut. If the company cannot drive adoption with a $200 net price, will a $100 net price change the story in a meaningful way? Good point that I had failed to account for. If that's true, then it's even more dire than I imagined. If the company is already operating at the lower price point of $200, then that's an option they no longer have to try and drive growth. If MNKD is selling at 1/3 of the retail price, or the price initially factored in to calculate revenue projections, then they'd need what.....12,000 scripts to break even? I don't think they need that many to create confidence in the product but it's a long way from the current state of affairs. I hope commercials and label changes help, but I think the ship has sailed already. It's a superior product with no demand and unfortunately, demand is what determines success and not efficacy. We've witnessed that over the last two years. |
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Post by therealisaching on Dec 12, 2016 10:27:51 GMT -5
I partially agree with you, but I wonder if the company can afford to do it. If you look at the actual number of scripts reported for the third quarter and divide that into the sales number, the average revenue per script is just shy of $200 on a net basis and not the $600 gross figure reported by Symphony. This difference exists because Symphony reports gross pharmacy charges and they do not have visibility to the cost of rebates, free samples, or the impact of the co-pay cards which do not impact the pharmacy itself, but which reduce the revenue actually realized by MKND. Co-pay cards and rebates are not free to the company; they are just different words for a price discount. I am not sure you can make a script cheaper than $200 and still afford to run the company even in survival mode. While it is always dangerous to look at a single quarter's data to extrapolate into the future, based on the net sales information we have from third quarter and a recurring quarterly cash burn rate of $22 million the breakeven number of scripts is significantly higher than 4,000 even without a price cut. If the company cannot drive adoption with a $200 net price, will a $100 net price change the story in a meaningful way? Good point that I had failed to account for. If that's true, then it's even more dire than I imagined. If the company is already operating at the lower price point of $200, then that's an option they no longer have to try and drive growth. If MNKD is selling at 1/3 of the retail price, or the price initially factored in to calculate revenue projections, then they'd need what.....12,000 scripts to break even? I don't think they need that many to create confidence in the product but it's a long way from the current state of affairs. I hope commercials and label changes help, but I think the ship has sailed already. It's a superior product with no demand and unfortunately, demand is what determines success and not efficacy. We've witnessed that over the last two years. I believe the avg script price is running at approx $352. You have to back into the number. In one of the slides during the cc showed sales of MNKD ndc by month. So of the total units MNKD sales were 10% in July, 49% in August & 78% in September.
Based on the numbers in the slide I'm estimating 1626 MNKD ndc scripts sold for the quarter. Per their 10q revenue for MNKD ndc was $573,000 net of all discounts.
$573,000/1626 = $352/script.
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Post by slugworth008 on Dec 12, 2016 20:53:01 GMT -5
I'm not sure when or if we'll see scripts pick up. We've been circling around between 250-300 for several weeks now and there isn't anything on the short-term horizon that leads me to believe that there's any reason for it to change. Doctors aren't writing scripts for it and while some patients are getting insurance coverage, some are still left paying out of pocket for Afrezza, which can be quite costly. See some of the Tudiabetes forums and you'll see. I understand that one of Mike's selling points is that the cost for Afrezza hasn't gone up in two years, but if it was priced exorbitantly high to begin with, that isn't much of a selling point. Insurance coverage revolves around cost, and cost alone. If they lowered the price, more insurance companies would cover it, as it would improve their bottom line. The bottom line is all they care about. You can't expect to charge a premium for Afrezza with so little demand. It's a failed strategy that has demonstrated its flaws since SNY was marketing the drug. Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price. Doing it backwards will kill your sales, as we've seen over the past two years. But that doesn't even begin to address the major issues of doctor awareness or willingness to prescribe, which is something altogether. Barring a massive improvement in the label or massive adoption by pediatricians for the use in children, I don't think Afrezza sales pick up. The ship has run its course and there simply is no demand, no awareness, and no willingness on the part of doctors to prescribe. Doing what they're doing now will result in the same weekly numbers that we've seen for month after month. After all, the definition of insanity is doing the same thing over and over and expecting different results... "Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price." That IS exactly how Microsoft Word got traction initially and unseated "WordPerfect". They practically gave it away then once they owned the market up in price it went. I'm not advocating that MNKD "practically give Afrezza away" but lowering the price enough to get it on insurance formularies is a good and proven strategy - IMO |
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Post by art606a on Dec 12, 2016 21:03:58 GMT -5
