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Post by nadathing on Jul 8, 2017 6:55:08 GMT -5
Yes. It was a promising drug. Refill numbers don't lie. Refill numbers indicate it does not work for the majority who try it. It is not an insurance issue that causes people not to refill. You wouldn't fill a script you could not afford. You can say it is titration. Fine. Why hasn't that been resolved THREE years after approval. I believe the analyst who called it a niche drug was right. It may be a great drug for juvenile T1's. We may never know as the trials may not have even started and the company is out of money in 4-5 months. No, they get the script and then the insurance says no. Then the reps, doctors, or MNKD cares have to help with writing the appeal letters to the insurance company's. The people, most, love it by that time and are really pissed they can't get it. I think MNKD has sent some of them some Afrezza in the mean time to hold them over..( not sure about that but it sounded like that on Twitter) I know Mike try's to reach out himself and help if they tweet to him:-) I base my statement on personal experience. Maybe it is not the norm. My doctor advises me to check with my insurance company before she writes a script for certain meds. I also go to my CareMark site and look up drug prices. Since Afrezza is listed as "pre-authorization required" the insurance company would have to send the doctor authorization to write the script and I would know the cost. My BCBS plan covers Afrezza for $50 co-pay a month. That is the same as my GLP-1 (Trulicity). Because I participate in a health welllness program I get 50% off my co-pay making the actual cost to me $25 a month. |
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Post by nadathing on Jul 8, 2017 6:58:45 GMT -5
Hi Nada, I'm involved with analyzing Trx leakage occasionally and it seems to me that if the majority were leaving due to efficacy there would be stories everywhere by now talking about how it doesn't work. Granted maybe there are and it's just me living in a bunker. When I buy something that doesn't work I usually just don't buy it again. I don't leave comments on boards or review sites unless I have a bad experience and the retailer or manufacturer doesn't make it right. But, that's just me. |
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Post by sportsrancho on Jul 8, 2017 7:26:34 GMT -5
No, they get the script and then the insurance says no. Then the reps, doctors, or MNKD cares have to help with writing the appeal letters to the insurance company's. The people, most, love it by that time and are really pissed they can't get it. I think MNKD has sent some of them some Afrezza in the mean time to hold them over..( not sure about that but it sounded like that on Twitter) I know Mike try's to reach out himself and help if they tweet to him:-) I base my statement on personal experience. Maybe it is not the norm. My doctor advises me to check with my insurance company before she writes a script for certain meds. I also go to my CareMark site and look up drug prices. Since Afrezza is listed as "pre-authorization required" the insurance company would have to send the doctor authorization to write the script and I would know the cost. My BCBS plan covers Afrezza for $50 co-pay a month. That is the same as my GLP-1 (Trulicity). Because I participate in a health welllness program I get 50% off my co-pay making the actual cost to me $25 a month. Sounds like the smart thing to do all the way around. I know my clients ( Health Net ) insurance did not ask for a pre-authorization letter. And the doctor just wrote the script and mailed it to him. I think the co-pay when the teenagers started two years ago was $30 and now it's $60. The kids were not given samples because their Endo at the time said no. So they had to get the script from a GP out of state. But others I have heard get the samples. Really like it. Get a script and then run into a dead end with the insurance until 1-3 letters have been written. If they keep at it sounds like they at last get it covered. But how many just give up? IDK. |
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Post by mnholdem on Jul 8, 2017 7:43:47 GMT -5
One has to consider how the insurers will rate Afrezza after the label upgrade to ultra rapid-acting is approved. A first-in-class drug usually gets preferred rating, but Novo's faster-acting RAA Fiasp is also vying for that "Ultra-Rapid" classification in the USA. They already have the ultra label in the EU, so I imagine the insurers may give Fiasp preferred coverage over Afrezza in that drug classification. Mike will have a very short window of opportunity to market the hell out of the new label before Novo Nordisk steps up to the plate.
It's a cutthroat market.
