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Post by sayhey24 on Jan 30, 2017 17:05:35 GMT -5
There is no doubt Mannkind has a huge marketing problem and pricing is part of that problem. If afrezza was meant to be used as 1 cartridge per meal, Mike C. may be right and afrezza is actually cheaper. But Mike is not. For afrezza to exceed RAA A1c values a second dose is often required to mimic phase 2 insulin release. When you add in corrections and snacks a better estimate is at least 180 cartridges per month. Afrezza is now sold as 4/8/12 units. Al talked about the 16u and the new process to allow it. I think they need to not only make the 16u but a 1u and 2u for corrections and for the kids. IMO, Mannkind needs to rework packaging and the way it is priced and come in at a 20% lower price point to RAAs to gain some traction.
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Post by surplusvalue on Jan 30, 2017 22:59:14 GMT -5
There is no doubt Mannkind has a huge marketing problem and pricing is part of that problem. If afrezza was meant to be used as 1 cartridge per meal, Mike C. may be right and afrezza is actually cheaper. But Mike is not. For afrezza to exceed RAA A1c values a second dose is often required to mimic phase 2 insulin release. When you add in corrections and snacks a better estimate is at least 180 cartridges per month. Afrezza is now sold as 4/8/12 units. Al talked about the 16u and the new process to allow it. I think they need to not only make the 16u but a 1u and 2u for corrections and for the kids. IMO, Mannkind needs to rework packaging and the way it is priced and come in at a 20% lower price point to RAAs to gain some traction. The intial impedments to the commercializing success of Afrezza (Sanofi aside)has been known for some time: titration, retention, coverage and pricing.MNKD has/is addressing the first three but has made it clear that pricing will remain where it is. When the pricing issue was raised at a previous CC MNKD stated clearly that since all other insulins had gone up in price and Afrezza didnt then it was cheaper (comparatively speaking in this sense). As well MNKD stated that if they lowered their price even more then it would be difficult to raise it after with insurance/coverage. This was MNKD's explanation. And notice that MNKD didnt say they couldnt lower their pricing but wouldnt for the reasons they gave. Now no doubt Afrezza is head and shoulders above other mealtime insulins and a great product and maybe it's because of this that management thinks its pricing is competitive given the outstanding aspect of the product. To be honest, MNKD isnt even a pimple on the arse of any of the players in the diabetes space. They can have the best product in the world but if they cant commercialize it then its worth squat. MNKD has to build numbers and they need some market share traction first to get it commercialized on a larger scale later; for all intents and purposes the entrance doors are very narrow. I am of the view that MNKD needs to change its strategy with respect to pricing as well and build volume based on pricing ( alongside endo education and mass marketing since no one knows about it). The reason (excuse) that MNKD gave that it wouldnt be able to raise prices later is nonsense; just look at how year after year prices on established products go up. First establish a market presence (200-600 scripts is not a presence at all really) and then worry about how you would raise prices later. I dont get why MNKD acknowledges the first three and not the fourth.
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Post by babaoriley on Jan 30, 2017 23:14:11 GMT -5
Cut the price and tie-in a membership on this board for free (plus 50 criticism-free posts, guaranteed, irrespective of the topic or viewpoint)! No other insulin maker can possibly compete with that!
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Post by akemp3000 on Jan 30, 2017 23:24:38 GMT -5
This is an interesting perspective. Many shorts think MNKD is on its last legs and is about to fail yet MNKD has the option to reduce pricing and go after market share...but doesn't. This supports the idea that Matt, Mike and team know something very important that we don't. Let's hope Wednesday's call will shed some light. If it doesn't and turns out to be just another call to update progress, so be it. I for one will NEVER turn loose of a single share knowing MNKD owns the greatest drug of a generation that can immediately help the world's largest healthcare pandemic...if only the world knew...sigh...IMHO
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Post by surplusvalue on Jan 30, 2017 23:29:31 GMT -5
Cut the price and tie-in a membership on this board for free ( plus 50 criticism-free posts, guaranteed, irrespective of the topic or viewpoint)! No other insulin maker can possibly compete with that! I have to disagree (see it wouldnt work already). The criticism free posts wouldnt necessarily be a draw. Part of the attraction to participating is the criticism;both giving and receiving (pick your poison ) Besides when you repress something, after the repression is lifted it comes back with a vengeance.
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Post by surplusvalue on Jan 31, 2017 0:24:34 GMT -5
This is an interesting perspective. Many shorts think MNKD is on its last legs and is about to fail yet MNKD has the option to reduce pricing and go after market share...but doesn't. This supports the idea that Matt, Mike and team know something very important that we don't. Let's hope Wednesday's call will shed some light. If it doesn't and turns out to be just another call to update progress, so be it. I for one will NEVER turn loose of a single share knowing MNKD owns the greatest drug of a generation that can immediately help the world's largest healthcare pandemic...if only the world knew...sigh...IMHO Oh I see, MNKD has the chance to capture market share and be successful in commercialization but doesnt want to because it has a big secret we are not privy to. I think you must have read too many conspiracy posts on this board. Regardless of what we dont know and management does (whether substantial or not) what everyone knows (both us and management) is that they have not been able to commercialize Afrezza in any meaningful sense. What they may know (hidden from us? if anything) is entirely irrelevant since whatever it is or isnt they will still have to commercialize Afrezza; there are no miracles or short cuts to doing this...the grunt work cannot be avoided. Did you ever see the Wizard of Oz? Remember the scene where the main characters Dorothy, Tin man , Scarecrow, and Lion confront the assumption of a miraculous all powerful force hidden from them and discover that no such hidden powerful agent exists when the curtain is pulled back to reveal just an ordinary man?
