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Post by stevil on Apr 5, 2016 12:32:53 GMT -5
So nothing was said about any kind of financial settlement?
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Post by stevil on Apr 4, 2016 15:20:28 GMT -5
Call me an optimistic. You have to wonder about the deal. If cash was offered and for some reason this current deal was better, I would highly doubt cash is a problem. Could be wrong. But also SO many possibilities in terms of Afrezza moving forward. International partner. Increased RX. Further Cricket deals. Until I see current weekly Rxs go to zero I will remain loyal and belief in MNKD. THERE ARE to MANY possible good outcomes to have an attitude like yours. Again, call me an optimistic! I'm a bit on the skeptical side, though I would love for you to be right. Here is why I am skeptical: First argument: the deal was better with no cash offered. I tended to believe the same when Sanofi "only" offered USD 150m in upfront cash for Afrezza - that somehow the profit sharing led to a higher "best-case" outcome for MNKD given the milestones and the 65:35 profit sharing. We all know that upfront cash would have been the better choice and might have committed Sanofi more strongly. I know from M&A negotiations from my day-time job that upfront cash is very important and often involves the toughest negotiations, whereas milestones are usually a way to save face for both parties and bridge some sort of valuation disagreement in a friendly way. So bottom line: no upfront payment for TS is a negative. MNKD really needs cash very urgently. Not just my interpretation. Matt has said it, it's all over the 10-K, it is clear as daylight. Given how difficult the current situation is, MNKD should be prepared to give up some long-term gain for short-term survivability (=cash). You must be new here. Let me be the first to welcome you to Proboards.
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Post by stevil on Apr 4, 2016 0:34:35 GMT -5
Boom. Compromise.
Lower the price in the states that have insulin exclusivity deals already in place and keep the prices high in states that don't.
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Post by stevil on Apr 3, 2016 20:39:19 GMT -5
So, to be clear. The card caps the cost for a prescription at $30. Your solution has it at $41 and uncapped. Therefore reducing the cost only benefits the PBMs and insurers since they are the ones who pick up the difference. Sell them Afrezza at $41 or $141 it still costs the user $30 with a card so all you are doing is giving away margin (to the PBMs). Hmm, but giving the insurance companies a bit more savings would mean Afrezza moved to a preferred tier and more scripts written with co-pays equal to the competition. Wouldn't that be nice to have a even playing field? Lowering the price for both insurance companies and patients is beneficial to everyone. And people who say why worry about the margins the insurance companies make money, need to readjust their socialist liberal thinking, since we are in a capitalistic society everyone wants to make and is entitled to make a profit for their work. What would you say if MNKD wanted to make a profit for their work? One drug isn't going to cut too much into an insurance company's margins. If it does, they just raise their rates the following year to make up for it. You can still undercut the competition's co-pays by pricing the drug at the same price as the competition. Every manufacturer makes a contract with each insurance company to sell one unit for x amount. That amount can vary depending on who the insurance company is and what they agree to. Some insurers want to ensure better coverage so they are a little less picky when it comes to how much they will pay for an item. But you get what you pay for, so the premiums for those plans are higher. The cost gets passed down to the client. Insurance companies have very complex but accurate algorithms that let them know how much money it will take to cover all of their clients. Then they divide that number by how many clients they have and charge that amount per person on the plan. Anyway, what I'm getting at is that you don't have to save the insurance company money. You don't have to cut off your nose to spite your face. MNKD can charge competitive pricing for Afrezza to get good tier placement. They don't need to give the house away in order to do it. If they price Afrezza competitively, they will allow their patients to pay the same copays as those who are on the other prandials. That's where the insurance cards come in. MNKD would pay the patient's copay to whatever pharmacy the patient decides to get the script filled. MNKD could recoup full money from the insurance and only miss out on whatever the copay is for that individual person. That way, they make the full amount and still undercut their competition. The insurance companies will make sure they get theirs. And you don't want them to be the ones that profit anyway. All they do with their profits are spread the wealth to their executives and shareholders. They don't ever lower their rates if they overcharged the previous year. So the amount of people you benefit are much smaller when the insurance company "wins". Help the people. Help the drug company that helps people (in this case MNKD, not always). Screw the insurance companies whenever you can... Even the drug companies can shift money around for more R&D to make better drugs in the future. It's never a good thing when an insurance company has a surplus... Sorry, getting off topic...