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Post by sportsrancho on Jul 8, 2017 7:48:58 GMT -5
Hi Nada, I'm involved with analyzing Trx leakage occasionally and it seems to me that if the majority were leaving due to efficacy there would be stories everywhere by now talking about how it doesn't work. Granted maybe there are and it's just me living in a bunker. When I buy something that doesn't work I usually just don't buy it again. I don't leave comments on boards or review sites unless I have a bad experience and the retailer or manufacturer doesn't make it right. But, that's just me. From talking to doctors, old reps, new reps, even old SNY reps, the dosing has come a long way! Faster than the insurance problems. The kids having a MNKD long for a dad didn't have issues. Because he wasn't going to let them stop in 3 days because they had a scratchy throat. Which goes away. Once they learned how much they needed. Taking more, splitting the doses, using a Dexcom. WOW! There is nothing that comes close to competing with Afrezza! |
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Post by barnstormer on Jul 8, 2017 8:23:25 GMT -5
You do realize that Matt had never been a CEO and if you look accross many great companies CFO's rarely translate into CEO's. Great CEO's have a sales background in their resume. It takes a lot of talent to sell the comany's vision. Matt could barely speak on the earnings calls. Mike has no problem relating the company vision. I'll take Mike any day over a CFO that bungled important issues like delisting notification and warrant filing.
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Post by straightly on Jul 8, 2017 11:33:31 GMT -5
I base my statement on personal experience. Maybe it is not the norm. My doctor advises me to check with my insurance company before she writes a script for certain meds. I also go to my CareMark site and look up drug prices. Since Afrezza is listed as "pre-authorization required" the insurance company would have to send the doctor authorization to write the script and I would know the cost. My BCBS plan covers Afrezza for $50 co-pay a month. That is the same as my GLP-1 (Trulicity). Because I participate in a health welllness program I get 50% off my co-pay making the actual cost to me $25 a month. Sounds like the smart thing to do all the way around. I know my clients ( Health Net ) insurance did not ask for a pre-authorization letter. And the doctor just wrote the script and mailed it to him. I think the co-pay when the teenagers started two years ago was $30 and now it's $60. The kids were not given samples because their Endo at the time said no. So they had to get the script from a GP out of state. But others I have heard get the samples. Really like it. Get a script and then run into a dead end with the insurance until 1-3 letters have been written. If they keep at it sounds like they at last get it covered. But how many just give up? IDK. Sporty: first, please let me assure you that I am truly want to understand this and am not bashing, if I might sound it. In scenario you described, the samples will not counted as Nrx. I am still trying to understand what happens AFTER the first prescription that is counted, why a refill is NOT followed up. Dosing could be one possible root cause. I believe we have addressed it. But how well did we address it? If very well, when should we expect the pickup in refill count? If there WERE an efficacy issue, that would explain the low refill count also. I don't think it is the reason because our enemies would have long since jumped on it and made news everywhere. In fact, I believe some time ago, I did see some mentioning to this direction, but it was before MNKD adjusted the dosing and there is no longer bad news in this front. So no bad news is good news. Another potential root cause was that Afrezza worked so well that the patient can lower the dosing or even skip and accidentally delayed the refill. This might be addtional dosing adjustment our doctors/patients need to learn. Yet another is that the patiant decide to go back to his/her routine and ONLY use Afrezza as supplemnet when needle is inconvenient or ultra fast additional insulin is called for. I don't think so either because Afrezza is still too much easier. Or the root cause can be all of the above. In all, I am still looking for a reason of the low refill. I fell so strongly that we should address this that, without adressing this, DTC will fail even if it managed to get a spike in NRX. OTOH, I am confident that MC IS on top of this and he will find the root cause and address it. That is the reason I am holding and buying believing that eventually we will overcome. |
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Post by mnholdem on Jul 8, 2017 12:09:52 GMT -5
You do realize that Matt had never been a CEO and if you look accross many great companies CFO's rarely translate into CEO's. Great CEO's have a sales background in their resume. It takes a lot of talent to sell the comany's vision. Matt could barely speak on the earnings calls. Mike has no problem relating the company vision. I'll take Mike any day over a CFO that bungled important issues like delisting notification and warrant filing. The most effective CEOs are typically outstanding communicators and Mike Castagna has demonstrated that he brings that skill set to the table. Michael has a Bachelor of Science Pharmacy and his Doctor of Pharmacy degree from the Massachusetts College of Pharmacy and his MBA from Wharton. With his credentials and over twenty years in the pharmaceuticals industry, most CEOs in the industry might consider him to be plenty qualified for the top spot. |
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Post by mango on Jul 8, 2017 13:19:16 GMT -5
