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Post by mannmade on Jan 1, 2017 11:50:07 GMT -5
Aged, Happy new year... Sample pack is given at doc's office. First script is for titration pack and yes it is free.
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Post by Deleted on Jan 1, 2017 12:28:31 GMT -5
Aged, Happy new year... Sample pack is given at doc's office. First script is for titration pack and yes it is free. Titration pack is free only if they have those free titration pack cards... and they possibly could send all patients with that card for making them want to try and titrate better |
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Post by agedhippie on Jan 1, 2017 12:38:07 GMT -5
Aged, Happy new year... Sample pack is given at doc's office. First script is for titration pack and yes it is free. Thanks. Mulling an end run around my endo and going to my PCP who does pretty much whatever I tell him on the diabetes side within reason. As a plus he is a pulmonologist. If it had to go through my insurance it would be a problem because they would automatically cancel my Humalog prescription which I would then have to get reinstated if there were problems so being able to do this outside insurance helps. |
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Post by Deleted on Jan 1, 2017 15:49:20 GMT -5
Aged, Happy new year... Sample pack is given at doc's office. First script is for titration pack and yes it is free. Thanks. Mulling an end run around my endo and going to my PCP who does pretty much whatever I tell him on the diabetes side within reason. As a plus he is a pulmonologist. If it had to go through my insurance it would be a problem because they would automatically cancel my Humalog prescription which I would then have to get reinstated if there were problems so being able to do this outside insurance helps. oh oh oh.. aged trying to try Afrezza? |
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Post by agedhippie on Jan 1, 2017 16:42:25 GMT -5
Thinking about it. I am not sure because my PBM doesn't cover it so I couldn't stay on it.
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Post by mannmade on Jan 1, 2017 18:34:40 GMT -5
Try mnkd cares and see if that makes a difference. Or the co pay card for a year.
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Post by cyn on Jan 2, 2017 13:58:34 GMT -5
Mango writes... "In the JP Morgan Conference slides MannKind mentions the diabetes care clinics multiple times and I get the sense that it will be THEM that actually spearhead physician awareness and increase the script counts. The slides state that the clinics will be centered around Afrezza and this would be a more personalized/hands on approach for helping patients with diabetes manage their condition. Correct me if I am wrong, but even The Endo Society does not even advocate diabetes drug innovation." Mango, you are so correct to highlight that the major challenge lies with the Endo's. Since the beginning of time, Endo's have been notorious for being lagers... always wanting to push a square peg into a round hole (purely for "their" convenience) by remaining complacent to the basic truth that "most" diabetic patients take risky short-cuts, want convenience, and lack in "perfect" medication discipline. The Endo's all know this truth but continue to refuse to take on the role of personal advocate to their patients despite the availability of new approaches that mitigate and shore-up these known patient treatment challenges. It's simply viewed by Endo's as not their responsibility even at the treatment detriment of their patients. In their view it's cheaper and easier to just kick the can down the road instead of trying to re-educate and re-train patients on a new medication regime. And, the Endo Society is just as culpable in their complacency and non-advocacy posture. This is why the diabetes care clinics focusing on new innovative approaches (like Afrezza) and serving as an "educator" is crucial to successful market penetration. Moreover, I don't believe for one moment that Sanofi didn't understand this basic "complacency" truth about Endo's and the Endo Society when launching their marketing campaign. This is why I believe it was purposeful sabotage and MNKD should have held Sanofi accountable. JMHO Read more: mnkd.proboards.com/post/new/6947#ixzz4UczDvLtB |
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Post by sportsrancho on Jan 2, 2017 15:11:34 GMT -5
I agree,
Even my client with the two kids on Afrezza told me over a year ago: It's much easier to get a script from a GP than an Endo! He had to get one from a GP. Then go back to the kids Endo with the results before the Ped Endo would get on board. But she's on board now!
Why aren't we targeting the GP's? I guess we are going to start to. I heard that somewhere.
Patient Awareness!