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Post by kc on Jan 31, 2017 5:14:08 GMT -5
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Post by sayhey24 on Jan 31, 2017 6:27:41 GMT -5
There is no doubt Mannkind has a huge marketing problem and pricing is part of that problem. If afrezza was meant to be used as 1 cartridge per meal, Mike C. may be right and afrezza is actually cheaper. But Mike is not. For afrezza to exceed RAA A1c values a second dose is often required to mimic phase 2 insulin release. When you add in corrections and snacks a better estimate is at least 180 cartridges per month. Afrezza is now sold as 4/8/12 units. Al talked about the 16u and the new process to allow it. I think they need to not only make the 16u but a 1u and 2u for corrections and for the kids. IMO, Mannkind needs to rework packaging and the way it is priced and come in at a 20% lower price point to RAAs to gain some traction. The intial impedments to the commercializing success of Afrezza (Sanofi aside)has been known for some time: titration, retention, coverage and pricing.MNKD has/is addressing the first three but has made it clear that pricing will remain where it is. When the pricing issue was raised at a previous CC MNKD stated clearly that since all other insulins had gone up in price and Afrezza didnt then it was cheaper (comparatively speaking in this sense). As well MNKD stated that if they lowered their price even more then it would be difficult to raise it after with insurance/coverage. This was MNKD's explanation. And notice that MNKD didnt say they couldnt lower their pricing but wouldnt for the reasons they gave. Now no doubt Afrezza is head and shoulders above other mealtime insulins and a great product and maybe it's because of this that management thinks its pricing is competitive given the outstanding aspect of the product. To be honest, MNKD isnt even a pimple on the arse of any of the players in the diabetes space. They can have the best product in the world but if they cant commercialize it then its worth squat. MNKD has to build numbers and they need some market share traction first to get it commercialized on a larger scale later; for all intents and purposes the entrance doors are very narrow. I am of the view that MNKD needs to change its strategy with respect to pricing as well and build volume based on pricing ( alongside endo education and mass marketing since no one knows about it). The reason (excuse) that MNKD gave that it wouldnt be able to raise prices later is nonsense; just look at how year after year prices on established products go up. First establish a market presence (200-600 scripts is not a presence at all really) and then worry about how you would raise prices later. I dont get why MNKD acknowledges the first three and not the fourth. My point is if Mike C. thinks pricing is OK were it is assuming a PWD will use 1 cartridge per meal, i.e. the 90 item box. The fact is for phase 1 and 2 release you will need double that which is double the price. Add in the corrections, snacks and those PWDs with T2 who currently take 50units of RAA for a meal. Pricing based on this model is off by atleast 2x or more and needs to be significantly reduced.
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Post by akemp3000 on Jan 31, 2017 7:09:32 GMT -5
This is exactly the point. The curtain has not yet been pulled back on MNKD. Soon enough, Matt, Mike and team will have no choice but to open the curtain and we will all learn if what's behind it is ordinary or extraordinary. To date, everyone can easily speculate but no one truly knows...yet.
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Post by mnholdem on Jan 31, 2017 8:33:44 GMT -5
I, too, have been an advocate for MannKind to lower the price of Afrezza. But my reasoning is that they could then take advantage of the current politic situation to get a bunch of free publicity for Afrezza.
That said, I'm wondering if management believes that the cost will soon be justified when Afrezza is assigned by the FDA a First-in-Class insulin in an entirely new classification of insulin: Ultra-Rapid Acting. Matt's comments made it sound like the new classification WILL happen later this year:
"Most of you know we did submit an FDA label change to better show the pharmacokinetics of the product and show that we really are an ultra-rapid acting insulin. We have a PDUFA date in September. We will get some good news there." - CEO Matthew Pfeffer JPMorgan Healthcare Conference, January 12, 2017.
There is also the possibility that USA pricing for Afrezza may determine the pricing in various regional jurisdictions globally. It's guaranteed that ex-U.S. prices for Afrezza will be lower. Perhaps MannKind doesn't want them to be too low. Someone said that once you've lowered your price, it's very difficult to raise them. However, once the regional pricing has been agreed upon outside the U.S., then MannKind could lower the price at home.