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Post by stevil on Apr 3, 2016 17:32:49 GMT -5
Spiro thinks if MNKD makes Afrezza $125 or so per month, that it will start flying off the shelves and who cares about insurance. There are millions of diabetics who will try it out of pocket at that cost. Just ask joeypotsandpans about that. At $125/month, insurance coverage will expand dramatically within 12 months. MNKD needs to just drop the price and get the word out and forget about a discount card. Spiro here, one of the lucky Type 2 diabetics using Afrezza, or should he say, one of the self proclaimed smart enough diabetic to use Afrezza. I'm not sure what the angst is against using discount cards? If MNKD were really smart, they'd dispense pre-filled scripts to the docs with just the sig missing that had a discount card attached to the script, or maybe even printed on the back. This is a tactic used by Suprep- a bowel prep compound used for colonoscopies. The active ingredient is basically the same thing as what's in Miralax, only with added Magnesium. But the cost for it is probably at least 5x as much, simply because instead of drinking a gallon of the nasty stuff, you only have to drink either 1-2 liters, 2-4 times less (my memory is failing me at the moment). They get around the increased cost by giving docs pre-filled scripts and discount cards. If people can pay the same price and drink 2-4 times less of the nasty solution, they'll choose the better option. It's not hard for a patient to hand the pharmacy either a stapled piece of paper or 2 separate pieces of paper. They have to hand something to the pharmacy anyway. Might as well lower the cost for the patients to free and then $30 thereafter (and keep the extra money from the insurance) rather than charging their patients more and recouping less... I don't think people would mind saving $95/month (using the $30/month max copay as an example) just by handing in an extra piece of paper. I'd do that all day long if I could. I'm sure you know just as well or better than anyone that dosing varies. You shouldn't have flat rates. Some people will need more than one pack and a combination of 2-3 strengths. Insurance is our friend in this instance. MNKD just needs to make more contracts to get added to the formularies. Discount cards are good for MNKD and better for the patients.
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Post by stevil on Apr 3, 2016 17:05:56 GMT -5
I think this is new today 3 April, at least it shows as new within 24 hours on google. At www.findacode.com/ndc/drugs/Afrezza Afrezza is listed as having National Drug Codes which state Mannkind as the Labeller, with separate codes for the Sanofi labelled product. I assume thats expected with the imminent handover back to Mannkind. However Im not sure of the signifcance, if any, of Mannkind having 5 listed drug codes while Sanofi have only 4 for afrezza. Curious whether that might mean eg a new dose cartridge capacity or pack size? Without a subscription to that site no way to tell. NB the official FDA database which ought to show these codes does not give hits for these, at www.accessdata.fda.gov/scripts/cder/ndc/default.cfm but there is a nitice on their site saying "FDA IT has discovered a processing error affecting the NDC Directory. We have reverted back to the version of the Directory dated 3/18/2016 until the issue is resolved.". Using that site I dont get any hits at all for Afrezza or Mannkind so presumably technical issue. www.drugs.com/ndc.htmlhere's a tool to help explain NDC codes. It looks like it's probably a new strength. The last 2 digits (left off from the info you provided), the "package code" is the quantity. So it's not a different quantity, as that would not change the first 2 groups of numbers. It's either a different formulation (unlikely) or a different strength (most likely). Edit: I don't know the legitimacy of the link you provided with the 5 NDC codes, but it could maybe be the oral tab someone was talking about earlier on here... That would be interesting... It seems like that would have to be FDA approved first though and we'd have heard about that by now...
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Post by stevil on Apr 3, 2016 16:03:09 GMT -5
Either I'm not understanding what you're saying or you don't understand how insurance coverage works...
If you price it at 35% of $161, or x amount of dollars... as long as the cost of the medication is more expensive than the copay, the patient will not enjoy any savings. The drug could cost $83,457,048 and if their copay is $30, they'd still pay $30. If the drug cost $30.01 and the copay was $30, the patient would still pay $30.
What agedhippie has been saying is that you're not saving the patients money by reducing the cost of the drug. You'd only be saving the patients without insurance, of which there aren't many (or weren't when I was in the pharmacy). Most importantly, you'd mostly only be saving the insurance companies money by reducing the cost of the medication- to the detriment of MNKD.
I'd suspect with Obamacare having no exclusions for previous conditions, the vast majority of diabetics would have insurance. So you'd only be helping the cash paying patients as well as those trying to hit their deductible, or those lucky enough to be in the doughnut-hole- the gap in coverage between hitting your first tier of coverage and then hitting the maximum out of pocket portion. These are generally only found in medicare coverages.
