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Post by golfeveryday on May 21, 2018 19:36:00 GMT -5
You could be right about STAT but the word is that MannKind's late-breaking poster at ADA2018 will show a significant reduction of severe hypo events. That would mean less of those costly EMT and emergency room visits. That has direct and short-term cost benefits to insurers and would capture their attention, IMHO. do I hear label change? |
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Post by mannmade on May 21, 2018 19:53:07 GMT -5
While in the past we might have said I think we can, I think we can...,(to paraphase the title of this thread) today I am confident enough to say I know we can, I know we can... It occurred to me while attending the ASM, that It is really only within the last six months imho, with the advent of certain specific events having taken place, that I finally feel after all these years, comfortable saying with a high degree of confidence as never before, that we will see Afrezza successfully be adoptied as the standard of care. With the benefit of hindsight, I would have to say the battle may have been too tough given the entrenced interests that seem to pervade the diabetes care market. However, now "the train is definately leaving the station" and will not be looking back for much longer imho... 1. FDA rules that CGM's can now be used for dosing guidance of insulin This makes TIR a more prominent story as real time dosing and management are now at the forefront of the diabetes care discussion, with the records to prove it as Peppy so likes to point out.  And this means that Mnkd has new and valuable allies in this discussion who can do lots of the heavy lifting to promote this change in discussion from Hba1c to TIR in Dexcom, Abbott, etc... 2. ADA announces that it will now consider review of the Standard of Care as an on-going year round dialouge instead of once a year updates Instead of a once a year update the ADA will now look at the SOC year round enabling more robust conversations and a constant dialouge that should support the findings that come out of the records from #1 above. 3. Hiring of Dr. K by mnkd. And who better to interpret items 1 and 2 abive and introduce Afrezza into the conversation as the best option to facilate TIR, both because of it's best in class effectivieness (PK/PD profile) and ease of use. Dr. K without items 1 & 2 does not work so well and items 1 & 2 without Dr. K do not work so well either imho, but together they provide both the fuel and the conductor that can get this done... While I agree with others on this board that the stat study results to be revealed at the coming ADA meeting are not likely to have an immediate effect on Afrezza sales, the results when announced will begin to lay an important part of the train track that enables Afrezza to move forward on it's journey and take us all along for the ride while helping pwd lead a longer and heaalthier life... GLTAPWD and GLTAL's... |
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Post by mango on May 21, 2018 22:03:44 GMT -5
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Post by Deleted on May 22, 2018 10:44:06 GMT -5
That’s what the word on the street is...I’m hearing second half of the year. ( 2H ) What mnholdem posted right above you is also the word on the street! Thanks. Sorry MN, missed your thoughts right in front of me. Immediate financial gratification for insurance companies should do it. |
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Post by dreamboatcruise on May 22, 2018 13:48:30 GMT -5
That’s what the word on the street is...I’m hearing second half of the year. ( 2H ) What mnholdem posted right above you is also the word on the street! Of course I cannot remember a time since FDA approval that if polled people here (and on whatever street that is) would not have said revenue were going to take off in a 6 to 9 month period. Is the word on the street that "significant growth" is merely enough to eek out lower end of rev guidance, or something much more dramatic? |
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Post by mnholdem on May 22, 2018 14:21:22 GMT -5
Seems to me, before you butted in, that we were talking about how presentations at ADA2018 could positively affect insurer coverage.
But you've only changed the course of the discussion to the next step in the progression. Improved adoption by endos and payers should lead to sales growth.
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Post by dreamboatcruise on May 22, 2018 14:30:58 GMT -5
I've written about my views on that several times. I did some digging for the board, probably no more than a week ago, and came up with some papers looking at time in range and at PPG spikes and cardiovascular complications that I think could be important in tying STAT results to improved clinical outcomes. Perhaps you didn't see when I butted in with that.
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Post by mnholdem on May 22, 2018 14:45:00 GMT -5
I did. I read every post. My comment above was not about STAT but rather the late-breaking poster. I thought you were attempting to hijack the discussion with your reply to Sports' post. Sorry.
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Post by joeypotsandpans on May 22, 2018 15:05:16 GMT -5
I did. I read every post. My comment above was not about STAT but rather the late-breaking poster. I thought you were attempting to hijack the discussion with your reply to Sports' post. Sorry. Speaking of late breaking posters accepted by the ADA, did you know that according to Dr. Kendall they only accept approx. 10% of those late breaking submissiions, which to me says they were impressed enough by the reduced hypo's when compared to aspart numbers that they thought it was 90% more important then the other submissions.  |
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Post by babaoriley on May 22, 2018 15:10:30 GMT -5
I did. I read every post. My comment above was not about STAT but rather the late-breaking poster. I thought you were attempting to hijack the discussion with your reply to Sports' post. Sorry. Speaking of late breaking posters accepted by the ADA, did you know that according to Dr. Kendall they only accept approx. 10% of those late breaking submissiions, which to me says they were impressed enough by the reduced hypo's when compared to aspart numbers that they thought it was 90% more important then the other submissions. I heard the doc say that, Joey, and you mean they don't do it strictly by lot, but by merit?
Gotta love a 7 game series in the East!!!! Hope they continue to pound each other!
