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Post by uvula on Mar 21, 2018 19:36:43 GMT -5
If you're lucky enough to be in a territory with an afrezza prescribing Dr you probably do okay, even if you are not the reason the Dr knows about afrezza.
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Post by golfeveryday on Mar 21, 2018 19:55:24 GMT -5
Sayhey, No one is questioning whether or not Afrezza works. The question is whether or not mnkd can figure out how to sell it. You saying "No one is questioning whether or not Afrezza works" to me is another turning point as "The skeptic in me(you) thinks the lost data none of us have seen is similar to the agreement with RLS". I have spoken with many doctors, most will now say they have heard of afrezza but when you talk with them they have little idea what it really is and its benefits. Part of the problem is the experience level of the sales team and being able to explain why afrezza should be the standard of care for most T2s while contrasting the antiglycemics. Then you have the 171 and 175 studies as the "standard" of information for what afrezza is. Read those and take them at face value and I could make a really good argument afrezza is at best a niche drug. Then look at the insurance coverage and cost and its pretty clear why afrezza has not sold. Throw in the lost years with Sanofi and the fact CGM Cloud technology is now starting to be used and it completes the story. It will only take a few clinical situations like what happened with Hilliard where Mike can now showcase the results that hospital group is now having plus some time, IMO about 2 years. The great news for MNKD is no BP has anything in their pipelines which can compete and MNKD now has Dr. Kendall on the team. a few Hillard type revelations and the tipping point will be near. |
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Post by mnholdem on Mar 21, 2018 20:14:19 GMT -5
Publications are needed, too. Many physicians that no longer accept calls from sales reps still read medical journals to stay current and there hasn't been much to read about Afrezza. I'm hoping that Dr. Kendall will change that.
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Post by nylefty on Mar 21, 2018 20:34:06 GMT -5
If you're lucky enough to be in a territory with an afrezza prescribing Dr you probably do okay, even if you are not the reason the Dr knows about afrezza. I've never been in sales, but every radio and TV station I've worked for had salespeople who could sell and those who could not (or at least not very well). The latter were usually fired unless they were related (by marriage or otherwise) to one of the bosses. |
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Post by sellhighdrinklow on Mar 21, 2018 20:46:03 GMT -5
I assume this company does not cover Afrezza? Will certainly be good news if you can convince them to. Actually they do cover afrezza if its prescribed. The problem is most PCPs know little about diabetes except for prescribing metformin. Their problem is they are incurring huge costs because metformin just hides for a few years bigger issues which turn into huge costs. The suggestion that these 45ish who are working for big companies are leaving in 5 years is completely wrong. By that age many have been institutionalized and they are figuring out strategies to make it to retirement and keep their health benefits. At 55 they are hoping not to get kicked out the door and they are hoping to make it to 60 and then 66. The root cause is the PCP. Their knowledge of diabetes is very limited and what they have been doing is wrong. The VDex model is the right model but it needs to be done with serious funding in some type of partnership with the Onduo's. Existing insurance companies have some exploratory projects with CGMs. The next step will be adding afrezza if they really want to achieve TIR. I did find out the other day a 500 PWD study is being done outside Philly with the IWatch CGM, so interesting things are happening. It is just taking so long. Clarification, seyhey... Study w cgm and Afrezza? |
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Post by falconquest on Mar 21, 2018 20:54:12 GMT -5
As a Sales Rep. I have to defend my peers. In order to be successful in sales you have to have something to sell. While we know Afrezza is truly a miracle drug, consider the barriers to entry. That is something that Reps. can't control. If you were brow beaten everyday because you didn't have adequate insurance coverage and it required a physician to hire an educator for a patient that should really have a CGM also, then the barriers to entry are very high. Reps. like to make money. If your product is considered a dud when it comes to barriers and demand is low, how motivated do you think you would be? We all know the Afrezza story but getting a physician to make a "paradigm shift" is likely very challenging. They will take the easy route. Dr. Kendall has his work cut out for him because Reps. can't change the current climate. It has to come from higher up. Holding Reps. feet to the fire is disingenuous. It boils down to marketing and that is a skill that Castagna is supposed to be good at. How do you explain Mike's statement that some MannKind reps have been doing well, while the fired reps were not producing? There are always sweet spots. Some of my peers have great territories where all they have to do is show up and things fall into their laps. Obviously I can't speak for the Mannkind Reps. that are successful and those that aren't because it's an entirely different field from mine. However, to automatically say the responsibility falls on the Reps. entirely is not true. There are a lot of factors that play into success and some are completely out of the Reps. control. |
