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Post by brotherm1 on Feb 3, 2017 18:18:40 GMT -5
I listened to the call tonight a few times, first since the live call that caused me to refocus on my health. I've not been able to yet find a transcript copy of it. Please correct me if I did not correctly paraphrase below what was said.
Matt said we are still working on EpiHale
Expect to hear back from the FDA about the label application in Q3
Mike said November to December scripts flattened after the contracted sales personnel were made aware of the transition to MNKD hiring sales personnel, and MNKD made a conscious effort to save money and not hire more during these months (Sounded to me like contracted sales personnel not being hired by MNKD in January either left after the announcement or were let go?; is November and December the time we were down to around 42 sales reps or would we have been down to less than that in November and December?)
Hired 80 over last four weeks with 10-15 years diabetes experience (I thought this is what I heard; I read a news article somewhere from a not credible source that said he said "several" have 10 plus years experience). Now 85% hired and have 10-12 more positions to fill.
1/3 of the Afrezza markets were growing, 1/3 flat and 1/3 declining for various reasons.
Will be selling to 75% of the rapid insulin market. Sales will be focused on more customer access in smaller geographical zones where reps will only need to travel up to a couple of hours.
Growth per script up 20% year over year with more units per script.
Cartridge volume up 75% for the same time period Sanofi sold Afrezza and on 1/10 of Sanofi's resources (I assume by resources he meant on 1/10 of the sales reps?)
7 of 10 that go through MNKD Cares get coverage
70% of commercial lives covered with little or no pre-authorization required
Medicare will have about 50% access going into 2018?
Out of pocket co-pays are reduced with larger packages per prescription
Social media to light up more next week and stronger online presence coming next 4-6 weeks
The biggest question I have now is about insurance coverage. Allegedly 70% of commercial lives are now covered with little or no pre-authorization. Does anyone here know what the percentage was when Sanofi was selling Afrezza or when Mike first started?
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Post by wgreystone on Feb 3, 2017 19:08:18 GMT -5
I am a little surprised that 70% commercial insurance with no prio-auth required. If that's true, it's great progress. Need to let doctors know!
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Post by brotherm1 on Feb 3, 2017 19:16:30 GMT -5
I thought his words were with "little" or no PA required?
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Post by wgreystone on Feb 3, 2017 19:24:34 GMT -5
"little" is kind of ambiguous. For doctors, PA is just PA.
Just checked my CVSCaremark coverage. Still requires PA. 90 4-U cartridges cost about $1500 with $150 copay. Seems still quite expensive.
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Post by dreamboatcruise on Feb 3, 2017 19:54:19 GMT -5
"little" is kind of ambiguous. For doctors, PA is just PA. Just checked my CVSCaremark coverage. Still requires PA. 90 4-U cartridges cost about $1500 with $150 copay. Seems still quite expensive. That seems too high to be correct. The average cost reported by Symphony is only mid $500's and that includes some 90 day fills. Are you sure that is correct? Is the $150 before the copay card or after?
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Post by brotherm1 on Feb 3, 2017 19:56:11 GMT -5
I just listened again. "ABOUT 70% of lives covered under commercial with MINIMUM or no PA required"
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Post by nylefty on Feb 3, 2017 21:01:17 GMT -5
"little" is kind of ambiguous. For doctors, PA is just PA. Just checked my CVSCaremark coverage. Still requires PA. 90 4-U cartridges cost about $1500 with $150 copay. Seems still quite expensive. That seems too high to be correct. The average cost reported by Symphony is only mid $500's and that includes some 90 day fills. Are you sure that is correct? Is the $150 before the copay card or after? My former employer (GE) just switched its employees and retirees from CVS Caremark to OptumRX (a division of UnitedHealth) I'm not diabetic but just checked and as a retiree a 90 day supply of Afrezza would cost me $35. No mention of a need for prior authorization (which Caremark required).
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Post by MnkdWASmyRtrmntPlan on Feb 3, 2017 21:01:24 GMT -5
I listened to the call tonight a few times, first since the live call that caused me to refocus on my health. I've not been able to yet find a transcript copy of it. Please correct me if I did not correctly paraphrase below what was said. Matt said we are still working on EpiHale Expect to hear back from the FDA about the label application in Q3 Mike said November to December scripts flattened after the contracted sales personnel were made aware of the transition to MNKD hiring sales personnel, and MNKD made a conscious effort to save money and not hire more during these months (Sounded to me like contracted sales personnel not being hired by MNKD in January either left after the announcement or were let go?; is November and December the time we were down to around 42 sales reps or would we have been down to less than that in November and December?) Hired 80 over last four weeks with 10-15 years diabetes experience (I thought this is what I heard; I read a news article somewhere from a not credible source that said he said "several" have 10 plus years experience). Now 85% hired and have 10-12 more positions to fill. 1/3 of the Afrezza markets were growing, 1/3 flat and 1/3 declining for various reasons. Will be selling to 75% of the rapid insulin market. Sales will be focused on more customer access in smaller geographical zones where reps will only need to travel up to a couple of hours. Growth per script up 20% year over year with more units per script. Cartridge volume up 75% for the same time period Sanofi sold Afrezza and on 1/10 of Sanofi's resources (I assume by resources he meant on 1/10 of the sales reps?) 7 of 10 that go through MNKD Cares get coverage 70% of commercial lives covered with little or no pre-authorization required Medicare will have about 50% access going into 2018? Out of pocket co-pays are reduced with larger packages per prescription Social media to light up more next week and stronger online presence coming next 4-6 weeks The biggest question I have now is about insurance coverage. Allegedly 70% of commercial lives are now covered with little or no pre-authorization. Does anyone here know what the percentage was when Sanofi was selling Afrezza or when Mike first started? Brotherm1, I listened to it and added things where you left out and just beefed it out a little more. Matt Got company back from SNY and converted company from manufacturing to commercialization. Need 10 days over $1 before march 13th Cannot and will not allow it to become delisted There will be more things to organically improve SP Filed special media proxy stmt for stock split if necessary RS’s have obtained a bad reputation, as most co’s are under duress and continue to decline as they are doing it from a position of weakness. We are not doing under weakness, but strength. New sales force New clinical care Optimum dosing/titration will be good as cgm’s become more widely used Mike will cover Managed Care improvements Mike Any trend to turn around will take 3-6 months Larger territory now and more focused so reps don’t have to travel so far They announced in mid to late November that they are moving to a contract sales model and their temps lost ambition. They hired well over 80 people over the last 4 weeks. 