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Post by peppy on Sept 20, 2017 12:13:48 GMT -5
Some can't resist stirring up trouble and negativity. Sorry, I would have thought that was what you are intending to do. Perhaps your understanding of who the audience is here is different than mine. Seems like everyone here believes Afrezza is great, so I guess if they didn't already believe that, then you've done one heck of a job convincing them in the short time you've been here. For me, it's easy enough to skip over repeated "Afrezza is great" posts, so if the moderators don't have problem with interjecting that into every thread, it doesn't bother me. alrighty then,
twitter.com/hashtag/afrezza?lang=en
sweet potato tots, I bet they are good.
anecdotal but from Mike H at tudiabetes. he should know.
(It is pretty great)
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Post by dreamboatcruise on Sept 20, 2017 12:27:08 GMT -5
They already have direct access to work with patients insurance through Mannkind cares. This might be just a way to reduce hops to get the samples to patients .
This will allow only patients that request samples get samples and I believe the request still has to come through the providers and not directly by patients. It's just that Mannkind will no longer have samples sitting at providers office idle or just one patient using samples for months together --- This might be just a way to get their foot in the door and a step closer to direct marketing, sales, and logistics OTC... Not sure how you're tying all of those together that vouchers rather than samples is at all linked to making Afrezza OTC... other than perhaps in the sense that a school kid walking into 1st grade is a step towards becoming an astronaut... retrospectively true for astronauts, but walking into 1st grade in no way means the kid will ever consider much less achieve being an astronaut. To me it simply seems a logical way of doing it... avoids needing to stock doctors office and avoids the reluctance they have to take up limited refrigerator space, and has the side benefit (or perhaps the real desired benefit) of having the free sample count in the IMS script numbers since it's filled at pharmacy. |
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Post by kc on Sept 20, 2017 12:50:26 GMT -5
The thread is about Afrezza. Anything else? What is it? |
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Post by dreamboatcruise on Sept 20, 2017 12:51:40 GMT -5
peppy... mmmmmm, pass the plate and a 12u. I make a good hash that has sweet potato and turnip... maybe I need to market that combo as a tater tot.
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Post by mango on Sept 20, 2017 22:04:44 GMT -5
Sorry, I would have thought that was what you are intending to do. Perhaps your understanding of who the audience is here is different than mine. Seems like everyone here believes Afrezza is great, so I guess if they didn't already believe that, then you've done one heck of a job convincing them in the short time you've been here. For me, it's easy enough to skip over repeated "Afrezza is great" posts, so if the moderators don't have problem with interjecting that into every thread, it doesn't bother me. alrighty then,
twitter.com/hashtag/afrezza?lang=en
sweet potato tots, I bet they are good.
anecdotal but from Mike H at tudiabetes. he should know.
(It is pretty great)
Is that mad cow? Or brisket or mushrooms? |
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Post by lakon on Sept 21, 2017 14:04:32 GMT -5
--- This might be just a way to get their foot in the door and a step closer to direct marketing, sales, and logistics for OTC... Not sure how you're tying all of those together that vouchers rather than samples is at all linked to making Afrezza OTC... other than perhaps in the sense that a school kid walking into 1st grade is a step towards becoming an astronaut... retrospectively true for astronauts, but walking into 1st grade in no way means the kid will ever consider much less achieve being an astronaut. To me it simply seems a logical way of doing it... avoids needing to stock doctors office and avoids the reluctance they have to take up limited refrigerator space, and has the side benefit (or perhaps the real desired benefit) of having the free sample count in the IMS script numbers since it's filled at pharmacy. The title of this thread says it all. Someone else pointed out that MannKind Cares is already working directly with insurers of PWD. What's the real difference, besides perception, between a sample pack and a mail order prescription/subscription directly to your doorstep? Or direct marketing? Or direct sales? I added a correction 'for' OTC. Getting the logistics in-place is a step closer to fulfilling Al's dream. To reach 400+ million PWD, it will have to be direct and OTC, but one step at a time. Just getting more ducks in a row, and yes, counting in IMS is smart. Getting closer and closer to the patient is also very smart. The patients will drive this drug and others, not physicians, not insurance, ... I was amused by your attempt at levity, but not analogy. |
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Post by nylefty on Sept 21, 2017 14:39:57 GMT -5