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Post by dreamboatcruise on Jan 31, 2017 11:06:12 GMT -5
This is exactly the point. The curtain has not yet been pulled back on MNKD. Soon enough, Matt, Mike and team will have no choice but to open the curtain and we will all learn if what's behind it is ordinary or extraordinary. To date, everyone can easily speculate but no one truly knows...yet. And I assume that bad falls within your category of extraordinary as well as something good? It seems some assume that if things are not disclosed they must be good. As someone with decades of investing experience, I've been surprised by undisclosed bad news as often or more so than being surprised by good news. I'm of the opinion that the call tomorrow probably isn't to announce the "ordinary". The announcement mentioned "developments" rather than "progress". Granted I'm reading tea leaves at this point but that word along with the hasty scheduling of the call leads me to believe it will be some real new development rather than rehashing plan previously discussed. So I suspect it will be something out of the ordinary... good or bad. I go into call with a mixture of hope and apprehension.
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Post by zuegirdor on Jan 31, 2017 13:22:53 GMT -5
There is no doubt Mannkind has a huge marketing problem and pricing is part of that problem. If afrezza was meant to be used as 1 cartridge per meal, Mike C. may be right and afrezza is actually cheaper. But Mike is not. For afrezza to exceed RAA A1c values a second dose is often required to mimic phase 2 insulin release. When you add in corrections and snacks a better estimate is at least 180 cartridges per month. Afrezza is now sold as 4/8/12 units. Al talked about the 16u and the new process to allow it. I think they need to not only make the 16u but a 1u and 2u for corrections and for the kids. IMO, Mannkind needs to rework packaging and the way it is priced and come in at a 20% lower price point to RAAs to gain some traction. Agree with your proposition but note its a big ask from company, shareholders and regulators...
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Post by saxcmann on Jan 31, 2017 14:18:04 GMT -5
There is no doubt Mannkind has a huge marketing problem and pricing is part of that problem. If afrezza was meant to be used as 1 cartridge per meal, Mike C. may be right and afrezza is actually cheaper. But Mike is not. For afrezza to exceed RAA A1c values a second dose is often required to mimic phase 2 insulin release. When you add in corrections and snacks a better estimate is at least 180 cartridges per month. Afrezza is now sold as 4/8/12 units. Al talked about the 16u and the new process to allow it. I think they need to not only make the 16u but a 1u and 2u for corrections and for the kids. IMO, Mannkind needs to rework packaging and the way it is priced and come in at a 20% lower price point to RAAs to gain some traction. Good points sayhey. I'd do 2u and 18u only. I'd lower the price by 15% from other RAAs. I would target more PCPs and schedule a lot more lunch and learns in offices. "Ultra" label will make a big difference selling docs.
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Post by sportsrancho on Jan 31, 2017 15:20:12 GMT -5
One more time!! Thanks sax,
I'd do 2u and 18u only. I'd lower the price by 15% from other RAAs. I would target more PCPs and schedule a lot more lunch and learns in offices. "Ultra" label will make a big difference selling docs.
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Post by sweedee79 on Jan 31, 2017 17:47:01 GMT -5
an article in today's New York times.
Drug Makers Accused of Fixing Prices on Insulin
www.nytimes.com/2017/01/30/health/drugmakers-lawsuit-insulin-drugs.html
A lawsuit filed Monday accused three makers of insulin of conspiring to drive up the prices of their lifesaving drugs, harming patients who were being asked to pay for a growing share of their drug bills.
The price of insulin has skyrocketed in recent years, with the three manufacturers — Sanofi, Novo Nordisk and Eli Lilly — raising the list prices of their products in near lock step, prompting outcry from patient groups and doctors who have pointed out that the rising prices appear to have little to do with increased production costs.
I wish that MannKind had the guts to really price Afrezza at 50% of the market price to get some volume sales. Or just do that for the Medicare, Medicaid, Tri-Care markets. We need to get Afrezza known by the Diabetic community. Reading the article its heartbreaking what diabetics have to deal with to get life saving insulin at a fair or reasonable price.
I wish the price would be lowered as to make it available to everyone.... Because the price of any insulin is so high many part D plans have lowered ALL insulin to tier 3 and tier 4... and only cover certain insulins.... some part D insurers cover humolog....... some cover novolog.... but usually not both ... and as far as I can see there are only a couple of part D insurers who cover Afrezza... Afrezza is still more expensive than any other insulin on the market and genetic or biosimilar insulins will be coming... the cost of insulin has skyrocketed in the past year.. Even though our seniors have paid into medicare all of their lives in the hope and trust that they would be cared for in their old age... they have ended up having to buy supplement insurances which amounts to aprox. 300$ per person per month(which will go up).... and a senior with type 1 diabetes pays out aprox 2 to 300$ a month for insulin not to mention their other meds... Even though seniors have saved money all of their lives for reitirement .... with the cost of insurance supplements and medicines, not to mention the large increases in cost of living.... it doesn't leave them very much to live a quality life... Is it ethical?? I don't think it is.... Even a modest decrease in price would help patients be able to afford it... I would think that this would not only help patients but also the company.
I don't believe that the very best care is readily available to most seniors on medicare .. and to me that is sad.. We will all be seniors some day...
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