So if you're saying to reduce the cost of the medication to gain better insurance coverage, I think that's what Matt has been stating he'd be doing. Lowering the cost even one cent below what would be necessary to gain coverage likely wouldn't be very advantageous for us as a company.
I'll admit that the landscape may have changed since I was last in the pharmacy. Medicare didn't use to allow discount cards to be applied to their customers. Also, the way insurance plans are structured now, it's possible that the deductible is so high that reducing the price of the drug might be better for those trying to reach it. But according to when I was last in the pharmacy- a couple years ago, the majority of our customers had tiered copays. Discount cards are better for the company (and most patients) than lowering the cost of the medication for better tier placement. We just need to be really good about supplying docs with stacks of discount cards so that everyone who gets prescribed Afrezza gets a discount card.
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Post by stevil on Apr 3, 2016 14:26:16 GMT -5
Think of how it looks from the other side, Stevil. Have you ever held a short position when the tide changes and you can't see a reason the price won't keep rising. It's a rather uncomfortable feeling. From my perspective, the number of shares is not important; it's the number of shares that are short and the number available to cover that matter. It would seem the former is large, the latter is small (based on recent borrowing charges) and things could get interesting. The stock price could also just melt up or melt down if there is no compelling news. We'll find out soon enough. I'm not disagreeing with you necessarily. I guess I see how it's possible, but with that many shares, there would have to be a ton of buyers to cause such a squeeze. I don't think shorts would cover unless their shares got called in. They'd know that any quick influx in price would likely be the worst time to cover, as the price would probably come down just a bit from those taking profits. Especially with a stock like this that seems to have an incredible amount of traders instead of investors. I guess it's silly to discuss it... You said it best- we'll find out soon enough.
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Post by stevil on Apr 3, 2016 12:24:24 GMT -5
Have we not diluted ourselves out of a short squeeze? I realize that we were just at $7 a share less than 12 months ago, but with roughly 400 million shares, is it not expecting too much to have a short squeeze? Sure, we see TSLA and AMZN and NFLX increase by billions of dollars in a day, but is it reasonable to expect MNKD to raise more than a couple billion dollars in value in a day?
I haven't been around this stock as long as some of you have. I've not seen how easily it can move upwards.
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Post by stevil on Mar 29, 2016 23:35:53 GMT -5
I'm sorry, but if we're grasping at straws like Twitter & FB as a way forward then I'm still PRAYING that all of this, the job openings, Vdex, RLS, ALL OF IT, are just a bluff to negotiate a coming buy out.... And I mean PRAYING! The awareness of Afrezza is ZERO!!!!! Ins reps, endos, pharmisist... NO ONE has a clue.... To think a company like MNKD, is going to take on BP, who's trying to kill it, ALONE, on bankruptcy's door step, using Twitter & FB, is absolutely delusional!!!!!! All we need from Vdex and RLS is for those to help provide a runway for us to launch Afrezza. I can't remember if Matt said they've shut down R&D for a little while... makes sense to do so even if he didn't as they've gotten a little ahead of themselves in creating products that don't have any demand yet. This board talks out of both sides of their mouth when they now say that docs are aware of Afrezza... I'll leave that comment alone... but there is reason to believe that MNKD still has a chance going forward with insurance prices *hopefully* decreasing as tier placement improves. As I said in another thread, it wouldn't surprise me if docs aren't that impressed with a more rapid insulin. Whenever a drug can mimic the body's natural physiology, one should take notice. However, I wouldn't be surprised if the sentiment was "what you're on is good enough but if you want to spend $X more, you can have a product that hasn't really proven to be superior." I saw it all the time when I worked in the pharmacy. Especially when it came to gout. Brand name drugs were sometimes 10x more money than the cheaper generics and people opted for the generics that didn't work near as well (but worked adequately) just because they couldn't afford to pay that kind of money for medication. As I'm sure you're aware, diabetes is an expensive disease. It might just be that patients couldn't afford the increased copay, or didn't view it as a worthwhile investment. It's unfortunate that we launched without the correct label. My biggest fear now is that docs will ignore us because of a "been there, done that" attitude. I really think that better data from clinical trials will be the impetus that pushes us to blockbuster status. That, coupled with cheaper pricing, will catapult us forward. We saw it with Lipitor. It worked better than all the other statins in its class, but it was soooo much more expensive when it first came out, especially with all the other statins going generic shortly after it came out. Once data from trials came out that showed it was far superior than the other drugs in its class, doctors only prescribed for it. What good physician would recommend an inferior medicine to their patient? If Afrezza can prove its worth to both patients and doctors alike, there's no telling how much money it will make. If it doesn't prove its worth, then it wasn't really worth investing in anyway. Matt P said insurance will get taken care of, hopefully trials are in the works to prove superiority to give us a better label. Marketing a superior product shouldn't require a ton of money. It should be so effective that the ROI will bolster further marketing. It might take us longer than we'd like to get there, but make no mistake, getting additional funding from Vdex and RLS will only be a good thing for us.... as long as we have the data to back us up... I'm in the camp of not wanting to be bought out. We won't get anywhere near what we're worth right now. We still have latent potential that needs just a few more variables to be solved before I'm willing to throw in the towel.