To me it simply seems a logical way of doing it... avoids needing to stock doctors office and avoids the reluctance they have to take up limited refrigerator space, and has the side benefit (or perhaps the real desired benefit) of having the free sample count in the IMS script numbers since it's filled at pharmacy. The title of this thread says it all. Someone else pointed out that MannKind Cares is already working directly with insurers of PWD. What's the real difference, besides perception, between a sample pack and a mail order prescription/subscription directly to your doorstep? Or direct marketing? Or direct sales? I added a correction 'for' OTC. Getting the logistics in-place is a step closer to fulfilling Al's dream. To reach 400+ million PWD, it will have to be direct and OTC, but one step at a time. Just getting more ducks in a row, and yes, counting in IMS is smart. Getting closer and closer to the patient is also very smart. The patients will drive this drug and others, not physicians, not insurance, ... The numbers we see every Friday are from Symphony Health, not IMS. I don't think IMS numbers are publicly available. |
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Post by dreamboatcruise on Sept 21, 2017 16:06:56 GMT -5
Not sure how you're tying all of those together that vouchers rather than samples is at all linked to making Afrezza OTC... other than perhaps in the sense that a school kid walking into 1st grade is a step towards becoming an astronaut... retrospectively true for astronauts, but walking into 1st grade in no way means the kid will ever consider much less achieve being an astronaut. To me it simply seems a logical way of doing it... avoids needing to stock doctors office and avoids the reluctance they have to take up limited refrigerator space, and has the side benefit (or perhaps the real desired benefit) of having the free sample count in the IMS script numbers since it's filled at pharmacy. The title of this thread says it all. Someone else pointed out that MannKind Cares is already working directly with insurers of PWD. What's the real difference, besides perception, between a sample pack and a mail order prescription/subscription directly to your doorstep? Or direct marketing? Or direct sales? I added a correction 'for' OTC. Getting the logistics in-place is a step closer to fulfilling Al's dream. To reach 400+ million PWD, it will have to be direct and OTC, but one step at a time. Just getting more ducks in a row, and yes, counting in IMS is smart. Getting closer and closer to the patient is also very smart. The patients will drive this drug and others, not physicians, not insurance, ... I was amused by your attempt at levity, but not analogy. A Direct marketing would be great, just need money to do it. Pharmas spend billions on direct to consumer marketing... MNKD simply doesn't have the $. What besides perception is different? Delivering a voucher can be done via the internet while delivering a drug requiring refrigeration involves a lot of physical logistics. Likely state laws about needing to be licensed pharmacy are also involved. And the big difference is that MNKD would have to strike deals with insurance companies to have it covered... and many insurance plans likely have exclusivity deals with their PBMs that would preclude cutting the PBM out of the profit chain. Most insurance/PBMs have delivery to door as an option for meds used on regular basis. Afrezza I would think is already available that way. Theoretically it's possible that MNKD could sell directly to consumers but seems they need to focus on getting docs to prescribe before they try to change the entire distribution model of drugs to eek out extra percent of profit (which isn't ever going to be profit unless they get the prescriptions written to a much higher level). And my prior post was about OTC. I still don't see how providing a piece of paper to consumer to take to pharmacy has anything to do with logistics of Afrezza becoming an over the counter drug. The latter is purely an issue of getting FDA approval. Providing vouchers for sample packs in no way indicates MNKD is even thinking about submitting Afrezza for change to OTC status. |
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Post by dreamboatcruise on Sept 21, 2017 16:10:04 GMT -5
The title of this thread says it all. Someone else pointed out that MannKind Cares is already working directly with insurers of PWD. What's the real difference, besides perception, between a sample pack and a mail order prescription/subscription directly to your doorstep? Or direct marketing? Or direct sales? I added a correction 'for' OTC. Getting the logistics in-place is a step closer to fulfilling Al's dream. To reach 400+ million PWD, it will have to be direct and OTC, but one step at a time. Just getting more ducks in a row, and yes, counting in IMS is smart. Getting closer and closer to the patient is also very smart. The patients will drive this drug and others, not physicians, not insurance, ... The numbers we see every Friday are from Symphony Health, not IMS. I don't think IMS numbers are publicly available. Yes, my bad. We did have IMS initially, but I guess whoever had access is no longer providing them. Even Symphony aren't freely available. |
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Post by nylefty on Sept 21, 2017 16:52:27 GMT -5
