My Story

[ppallap]

Hello Everyone,

I follow this board in read only mode and I am a long MNKD for more than 10 years now. I strongly believe in the potential of the drug and hence never sold the stock, only bought (Yeah, I am an idiot)
In fact bought a lot  above $10 a share, pre-split. I really expected this break through technology to take off and help many diabetics like me and also make some money as an investor.

I have been diabetic for the last 18 years and still managing on Metformin and Januvia. Finally last week my PCP suggested me to move to insulin since my A1C (7.9) no longer can be controlled through pills.
I was immediately exited and asked her about Afrezza. She immediately denied with the following reasons:

1) Insurance does not pay since its expensive (I live in California and carry CIGNA OAP insurance)
2) We need to bring endo on board with us to prescribe Afrezza.
3) Afrezza is really prescribed if you really need high doses of insulin. 


I am confused. Are these restrictions really true ? Did anyone face this situation ? Is this one of the reason why Afrezza is not flying off the shelves ?

Thanks.

[babaoriley]

Mar 26, 2018 16:18:25 GMT -5 ppallap said:

Hello Everyone,

I follow this board in read only mode and I am a long MNKD for more than 10 years now. I strongly believe in the potential of the drug and hence never sold the stock, only bought (Yeah, I am an idiot)
In fact bought a lot  above $10 a share, pre-split. I really expected this break through technology to take off and help many diabetics like me and also make some money as an investor.

I have been diabetic for the last 18 years and still managing on Metformin and Januvia. Finally last week my PCP suggested me to move to insulin since my A1C (7.9) no longer can be controlled through pills.
I was immediately exited and asked her about Afrezza. She immediately denied with the following reasons:

1) Insurance does not pay since its expensive (I live in California and carry CIGNA OAP insurance)
2) We need to bring endo on board with us to prescribe Afrezza.
3) Afrezza is really prescribed if you really need high doses of insulin. 


I am confused. Are these restrictions really true ? Did anyone face this situation ? Is this one of the reason why Afrezza is not flying off the shelves ?

Thanks.

Your point 3, did you mean "really" or "rarely?"  If you've read this board, I think you get the sense that your type of experience has been shared by many.  Your point 2 is incorrect, any fly by night MD can prescribe Afrezza.  Your number 1, IMO, is public enemy number 1.  I think you'll get some excellent advice on how to proceed from the regular posters.

[akemp3000]

Suggest contacting Afrezza directly or Vdex in California for some better guidance on insurance, prescriptions...and new doctors.

[centralcoastinvestor]

Mar 26, 2018 16:18:25 GMT -5 ppallap said:

Hello Everyone,

I follow this board in read only mode and I am a long MNKD for more than 10 years now. I strongly believe in the potential of the drug and hence never sold the stock, only bought (Yeah, I am an idiot)
In fact bought a lot  above $10 a share, pre-split. I really expected this break through technology to take off and help many diabetics like me and also make some money as an investor.

I have been diabetic for the last 18 years and still managing on Metformin and Januvia. Finally last week my PCP suggested me to move to insulin since my A1C (7.9) no longer can be controlled through pills.
I was immediately exited and asked her about Afrezza. She immediately denied with the following reasons:

1) Insurance does not pay since its expensive (I live in California and carry CIGNA OAP insurance)
2) We need to bring endo on board with us to prescribe Afrezza.
3) Afrezza is really prescribed if you really need high doses of insulin. 


I am confused. Are these restrictions really true ? Did anyone face this situation ? Is this one of the reason why Afrezza is not flying off the shelves ?

Thanks.

I would contact MannKind Cares directly.  See website below.

afrezza.aspnprograms.com/

The next time you talk with your PCP it will help to have ample information to counter the reasons listed by your PCP.  MannKind can also answer insurance questions as well.

[sportsrancho]

None of them are true, get a new doctor.
My clients kids were prescribed Afrezza for a year off label by a PCP.
Their next prescription was from an Endo, pediatric in California.
HealthNet insurance, co-pay $60 a month.
Both T1...4 unit snacks..8 meals. 12 for pizza:-)

[mannmade]

Look up the prescribing doctors on the Mannkind cares web site for one in your area.