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Post by digger on Mar 21, 2018 21:50:25 GMT -5
As a Sales Rep. I have to defend my peers. In order to be successful in sales you have to have something to sell. While we know Afrezza is truly a miracle drug, consider the barriers to entry. That is something that Reps. can't control. If you were brow beaten everyday because you didn't have adequate insurance coverage and it required a physician to hire an educator for a patient that should really have a CGM also, then the barriers to entry are very high. Reps. like to make money. If your product is considered a dud when it comes to barriers and demand is low, how motivated do you think you would be? We all know the Afrezza story but getting a physician to make a "paradigm shift" is likely very challenging. They will take the easy route. Dr. Kendall has his work cut out for him because Reps. can't change the current climate. It has to come from higher up. Holding Reps. feet to the fire is disingenuous. It boils down to marketing and that is a skill that Castagna is supposed to be good at. How do you explain Mike's statement that some MannKind reps have been doing well, while the fired reps were not producing? The current reps are only averaging about two new scripts a week each, so how much better are the "producing" reps doing? More to the point, how are they achieving their better numbers? When I reflect on it, I don't see how one rep can make a presentation that's significantly better than another, so what are the producing reps doing to get better numbers? |
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Post by kc on Mar 21, 2018 22:44:20 GMT -5
My endo practices at The International Diabetes Center in St. Louis Park, MN (suburb of Minneapolis). This was a site for a P3 trial of Bydureon that I participated in for 3 years. My doctor was not involved in the study. When Bydureon was approved she was reluctant to prescribe it because of the black box warning. I insisted and she wrote the script. I asked if she had heard of or seen a presentation on Afrezza and she said no. She said that pharma reps are not allowed to see the doctors. What a mess. Sad that this group is so closed minded. Interesting that doctor Kendall worked there back in 2008. Maybe he will target them. |
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Post by straightly on Mar 21, 2018 22:52:22 GMT -5
As a Sales Rep. I have to defend my peers. In order to be successful in sales you have to have something to sell. While we know Afrezza is truly a miracle drug, consider the barriers to entry. That is something that Reps. can't control. If you were brow beaten everyday because you didn't have adequate insurance coverage and it required a physician to hire an educator for a patient that should really have a CGM also, then the barriers to entry are very high. Reps. like to make money. If your product is considered a dud when it comes to barriers and demand is low, how motivated do you think you would be? We all know the Afrezza story but getting a physician to make a "paradigm shift" is likely very challenging. They will take the easy route. Dr. Kendall has his work cut out for him because Reps. can't change the current climate. It has to come from higher up. Holding Reps. feet to the fire is disingenuous. It boils down to marketing and that is a skill that Castagna is supposed to be good at. How do you explain Mike's statement that some MannKind reps have been doing well, while the fired reps were not producing? All reps are not the same? How many on this board is as good as Sporty in recruiting drs? |
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Post by akemp3000 on Mar 22, 2018 6:04:46 GMT -5
Prior to the label change, the Afrezza sales rep message was somewhat limited by the FDA to being "non-inferior". With the recent label change, the message improved whereby sales reps could share the PK/PD profile and faster onset. Dr. Kendall should soon be able to use the STAT study along with some of the historical trial data to escalate the sales message to "superior". IMO, this moves the paradigm shift off the launching pad. Doctors, patients, educators, insurance providers, the ADA and the global diabetes market will finally learn the secret Al Mann knew for years...Afrezza isn't just another alternative. It's superior science.