The title of this thread says it all. Someone else pointed out that MannKind Cares is already working directly with insurers of PWD. What's the real difference, besides perception, between a sample pack and a mail order prescription/subscription directly to your doorstep? (snip) Direct marketing would be great, just need money to do it. Pharmas spend billions on direct to consumer marketing... MNKD simply doesn't have the $. What besides perception is different? Delivering a voucher can be done via the internet while delivering a drug requiring refrigeration involves a lot of physical logistics. Likely state laws about needing to be licensed pharmacy are also involved. And the big difference is that MNKD would have to strike deals with insurance companies to have it covered... and many insurance plans likely have exclusivity deals with their PBMs that would preclude cutting the PBM out of the profit chain. Most insurance/PBMs have delivery to door as an option for meds used on regular basis. Afrezza I would think is already available that way. (snip) As I've posted before, Afrezza is available for home delivery under my GE prescription plan for employees and retirees, administered by OptumRx. $35 for a three-month supply. |
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Post by lakon on Sept 23, 2017 3:30:17 GMT -5
The title of this thread says it all. Someone else pointed out that MannKind Cares is already working directly with insurers of PWD. What's the real difference, besides perception, between a sample pack and a mail order prescription/subscription directly to your doorstep? Or direct marketing? Or direct sales? I added a correction 'for' OTC. Getting the logistics in-place is a step closer to fulfilling Al's dream. To reach 400+ million PWD, it will have to be direct and OTC, but one step at a time. Just getting more ducks in a row, and yes, counting in IMS is smart. Getting closer and closer to the patient is also very smart. The patients will drive this drug and others, not physicians, not insurance, ... I was amused by your attempt at levity, but not analogy. A Direct marketing would be great, just need money to do it. Pharmas spend billions on direct to consumer marketing... MNKD simply doesn't have the $. What besides perception is different? Delivering a voucher can be done via the internet while delivering a drug requiring refrigeration involves a lot of physical logistics. Likely state laws about needing to be licensed pharmacy are also involved. And the big difference is that MNKD would have to strike deals with insurance companies to have it covered... and many insurance plans likely have exclusivity deals with their PBMs that would preclude cutting the PBM out of the profit chain. Most insurance/PBMs have delivery to door as an option for meds used on regular basis. Afrezza I would think is already available that way. Theoretically it's possible that MNKD could sell directly to consumers but seems they need to focus on getting docs to prescribe before they try to change the entire distribution model of drugs to eek out extra percent of profit (which isn't ever going to be profit unless they get the prescriptions written to a much higher level). And my prior post was about OTC. I still don't see how providing a piece of paper to consumer to take to pharmacy has anything to do with logistics of Afrezza becoming an over the counter drug. The latter is purely an issue of getting FDA approval. Providing vouchers for sample packs in no way indicates MNKD is even thinking about submitting Afrezza for change to OTC status. FDA approval for OTC is part of the puzzle. Direct CRM of PWD, pharmacy licenses, DTC, online prescriptions (eventually subscriptions), (direct) home delivery, mobile apps, among other things would be innovative (Amazon). Cutting out the middleman is the key to most Internet innovation, optimization, and efficiency. My comment was not intended to make a mountain out of a mole hill, just tongue in cheek observation that that's one small step towards the end game. The end game is debatable, but huge success would entail what I lay out. To reach Al's goal, whether or not we are still on track, we need to become way more efficient, and the things that I am writing about are only difficult because of politics and regulations. These are not insurmountable, just slow to change. The science is much harder, and that's been solved. When you are talking about a significant percentage of the population as well as even more significant cost to society, something has to change. |
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Post by dreamboatcruise on Sept 23, 2017 15:25:08 GMT -5
lakon... hopefully becoming OTC isn't a necessary part of the puzzle for success, because I doubt that's going to happen. Management hasn't even mentioned that as a possibility. It's purely hopium from here. I'm not even sure it is really something people should hope for, as I would think zero chance of getting better insurance coverage for something that is sold OTC. "Internet" innovation is kinda interesting. Amazon certainly has changed the game, but they are just a different middle man. There are all sorts of new direct "subscription" services... razors, clothes, perfume, blue apron, etc. But many of those really boil down to the Columbia House Record Club model... roping you in with a cheap introductory offer. So I'm a bit skeptical that is truly innovation. But you know I'm a skeptic in general.  Though?... maybe if we had the ShamWow guy selling Afrezza on late night TV... "But wait... if you call in the next 5 minutes, we'll double the offer!". Or, we could stick to trying to convince doctors that Afrezza has clinical benefit.