You do realize that Matt had never been a CEO and if you look accross many great companies CFO's rarely translate into CEO's. Great CEO's have a sales background in their resume. It takes a lot of talent to sell the comany's vision. Matt could barely speak on the earnings calls. Mike has no problem relating the company vision. I'll take Mike any day over a CFO that bungled important issues like delisting notification and warrant filing. Mike also used to be a sales rep when he first got his pharmacy degree. So he has essentially worked from "the bottom up" in a way because he was a pharmacy tech before going to pharmacy school. In his interview he also mentioned how he did not understand/agree with the idea of people with zero science backgrounds running pharma companies. I think he is a perfect fit for MannKind. |
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Post by mango on Jul 8, 2017 13:24:17 GMT -5
You do realize that Matt had never been a CEO and if you look accross many great companies CFO's rarely translate into CEO's. Great CEO's have a sales background in their resume. It takes a lot of talent to sell the comany's vision. Matt could barely speak on the earnings calls. Mike has no problem relating the company vision. I'll take Mike any day over a CFO that bungled important issues like delisting notification and warrant filing. The most effective CEOs are typically outstanding communicators and Mike Castagna has demonstrated that he brings that skill set to the table. Michael has a Bachelor of Science Pharmacy and his Doctor of Pharmacy degree from the Massachusetts College of Pharmacy and his MBA from Wharton. With his credentials and over twenty years in the pharmaceuticals industry, most CEOs in the industry might consider him to be plenty qualified for the top spot. Bachelors was from Philadelphia College of Pharmacy. |
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Post by agedsagerage on Jul 8, 2017 13:47:01 GMT -5
I don't quite see the same confidence in Mannkind as I did several years ago, or indeed just last year. It appears to me that what has had to be said has been said, what had to be done has been done. I like many others who have lost more than a few dollars in the company, are simply waiting for the inevitable. But claiming 3k/yr loss on my 1040 over the next 10 years (I'll be 83 by then) is a little consolation. Same here. No confidence whatsoever. I'm just waiting for that bankruptcy so I can finally start claiming my losses. Since it makes no sense for me to sell now (unless I find some guaranteed winner elsewhere to which I can shift my remaining few bits), I'm holding on for the 1% off chance that these knuckleheads in charge actually produce. |
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Post by sportsrancho on Jul 8, 2017 14:29:52 GMT -5
Sounds like the smart thing to do all the way around. I know my clients ( Health Net ) insurance did not ask for a pre-authorization letter. And the doctor just wrote the script and mailed it to him. I think the co-pay when the teenagers started two years ago was $30 and now it's $60. The kids were not given samples because their Endo at the time said no. So they had to get the script from a GP out of state. But others I have heard get the samples. Really like it. Get a script and then run into a dead end with the insurance until 1-3 letters have been written. If they keep at it sounds like they at last get it covered. But how many just give up? IDK. Sporty: first, please let me assure you that I am truly want to understand this and am not bashing, if I might sound it. In scenario you described, the samples will not counted as Nrx. I am still trying to understand what happens AFTER the first prescription that is counted, why a refill is NOT followed up. Dosing could be one possible root cause. I believe we have addressed it. But how well did we address it? If very well, when should we expect the pickup in refill count? If there WERE an efficacy issue, that would explain the low refill count also. I don't think it is the reason because our enemies would have long since jumped on it and made news everywhere. In fact, I believe some time ago, I did see some mentioning to this direction, but it was before MNKD adjusted the dosing and there is no longer bad news in this front. So no bad news is good news. Another potential root cause was that Afrezza worked so well that the patient can lower the dosing or even skip and accidentally delayed the refill. This might be addtional dosing adjustment our doctors/patients need to learn. Yet another is that the patiant decide to go back to his/her routine and ONLY use Afrezza as supplemnet when needle is inconvenient or ultra fast additional insulin is called for. I don't think so either because Afrezza is still too much easier. Or the root cause can be all of the above. In all, I am still looking for a reason of the low refill. I fell so strongly that we should address this that, without adressing this, DTC will fail even if it managed to get a spike in NRX. OTOH, I am confident that MC IS on top of this and he will find the root cause and address it. That is the reason I am holding and buying believing that eventually we will overcome. Stright, no you don't sound like you are bashing at all. All good points. I'm trying to understand it too. I know some do start on it and end up using for corrections only. ( not many) but some. I'll post tweets if I can find them. The orher thing: I'm pretty sure that people get the titration pack. ( Counts as a script ) and then weeks later get a letter of denial from their insurance. But I'll go see if I can find out for sure and get back to you:-) |
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Post by sportsrancho on Jul 8, 2017 14:37:05 GMT -5
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Post by sportsrancho on Jul 8, 2017 14:38:00 GMT -5
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Post by sportsrancho on Jul 8, 2017 14:43:24 GMT -5
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