[sportsrancho]

[peppy]

Mar 26, 2018 16:18:25 GMT -5 ppallap said:

Hello Everyone,

I follow this board in read only mode and I am a long MNKD for more than 10 years now. I strongly believe in the potential of the drug and hence never sold the stock, only bought (Yeah, I am an idiot)
In fact bought a lot  above $10 a share, pre-split. I really expected this break through technology to take off and help many diabetics like me and also make some money as an investor.

I have been diabetic for the last 18 years and still managing on Metformin and Januvia. Finally last week my PCP suggested me to move to insulin since my A1C (7.9) no longer can be controlled through pills.
I was immediately exited and asked her about Afrezza. She immediately denied with the following reasons:

1) Insurance does not pay since its expensive (I live in California and carry CIGNA OAP insurance)
2) We need to bring endo on board with us to prescribe Afrezza.
3) Afrezza is really prescribed if you really need high doses of insulin. 


I am confused. Are these restrictions really true ? Did anyone face this situation ? Is this one of the reason why Afrezza is not flying off the shelves ?

Thanks.

Quote: 1) Insurance does not pay since its expensive (I live in California and carry CIGNA OAP insurance)
2) We need to bring endo on board with us to prescribe Afrezza.
3) Afrezza is really prescribed if you really need high doses of insulin.

Reply: Physicians say anything they want when they do not want to? hmmm
Alternative facts?
Lyin SOB?

[ppallap]

Thanks for the responses. I will follow up with afrezza.aspnprograms.com/

[tingtongtung]

Mar 26, 2018 17:01:47 GMT -5 sportsrancho said:

None of them are true, get a new doctor.
My clients kids were prescribed Afrezza for a year off label by a PCP.
Their next prescription was from an Endo, pediatric in California.
HealthNet insurance, co-pay $60 a month.
Both T1...4 unit snacks..8 meals. 12 for pizza:-)

Are you generalizing about dosage?

Is that dosage set in stone? What are the variables?
* Age, weight of kids
* Snack type, contents, size
* Meal type, contents, size
* Pizza type, contents, size
* Any other variables...
* I dont know much about T1/T2. These dose doesn't cause hypo/hyper for them?

If dosage were really that easy, may be you should inform Mike and Vdex. Doctors should have no excuse to prescribe, patients should have no confusion/worries while taking.

I just don't understand why it's taking forever to see a continuous ramp with Afrezza. May be it's not pharma, but the doctors (inertia, lack of continuous learning, ...)  May be MNKD should go all in with ads rather than hiring sales people? :-)

[sportsrancho]

No it’s not set in stone, but that’s the point, you don’t have to count carbs you can be spontaneous. Eat what you want. No lows. Before Afrezza the family had many trips to the ER in the middle of the night with their daughter. It’s life changing. Kids figure it out. And now they have a CGM and a One Drop and the app.
Mike knows. They were the first kids on Afrezza. Also the son has never had to take mealtime shots since he was diagnosed after Afrezza was available. He’s the new generation:-) except for one shot a day he’s free!

[sayhey24]

tingtongtung- Dosage really is that easy for the T2 using only afrezza. Thats what the 118 study was all about. Dr Kendall now has it. Doctors should have no excuse to prescribe, patients should have no confusion/worries while taking. The problem was they were under dosing worrying about hypos. No hypos no worries.

PPallap - I am with Sports your doctor has no idea what she is talking about but she is not alone when it comes to afrezza. I would call the local sales rep and see if you can arrange a meeting assuming the local rep is knowledgeable on antiglycemics and the 9th circuit ruling on Januvia.
www.torhoermanlaw.com/appellate-court-reverses-incretin-lawsuit-case-dismissals/

[peppy]

Mar 26, 2018 18:05:47 GMT -5 tingtongtung said:

Mar 26, 2018 17:01:47 GMT -5 sportsrancho said:

None of them are true, get a new doctor.
My clients kids were prescribed Afrezza for a year off label by a PCP.
Their next prescription was from an Endo, pediatric in California.
HealthNet insurance, co-pay $60 a month.
Both T1...4 unit snacks..8 meals. 12 for pizza:-)

Are you generalizing about dosage?