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Post by mango on Sept 23, 2017 16:26:41 GMT -5
lakon ... hopefully becoming OTC isn't a necessary part of the puzzle for success, because I doubt that's going to happen. Management hasn't even mentioned that as a possibility. It's purely hopium from here. I'm not even sure it is really something people should hope for, as I would think zero chance of getting better insurance coverage for something that is sold OTC. "Internet" innovation is kinda interesting. Amazon certainly has changed the game, but they are just a different middle man. There are all sorts of new direct "subscription" services... razors, clothes, perfume, blue apron, etc. But many of those really boil down to the Columbia House Record Club model... roping you in with a cheap introductory offer. So I'm a bit skeptical that is truly innovation. But you know I'm a skeptic in general. Though?... maybe if we had the ShamWow guy selling Afrezza on late night TV... "But wait... if you call in the next 5 minutes, we'll double the offer!". Or, we could stick to trying to convince doctors that Afrezza has clinical benefit. An FDA official just recently admitted that the clinical trial system is flawed and needs to revised. Currently, in vivo studies can suffice as adequate evidence for label extensions in oncology anyway, but I think more therapeutic areas will implement good in vivo studies too. I read the other day that Claritin was once only available through prescription. I thought that was pretty crazy. Apparently it was no issue getting it OTC it was just a matter a patent expiring. OTC Afrezza would not be a liability on safety as it doesn't produce hypos. I have the FDA Adverse Events document proving it. It's currently safer than my drinking water even. The thing is, we're talking about health here and this is a hormone people cannot survive without. Everyone should be able to choose what insulin he or she wants to use for themselves. Unfortunately, injectable insulins are far from safe and this is what separates Afrezza from the herd, it's got the same safety as my own endogenous insulin does. I might be wanting to keep some Afrezza around for myself and that won't happen until I can bypass the prescription burden. Maybe next year. |
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Post by sellhighdrinklow on Sept 23, 2017 16:55:06 GMT -5
lakon ... hopefully becoming OTC isn't a necessary part of the puzzle for success, because I doubt that's going to happen. Management hasn't even mentioned that as a possibility. It's purely hopium from here. I'm not even sure it is really something people should hope for, as I would think zero chance of getting better insurance coverage for something that is sold OTC. "Internet" innovation is kinda interesting. Amazon certainly has changed the game, but they are just a different middle man. There are all sorts of new direct "subscription" services... razors, clothes, perfume, blue apron, etc. But many of those really boil down to the Columbia House Record Club model... roping you in with a cheap introductory offer. So I'm a bit skeptical that is truly innovation. But you know I'm a skeptic in general. Though?... maybe if we had the ShamWow guy selling Afrezza on late night TV... "But wait... if you call in the next 5 minutes, we'll double the offer!". Or, we could stick to trying to convince doctors that Afrezza has clinical benefit. An FDA official just recently admitted that the clinical trial system is flawed and needs to revised. Currently, in vivo studies can suffice as adequate evidence for label extensions in oncology anyway, but I think more therapeutic areas will implement good in vivo studies too. I read the other day that Claritin was once only available through prescription. I thought that was pretty crazy. Apparently it was no issue getting it OTC it was just a matter a patent expiring. OTC Afrezza would not be a liability on safety as it doesn't produce hypos. I have the FDA Adverse Events document proving it. It's currently safer than my drinking water even. The thing is, we're talking about health here and this is a hormone people cannot survive without. Everyone should be able to choose what insulin he or she wants to use for themselves. Unfortunately, injectable insulins are far from safe and this is what separates Afrezza from the herd, it's got the same safety as my own endogenous insulin does. I might be wanting to keep some Afrezza around for myself and that won't happen until I can bypass the prescription burden. Maybe next year. Claims that Afrezza cannot cause hypoglycemia are false. As a type 1, if I inhale an 8-unit cartridge before a meal , with a starting blood sugar level of 120, I will definitely be hypoglycemic if I don't eat anything. That's assuming my BS has been flat for the past two hours, not trending up. My guesstimate is I'd be hypoglycemic within 15-30 minutes and feeling the full effects of it. |
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Post by mango on Sept 23, 2017 18:03:55 GMT -5
An FDA official just recently admitted that the clinical trial system is flawed and needs to revised. Currently, in vivo studies can suffice as adequate evidence for label extensions in oncology anyway, but I think more therapeutic areas will implement good in vivo studies too. I read the other day that Claritin was once only available through prescription. I thought that was pretty crazy. Apparently it was no issue getting it OTC it was just a matter a patent expiring. OTC Afrezza would not be a liability on safety as it doesn't produce hypos. I have the FDA Adverse Events document proving it. It's currently safer than my drinking water even. The thing is, we're talking about health here and this is a hormone people cannot survive without. Everyone should be able to choose what insulin he or she wants to use for themselves. Unfortunately, injectable insulins are far from safe and this is what separates Afrezza from the herd, it's got the same safety as my own endogenous insulin does. I might be wanting to keep some Afrezza around for myself and that won't happen until I can bypass the prescription burden. Maybe next year. Claims that Afrezza cannot cause hypoglycemia are false. As a type 1, if I inhale an 8-unit cartridge before a meal , with a starting blood sugar level of 120, I will definitely be hypoglycemic if I don't eat anything. That's assuming my BS has been flat for the past two hours, not trending up. My guesstimate is I'd be hypoglycemic within 15-30 minutes and feeling the full effects of it. I don't think you would develop a severe hypo because of the way Afrezza works. It is working the same way a nondiabetic's insulin does. By introducing the first phase insulin response into the body, it signals to the liver the same way and the liver will attempt to compensate for low levels by producing more glucose if needed. I think it would take more time than 10-15 to experience symptoms of hypoglycemia like you describe and after drinking a Coke you would normalize very quickly considering Afrezza's action is very quick. Have you experienced a hypo on Afrezza before in that situation? |
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