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Post by agedhippie on Mar 22, 2018 9:14:39 GMT -5
Prior to the label change, the Afrezza sales rep message was somewhat limited by the FDA to being "non-inferior". With the recent label change, the message improved whereby sales reps could share the PK/PD profile and faster onset. Dr. Kendall should soon be able to use the STAT study along with some of the historical trial data to escalate the sales message to "superior". IMO, this moves the paradigm shift off the launching pad. Doctors, patients, educators, insurance providers, the ADA and the global diabetes market will finally learn the secret Al Mann knew for years...Afrezza isn't just another alternative. It's superior science. The other side of this is that despite the faster PK/PD Afrezza still gives the same performance as RAA insulin according to the trial data. That's the bottom line from what the reps can say. The STAT study is only a pilot, it says that right there in the submission, so the question is if it scales to larger population including those who do not have access to CGMs. My personal hope is that there is a full blown follow on study to prove that it does scale, and also to prove superiority. That's what will be needed. I think historical data is either a red herring, or what on earth were all the previous Chief Medical Officers doing? |
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Post by buyitonsale on Mar 22, 2018 14:21:14 GMT -5
It has been over a year since MNKD sales force started. I do not believe that doctors, whose job it is to treat diabetics, are not aware of Afrezza or its benefits at this point in time.
With or without the label change, they should know all about it.
They simply do not want to prescribe it for reasons other than not knowing... and this is what's important for management to accept.
If they accept it then they will change their strategy.
Mike keeps saying "promotionally responsive" but pointing towards doctors and reps does not make sense to me. Who would stop prescribing a medication after witnessing it works better for their patients because a rep did not visit them for a few weeks and why? Are they waiting for a free lunch?
Is MNKD going to waist another year before realizing that it's patients that will drive sales, not sales reps?
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Post by sportsrancho on Mar 22, 2018 14:57:31 GMT -5
Mike keeps saying "promotionally responsive" but pointing towards doctors and reps does not make sense to me. Who would stop prescribing a medication after witnessing it works better for their patients because a rep did not visit them for a few weeks and why? Are they waiting for a free lunch?
Is MNKD going to waist another year before realizing that it's patients that will drive sales, not sales reps?
——————-
You know I agree with that, but I don’t agree with the first part of the post because I’ve met too many people, and I know too many people, that have asked their doctors and the doctors don’t have a clue. Or they think it was the bong. Just ask Hillard:-)
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Post by buyitonsale on Mar 22, 2018 15:37:16 GMT -5
Mike keeps saying "promotionally responsive" but pointing towards doctors and reps does not make sense to me. Who would stop prescribing a medication after witnessing it works better for their patients because a rep did not visit them for a few weeks and why? Are they waiting for a free lunch? Is MNKD going to waist another year before realizing that it's patients that will drive sales, not sales reps? ——————- You know I agree with that, but I don’t agree with the first part of the post because I’ve met too many people, and I know too many people, that have asked their doctors and the doctors don’t have a clue. Or they think it was the bong. Just ask Hillard:-) How can this be explained after at least a year of reps visiting pretty much all endocrinologists in their respective territories? After 3 years of being promoted at ADA? I believe that patients do not know, but professionals? The drug was approved in 2014 but doctors who treat diabetes do not know of Afrezza in 2018? Those particular doctors you speak of must be either completely disinterested in their own field...or they pretend not to know because of other reasons... In any case, my main point is that promoting Afrezza to specialists does not seem to work and management should shift their efforts to either PCPs or do more DTC advertising. |
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Post by peppy on Mar 22, 2018 15:45:18 GMT -5
Mike keeps saying "promotionally responsive" but pointing towards doctors and reps does not make sense to me. Who would stop prescribing a medication after witnessing it works better for their patients because a rep did not visit them for a few weeks and why? Are they waiting for a free lunch? Is MNKD going to waist another year before realizing that it's patients that will drive sales, not sales reps? ——————- You know I agree with that, but I don’t agree with the first part of the post because I’ve met too many people, and I know too many people, that have asked their doctors and the doctors don’t have a clue. Or they think it was the bong. Just ask Hillard:-)
After 3 years of being promoted at ADA? I believe that patients do not know, but professionals? The drug was approved in 2014 but doctors who treat diabetes do not know of Afrezza in 2018? Those particular doctors you speak of must be either completely disinterested in their own field...or they pretend not to know because of other reasons... keep going, explain it. please.  |
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