Is that dosage set in stone? What are the variables?
* Age, weight of kids
* Snack type, contents, size
* Meal type, contents, size
* Pizza type, contents, size
* Any other variables...
* I dont know much about T1/T2. These dose doesn't cause hypo/hyper for them?

If dosage were really that easy, may be you should inform Mike and Vdex. Doctors should have no excuse to prescribe, patients should have no confusion/worries while taking.

I just don't understand why it's taking forever to see a continuous ramp with Afrezza. May be it's not pharma, but the doctors (inertia, lack of continuous learning, ...)  May be MNKD should go all in with ads rather than hiring sales people? :-)

ting ting tong, sports is pretty close. 
dosing:
www.seventhform.com/vdexdownloads/vdex-whitepaper-072817.pdf
page 22.

Comments
Afrezza’s speed of action is both a blessing and a curse. Clearly, it is a large factor in the safety of the
product, but for longer meals, you may need more Afrezza to keep the post prandial levels in check. We
recommend follow-on doses. For example, we advise with a standard meal to dose Afrezza 15-20
minutes after the start of the meal, and then another dose of the same size about 45 minutes later.
With very long meals, we have even advised patients to administer two follow-on doses, for very tight
control.

Read more: mnkd.proboards.com/thread/7878/afrezza-starting-titrating#ixzz5AuDYJsDj

[digger]

Mar 26, 2018 16:18:25 GMT -5 ppallap said:

Hello Everyone,

I follow this board in read only mode and I am a long MNKD for more than 10 years now. I strongly believe in the potential of the drug and hence never sold the stock, only bought (Yeah, I am an idiot)
In fact bought a lot  above $10 a share, pre-split. I really expected this break through technology to take off and help many diabetics like me and also make some money as an investor.

I have been diabetic for the last 18 years and still managing on Metformin and Januvia. Finally last week my PCP suggested me to move to insulin since my A1C (7.9) no longer can be controlled through pills.
I was immediately exited and asked her about Afrezza. She immediately denied with the following reasons:

1) Insurance does not pay since its expensive (I live in California and carry CIGNA OAP insurance)
2) We need to bring endo on board with us to prescribe Afrezza.
3) Afrezza is really prescribed if you really need high doses of insulin. 


I am confused. Are these restrictions really true ? Did anyone face this situation ? Is this one of the reason why Afrezza is not flying off the shelves ?

Thanks.

Presuming you mean rarely and not really, you're doctor is probably referring to type 2s having high insulin resistance and therefore usually require considerably more insulin to control their sugar.

[tiberious]

Mar 26, 2018 16:30:43 GMT -5 babaoriley said:

Mar 26, 2018 16:18:25 GMT -5 ppallap said:

Hello Everyone,

I follow this board in read only mode and I am a long MNKD for more than 10 years now. I strongly believe in the potential of the drug and hence never sold the stock, only bought (Yeah, I am an idiot)
In fact bought a lot  above $10 a share, pre-split. I really expected this break through technology to take off and help many diabetics like me and also make some money as an investor.

I have been diabetic for the last 18 years and still managing on Metformin and Januvia. Finally last week my PCP suggested me to move to insulin since my A1C (7.9) no longer can be controlled through pills.
I was immediately exited and asked her about Afrezza. She immediately denied with the following reasons:

1) Insurance does not pay since its expensive (I live in California and carry CIGNA OAP insurance)
2) We need to bring endo on board with us to prescribe Afrezza.
3) Afrezza is really prescribed if you really need high doses of insulin. 


I am confused. Are these restrictions really true ? Did anyone face this situation ? Is this one of the reason why Afrezza is not flying off the shelves ?

Numero Uno)  Get a new doctor that will prescribe and don't look back.  You are the consumer and you know what is best for you. 

Thanks.

Your point 3, did you mean "really" or "rarely?"  If you've read this board, I think you get the sense that your type of experience has been shared by many.  Your point 2 is incorrect, any fly by night MD can prescribe Afrezza.  Your number 1, IMO, is public enemy number 1.  I think you'll get some excellent advice on how to proceed from the regular posters.