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Post by bill on May 22, 2018 16:12:16 GMT -5
That’s what the word on the street is...I’m hearing second half of the year. ( 2H ) What mnholdem posted right above you is also the word on the street! Thanks. Sorry MN, missed your thoughts right in front of me. Immediate financial gratification for insurance companies should do it. @scotta @sportsrancho Based on some DMs with Mike C. I've come to understand that there are two halves to the insurance companies. My interpretation of those DMs are that one half handles the fees and payments, and the other handles the drug coverage, pricing, and rebates. It seems the part of the insurance company we want to change is the one that handles drug coverage, but the part where we save the insurance companies money is the half that handles the payments. The two halves have their own profit / loss metrics and our trying to obtain change from the drug coverage half by saving the payments portion money has not worked and may not ever work if that's actually how things work. Instead, our best hope may be to get the Standard of Care changed. When Dr. K starts using words like barbaric in his presentations, folks might actually start to listen. |
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Post by mango on May 22, 2018 16:42:43 GMT -5
Thanks. Sorry MN, missed your thoughts right in front of me. Immediate financial gratification for insurance companies should do it. @scotta @sportsrancho Based on some DMs with Mike C. I've come to understand that there are two halves to the insurance companies. My interpretation of those DMs are that one half handles the fees and payments, and the other handles the drug coverage, pricing, and rebates. It seems the part of the insurance company we want to change is the one that handles drug coverage, but the part where we save the insurance companies money is the half that handles the payments. The two halves have their own profit / loss metrics and our trying to obtain change from the drug coverage half by saving the payments portion money has not worked and may not ever work if that's actually how things work. Instead, our best hope may be to get the Standard of Care changed. When Dr. K starts using words like barbaric in his presentations, folks might actually start to listen. This video is good therapy. |
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Post by dreamboatcruise on May 22, 2018 17:19:14 GMT -5
Thanks. Sorry MN, missed your thoughts right in front of me. Immediate financial gratification for insurance companies should do it. @scotta @sportsrancho Based on some DMs with Mike C. I've come to understand that there are two halves to the insurance companies. My interpretation of those DMs are that one half handles the fees and payments, and the other handles the drug coverage, pricing, and rebates. It seems the part of the insurance company we want to change is the one that handles drug coverage, but the part where we save the insurance companies money is the half that handles the payments. The two halves have their own profit / loss metrics and our trying to obtain change from the drug coverage half by saving the payments portion money has not worked and may not ever work if that's actually how things work. Instead, our best hope may be to get the Standard of Care changed. When Dr. K starts using words like barbaric in his presentations, folks might actually start to listen. There are more than one model and a lot of complications, but you're referring to the difference between the health plan organization and the Pharmacy Benefit Manager (PBM). We wen't through a whole wave in the industry where health plan organizations outsourced the pharmacy benefit management to 3rd party companies. Now some health plan insurers are (or considering) bringing it in house again. The model of having independent PBMs certainly did not result in the cost savings they claimed was their raison d'etre. From a consumer standpoint it looks an awful lot like a total scam. |
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Post by bill on May 22, 2018 19:03:33 GMT -5
@scotta @sportsrancho Based on some DMs with Mike C. I've come to understand that there are two halves to the insurance companies. My interpretation of those DMs are that one half handles the fees and payments, and the other handles the drug coverage, pricing, and rebates. It seems the part of the insurance company we want to change is the one that handles drug coverage, but the part where we save the insurance companies money is the half that handles the payments. The two halves have their own profit / loss metrics and our trying to obtain change from the drug coverage half by saving the payments portion money has not worked and may not ever work if that's actually how things work. Instead, our best hope may be to get the Standard of Care changed. When Dr. K starts using words like barbaric in his presentations, folks might actually start to listen. There are more than one model and a lot of complications, but you're referring to the difference between the health plan organization and the Pharmacy Benefit Manager (PBM). We wen't through a whole wave in the industry where health plan organizations outsourced the pharmacy benefit management to 3rd party companies. Now some health plan insurers are (or considering) bringing it in house again. The model of having independent PBMs certainly did not result in the cost savings they claimed was their raison d'etre. From a consumer standpoint it looks an awful lot like a total scam. Your comment is more precise than mine. Afrezza will save insurance companies lots of money by avoiding a whole host of diabetes-related costs, but the 3rd party PBMs who control access to Afrezza don't care because they make their money on drug discounts and rebates. Duh... I'd hadn't realized that most PBMs are third parties that have little incentive to support a drug like Afrezza that saves their insurance company employers money, but doesn't generate any meaningful revenues for them. I'm not sure MNKD can win that battle. Afrezza has nothing to offer PBMs... Sigh... |
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Post by liane on May 22, 2018 19:21:02 GMT -5
bill - Maybe that's why MNKD has kept the list price of Afrezza so high - so that they can rebate money to PBM's. I think Mike knows the game he must play to get widespread insurance coverage. Unfortunately, it screws the cash-paying patients.
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And this means that Mnkd has new and valuable allies in this discussion who can do lots of the heavy lifting to promote this change in discussion from Hba1c to TIR in Dexcom, Abbott, etc...