85% hired with 10-12 positions yet to fill Some will start the week of 2/13 They sold 75% of what SNY did in 2015 during the same 2016 time period with 1/10 the salesforce. They have worked out the kinks and now have Medicare, VA, Managed Care coverage, so now, the Table is now set. 70% of patients’ payors are approved You are correct about hiring 80 with 10-15 years of diabetes experience with deep relationships. So the news article you read was wrong. I’m guessing it was Motley Fool. Growth per script is up 20% in q4 vs last year with Sanofi Managed Care – Mannkind Cares – 7 out of 10 patients at MC will get covered. They have managed to get prior auth’s removed from 2 large payers. Medicare takes 18 months to change coverage. They have managed to get 1 payer to pay which doubled their coverage to 25%. They have submitted several bids for 2018 and will have probably well over 50% access going into 2018 from the Medicare side. In the short term they will focus on the commercial insured patients, which is where Dexcom started. On the Medicare side There are now 2 packages: for patients that need lower dosing and higher dosing. Matt Next earnings call will be first half of March. The audio is now on the MNKD website. On my pc, it only plays in IE and not Chrome: edge.media-server.com/m/p/wf9e94rm
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Post by dreamboatcruise on Feb 3, 2017 21:50:16 GMT -5
... They have worked out the kinks and now have Medicare, VA, Managed Care coverage, so now, the Table is now set. ... I didn't remember remember any mention of VA. What time was that mentioned? And as for Medicare, as you pointed out it was clearly stated 25% coverage currently, and seemed to imply no meaningful improvement until 2018. "Table is now set" seems a bit of an overstatement as to where our coverage stands... maybe half the table is set (better than 6 months ago, though). I assume that "table is now set" is your own commentary and not meant to represent something Mike said? That becomes confusing when personal commentary views are intermingled with what was said on the call.
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Post by brotherm1 on Feb 3, 2017 22:16:20 GMT -5
Thank you MIMRP. Anyone know what percent of the insulin market is covered by medicaire, VA and managed care? (side note: If I heard correctly, Mike said patients are split 50/50 between type 1 and 2?)
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Post by matt on Feb 6, 2017 9:07:30 GMT -5
My former employer (GE) just switched its employees and retirees from CVS Caremark to OptumRX (a division of UnitedHealth) I'm not diabetic but just checked and as a retiree a 90 day supply of Afrezza would cost me $35. No mention of a need for prior authorization (which Caremark required). You have to be careful when evaluating insurers. Your former employer GE might have switched prescription processing from CVS Caremark to OptumRx, but that doesn't mean they buy insurance coverage from those companies. GE, like most large employers, are self-insured and the company can pick and choose what they cover at what level. In those cases the PBMs just fill scripts for a fixed fee and GE pays whatever they have to pay for the drug. Most of the cases where Afrezza is well-reimbursed seem to be the more generous large employer plans which is great if you work for one of those companies.
In some other cases the large PBMs make Afrezza not available at all, or they "cover" it but put it on the lowest tier possible. When you get a tier 3 drug from a PBM you might as well be paying out-of-pocket since the amount covered plus the co-pay will be nearly as much as full retail price. You have to be careful to distinguish self-funded employer plans that use the large PBMs to administer their prescription benefits versus true insurance plans that use the large PBMs who take risk on the cost of the drugs. Since all the large insurance companies and all the PBMs act both as true insurance companies and as third-party administrators for self-insured plans, it is important to understand what kind of plan is covering Afrezza. The benefits provided by the same insurer, like United Healthcare, may differ substantially even within the same geographic market depending on who is taking the underwriting risk. As in most things, the company that actually writes the checks gets to decide what is covered.
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Post by madog365 on Feb 6, 2017 9:17:05 GMT -5
70% coverage is a huge positive development... i can imagine some docs who were hesitant to prescribe due to this barrier for their patients may be more open to try it out now. We should see some script growth over the next few weeks as the new sales team gets this information out there.
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Post by brotherm1 on Feb 6, 2017 10:21:16 GMT -5
70% coverage is a huge positive development... i can imagine some docs who were hesitant to prescribe due to this barrier for their patients may be more open to try it out now. We should see some script growth over the next few weeks as the new sales team gets this information out there. What was the percent of coverage when SNY was selling Afrezza or when Mike first started with MNKD ?
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Post by cjm18 on Feb 6, 2017 10:33:30 GMT -5
70% coverage is a huge positive development... i can imagine some docs who were hesitant to prescribe due to this barrier for their patients may be more open to try it out now. We should see some script growth over the next few weeks as the new sales team gets this information out there. What was the percent of coverage when SNY was selling Afrezza or when Mike first started with MNKD ? Didn't Mike throw around the 70% number in the middle of last year? I guess more of those 70 included PA and step.
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Post by madog365 on Feb 6, 2017 12:59:05 GMT -5
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