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Post by Deleted on Jan 2, 2017 15:24:44 GMT -5
I agree, Even my client with the two kids on Afrezza told me over a year ago: It's much easier to get a script from a GP than an Endo! He had to get one from a GP. Then go back to the kids Endo with the results before the Ped Endo would get on board. But she's on board now! Why aren't we targeting the GP's? I guess we are going to start to. I heard that somewhere. Patient Awareness! what does getting on board mean? is she putting teens on Afrezza now or she just agrees Afrezza is good and then it ends there? |
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Post by sportsrancho on Jan 2, 2017 15:33:16 GMT -5
I agree, Even my client with the two kids on Afrezza told me over a year ago: It's much easier to get a script from a GP than an Endo! He had to get one from a GP. Then go back to the kids Endo with the results before the Ped Endo would get on board. But she's on board now! Why aren't we targeting the GP's? I guess we are going to start to. I heard that somewhere. Patient Awareness! what does getting on board mean? is she putting teens on Afrezza now or she just agrees Afrezza is good and then it ends there? It means she just wrote a script for Tom's son. Good for a year. And she will write scripts for other kids but they have to be her patients. Sending people to her from out of town did not work. I have Vdex for that now:-)) |
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Post by Deleted on Jan 2, 2017 15:52:44 GMT -5
what does getting on board mean? is she putting teens on Afrezza now or she just agrees Afrezza is good and then it ends there? It means she just wrote a script for Tom's son. Good for a year. And she will write scripts for other kids but they have to be her patients. Sending people to her from out of town did not work. I have Vdex for that now:-)) thanks sports .. then that would probably limit the target to tom's kid's friends.. |
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Post by sportsrancho on Jan 2, 2017 16:25:43 GMT -5
It means she just wrote a script for Tom's son. Good for a year. And she will write scripts for other kids but they have to be her patients. Sending people to her from out of town did not work. I have Vdex for that now:-)) thanks sports .. then that would probably limit the target to tom's kid's friends.. You know I don't think they have many T1 friends. Also the last thing kids want to do is be on Twitter or FB! But all her patients are diabetic kids. So she might be writing other scripts. If the parents asked I'm sure she would. When the GP that wrote Jake's script the first time retired Tom sent him to their Endo and said to Jake, show her your results and ask for a script. Don't take no for a answer. And don't come home without the script! Jake came home with a BIG smile! Dad, I got it! Father teaching son:-) |
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Post by dreamboatcruise on Jan 3, 2017 12:46:18 GMT -5
That type of clinic model may well be a better standard of care. Unfortunately, attempts at that in the past have run into financial hurdles trying to operate within our insurance system. There was an article on this subject just a couple of years ago. Would be very encouraging news if a clinic could negotiate a performance based reimbursement scheme with payers. The slides also state the business model the clinics have position them in a way to be able to produce hundreds, yes hundreds, of clinics during 2017-2018. Majority of skeptics fail to realize exactly how much money William McCullough generates through being the owner of SHR which is also affiliated with a very large and renowned elite Beverley Hills practice and has numerous connections around Silicone Valley etc. Few have paid attention or even read the SHR website. It is kind of a foundation and a prelude to what is to come and what to expect. William McCullough actually adheres to the same kind of philosophy as Al Mann. He truly wants to help people and only have the best and always strive for innovation. SHR does not do any TV advertising, they are strictly a word of mouth multi-million (prob billion nearly) business that became this way just through word of mouth. Usually top quality products/services are those you hear about from your best friend or acquaintances. If someone truly likes and benefits from something and has a great experience, they will talk about it. Top quality sells itself. All of this is just IMO of course. Therebisbno telling how many wealthy millionaires McCullough has helping with Vdex. It could be a national prong approach for all we know. We do know that they definitely have the funds and the connections. The article I was referring to can be found by googling "In the Treatment of Diabetes, Success Often Does Not Pay". Hopefully Mr. McCullough has found a recipe for financial success. Diabetes treatment is different than hair restoration, the latter of which being all cash (i.e. non insurance reimbursement) business. SHR is limited to 6 offices nationally. That level of business probably easily can grow by word of mouth and be very profitably dealing exclusively with those that can afford to fully pay for medical treatment. Hundreds of clinics within 2 years of the first seems optimistic. As VDEX themselves learned in NJ, opening medical facilities in diverse states is not simple. I'm more hopeful that the near term benefit of VDEX might be some press coverage of VDEX's clinical success... or perhaps VDEX has more freedom to use clinical results in advertising... i.e. "85% of our patients achieve sub 6.0 a1c without increased incidence of hypos." However, counting on one brand new company such as VDEX to single-handedly create significant script growth is likely not realistic. IMO |
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Post by Deleted on Jan 3, 2017 12:51:07 GMT -5
I'm more hopeful that the near term benefit of VDEX might be some press coverage of VDEX's clinical success... or perhaps VDEX has more freedom to use clinical results in advertising... i.e. "85% of our patients achieve sub 6.0 a1c without increased incidence of hypos." However, counting on one brand new company such as VDEX to single-handedly create significant script growth is likely not realistic. IMO A different perspective - at today's rate of scripts - 15 new scripts - vdex location contributes to 10% of the scripts |
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Post by dreamboatcruise on Jan 3, 2017 12:57:42 GMT -5
The replies in this thread do not answer the posted question "Why isn't the script count growing?" They address a secondary question: "Why are there not more new patients being added?" The answer to the posted question is this: Script count is not growing because patients are not sticking with Afrezza. For every new user, one discontinues. Until MNKD addresses THAT question, no amount of new users will be helpful if they just discontinue. Once somebody is using Afrezza (after going through the spirometry and possibly pre-authorization) does the black box warning make them stop? No Would coughing fits make them stop? Maybe Would trial design that showed non-inferiority and showed 37% got to treatment goal make them stop? No Would not getting to treatment goal make them stop? Maybe Add in the cost associated if 1: Copay is high, 2: Coverage is denied or 3: Patient requires more doses than are covered by insurance and you have a few reasons why patients may discontinue use. If MNKD had retained even 70% of new patients, we would be seeing thousands of weekly prescriptions even at these low weekly new Rx numbers. Pouring water into a sieve is not effective no matter how wide open you set the tap. MNKD needs to properly address retention regardless of past mistakes, past trials or current label. It is the priority. Oh, and : Happy new year!  Good points, especially the payer coverage issues in my opinion. However, keep in mind that new scripts include whenever a prescription is renewed. Probably not a stretch to think that a doctor would give a fairly limited number of refills (if any) when prescribing a new drug like insulin that requires titration, and thus require another "new" prescription. In fact even if refills are still available, if patient found they needed more cartridges (which seems to be common), the doc would need to issue a "new" prescription to cover the increased monthly use. So adding up Nrx over time probably yields number significantly higher than the actual number of patients that have started Afrezza. But your point is still valid. |
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