VDEX
A few preliminary answers
Patient acquisition
We use an extremely effective social media campaign directed at PWD. Yes a DTC!!!
The ads pose questions (some more direct than others) to PWDs, they answer questions that guide them to ultimately sharing their contact information so as to have someone respond, to answer more questions about what we do and to set up an appointment.
A couple years back, our leads would generate appointments at a rate of about 5% and the leads were less than desirable. Now, our leads convert closer to 50% and they have better insurances, etc... We can also easily tweak the ads to acquire more of a particular type of insurance (public, private, HMO etc), type of patient (T1, T2, newly diagnosed, A1c above x, a particular ethnic group, etc.). This ability is very valuable to us and it will additionally come in very handy when conducting studies, for example.
Radio and billboards are also used/options in areas where social media is less prevalent and thus less effective.
Our DTC works because…
1) Our patient acquisition cost is well under $200 which more than works for us.
2) We don’t have a toxic drop rate.
Referrals
Some referrals will come from Drs. whom we have partnered with locally. In our experience, outside referrals tend to take time to develop. These relationships must be gently nurtured, as there is much fear and ego involved. After Drs/Endos see our results in their patients, over time, some begin to refer.
It’s really amazing to see how easily some refer after seeing what we do. They see the results in their patients. They are genuinely happy for them. They encourage them to continue VDEX therapy. They collaborate whenever needed. And they are happy someone is able to fight the Ins. fight for their patients and Win! All the while, putting their ego and fears aside to do what is best for the patient. Conversely, even after witnessing great change in BS control, many will demand that their patients return to their prior failed treatments (regardless of the level of failure) A1c >10%)with no explanation other than “It’s not for you”.
Again, it is not about Drs/Endos. We fail if we try to make it about them.
Unless you hire, train and sign their paychecks… Drs/Endos don’t care about this therapy.
Funding
Our strategy is not capital intensive. We have various avenues for funding that are currently engaged and we don’t anticipate any problems with acquiring capital.
VDEX Scripts numbers
Long ago, we stopped informing MNKD who our new providers were.
After we wrote the first White Paper, the FDA questioned MNKD about their association with VDEX and from that point on, the most basic of dealings (ordering samples, etc.) became strained.
Regardless of how this situation came to be, it seems that an overabundance of caution (at times applied through plain old avoidance) was how MNKD chose to deal with us. We get that we don’t know what we don’t know but it felt like there was a better way to handle things for both parties.
With that in mind, we thought it best to just stop notifying MNKD that a new provider had started since they would only seem to be penalized for doing so. Several times, we sent in sample requests from a known and unknown provider. The known provider got 2 packs (1-4u/8u, 1-8u/12u) and the unknown provider got 6 packs (3-4u/8u, 3-8u/12u) each time.
Regardless of why it was happening, our job was to adapt and find a better way.
Along with providers that are known, there are other providers working in VDEX clinics that are unknown to MNKD. We also have providers that are trained, writing scripts in their current practice and biding their time until we pull the trigger and open a VDEX facility for them to fill full and part-time positions.
It’s not about blame but it was a shame and yet another reason why we decided to keep things to ourselves going forward. This is the main reason that MNKD would simply have no real idea about how many scripts we write. When MNKD publicly released our script numbers, they were most likely releasing what they know to be true.
Our clinics will speak for themselves.
We understood our situation called for us to…
Do enough to get major investors onboard (for rapid expansion) and not do too much as to run our resources thin and raise they attention of competition.
As we have mentioned before, we have limited our expansion, providers per location, days/hours of operation, advertising, and just about everything else.
We would have cut our own throats by expanding organically and proving the model to others with deep pockets that would swoop in and bury us. Not attractive to us
What we know and what you will soon see for yourself is that 1 VDEX provider is an extremely potent Afrezza prescriber.
It doesn’t take that many providers, working full time, to make a substantial difference to MNKD’s bottom line.
Stephen Brown
VP VDEX Diabetes