I'm not sure when or if we'll see scripts pick up. We've been circling around between 250-300 for several weeks now and there isn't anything on the short-term horizon that leads me to believe that there's any reason for it to change. Doctors aren't writing scripts for it and while some patients are getting insurance coverage, some are still left paying out of pocket for Afrezza, which can be quite costly. See some of the Tudiabetes forums and you'll see. I understand that one of Mike's selling points is that the cost for Afrezza hasn't gone up in two years, but if it was priced exorbitantly high to begin with, that isn't much of a selling point. Insurance coverage revolves around cost, and cost alone. If they lowered the price, more insurance companies would cover it, as it would improve their bottom line. The bottom line is all they care about. You can't expect to charge a premium for Afrezza with so little demand. It's a failed strategy that has demonstrated its flaws since SNY was marketing the drug. Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price. Doing it backwards will kill your sales, as we've seen over the past two years. But that doesn't even begin to address the major issues of doctor awareness or willingness to prescribe, which is something altogether. Barring a massive improvement in the label or massive adoption by pediatricians for the use in children, I don't think Afrezza sales pick up. The ship has run its course and there simply is no demand, no awareness, and no willingness on the part of doctors to prescribe. Doing what they're doing now will result in the same weekly numbers that we've seen for month after month. After all, the definition of insanity is doing the same thing over and over and expecting different results... "Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price." That IS exactly how Microsoft Word got traction initially and unseated "WordPerfect". They practically gave it away then once they owned the market up in price it went. I'm not advocating that MNKD "practically give Afrezza away" but lowering the price enough to get it on insurance formularies is a good and proven strategy - IMO The thing is that your competitors are huge, diversified, and very rich and could lower their insulin prices to zero for as long as need be to put you out of business. |
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Post by sophie on Dec 12, 2016 21:12:11 GMT -5
It would be cheaper for them to buy Afrezza than to do what you said. I don't think they feel threatened by Afrezza, otherwise they would own it and bury it if they chose to do so.
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Post by slugworth008 on Dec 12, 2016 21:53:54 GMT -5
"Create adoption (and demand) by making it readily available (cheaper) and THEN raise the price." That IS exactly how Microsoft Word got traction initially and unseated "WordPerfect". They practically gave it away then once they owned the market up in price it went. I'm not advocating that MNKD "practically give Afrezza away" but lowering the price enough to get it on insurance formularies is a good and proven strategy - IMO The thing is that your competitors are huge, diversified, and very rich and could lower their insulin prices to zero for as long as need be to put you out of business. We only need to lower the price enough to grease the acceptance of the insurance formularies. Thereby making it easier to get coverage and PWD's to write scripts. Our competitors have shareholders as well...... |
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Post by agedhippie on Dec 13, 2016 12:24:49 GMT -5
The thing is that your competitors are huge, diversified, and very rich and could lower their insulin prices to zero for as long as need be to put you out of business. We only need to lower the price enough to grease the acceptance of the insurance formularies. Thereby making it easier to get coverage and PWD's to write scripts. Our competitors have shareholders as well...... The problem is that the insurers give exclusivity on a basket of diabetes treatments. If they remove exclusivity for insulin then the cost of the basket to the insurer goes up because it has less value to the supplier now. The insurer ends up paying more across the board (including for RAA) in exchange for cheaper Afrezza - that's a bad deal for the insurer and why price cutting will not work with insurers. Now there is the high deductable/self-funding market where it would help but how big is that? |
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Post by mikesmilitaria on Dec 18, 2016 17:34:08 GMT -5
When MNKD releases it subsequent to their news.
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Post by saxcmann on Dec 18, 2016 17:38:36 GMT -5
When MNKD releases it subsequent to their news. Welcome Mike! Long time no hear. |
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Post by hawaiiguy42 on Feb 1, 2017 16:50:51 GMT -5
I posted a few weeks ago, by they end of January 2017 we will see a positive turn around in script numbers. I also believe sometime in April to June of 2017 we will begin to see a "snow ball" affect of users. If this occurs, by December 2017 (this time next year) scripts will have dramatically increased. Now I'm not a card reader, but I can see (envision) the road path by putting all the pieces of the puzzle together. Once the pieces all come together, MNKD will no longer need to worry about a runway... all the cards will fall into place, FINALLY! Well I guess I was wrong once again. Apparently the pieces cannot be put together due to exterior roadblocks, very disappointed.  Wish you all the best, and hope the CC is beneficial but I honestly think it's going to be the same old, same old. And once again the exterior roadblocks will prevail along with the shorts increasing their positions. I still believe in Afrezza and Mannkind, I just do not have the time or funding to continue... move onto future MJ stocks. |
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