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Post by stevil on Mar 29, 2016 20:29:40 GMT -5
Doctors don't use Twitter or Facebook to learn about new drugs. Use them to learn of a drug? No. Stumble upon it on social media and go and do their own research? Yes. I'm not there yet, but I think it just depends on the kind of person the doctor is as well as the kind of information presented through social media. If the information is more scientific and appeals to "reason", I'd say it'd have a higher chance of being investigated by a physician. I'm quickly learning that the things I value now hold a much higher significance than they used to now that I have much less time to waste. I'm not sure if that will ever change until I retire. Physicians are very busy people and live demanding lifestyles. And then they go home to a new world with new demands if they have spouses and/or children. You'd be surprised about how many wives' tales and other nonsense floats out there on the internet. Some docs may have their interest piqued, some may view it as a waste of time and avoid it because it's not from a reputable source. I don't think it'd hurt, though. Definitely wouldn't rely on it to be super effective.
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Post by stevil on Mar 29, 2016 20:23:15 GMT -5
... and watch the diabetics head in the other direction. Nobody likes being blatantly sold to, especially when it's because they have a medical condition. Let's not alienate the people. What? ? agedhippie is saying that targeting diabetics is reducing them to "customers" rather than human beings with a disease. I still think it'd be cool if more people like Matt from Australia made videos targeting "the people" with an exciting opportunity to help them. Don't have to sell them anything, just share amazing results and the freedom that it could bring through better health.
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Post by stevil on Mar 23, 2016 14:15:28 GMT -5
Are you saying that for NJ or across the board? Because in my state, physicians don't have to sign off or even be present for the P.As to practice. They only have to communicate once a week to show oversight. All they need to prescribe is the supervising's name on the script, which is usually printed at the top under their (PAs) name.
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Post by stevil on Mar 23, 2016 14:06:41 GMT -5
One other thing I forgot to mention- Google is in the business of data mining and collection. If there was ever a company to partner with to have the most cost-effective marketing due to enhanced targeting, Google would be the one. I'm sure this isn't news to many but it would be nice for MNKD management to even approach Google with some sort of deal so that they can stretch their marketing dollars farther. Although I'm not sure if Google would listen to a small company like us... We can dream, right?
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Post by stevil on Mar 23, 2016 12:18:49 GMT -5
So let's say all of these people and companies are associated with RSL. How does that actually help Mannkind in any way other than the deal they just signed that so far has not created one red cent for the company? I'd say knowing who the RLS backers are would help only in terms of the market's sentiment of the value of Technosphere. I'm not a supporter of the Google/Verily/Dex theory, but let's use that as an example. If it were to become publicly known that Verily has an interest in MannKind's technology, I think you might see a jump in MNKD share price for two reasons:
1. A partner with financial muscle increases the likelihood that they will develop the drug(s), pay for FDA trials and eventually bring the drug(s) to market.
2. A big player, by showing interest in a technology - in this case Technosphere - tends to validate the technology in the eyes of investors. People would think, "Hmmm...what does Google see that I don't see?" The perception that Google (Verily) only deals in projects that are likely to be HUGE would be an enticement to buy shares of MNKD. Investors would be assuming that Verily has done their due diligence and if it's good enough for them... well, you know the rest.
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I don't think that point 1 can be overstated. Google has one of the biggest backings of any company in the world, I think second only to Apple if I remember correctly. Not only that, but they're not in it for the short term- to point 2. If Google gets involved, they are going to dump loads of money into whatever company they partner with. And so far, Google hasn't had many misses. They also go out of their way to care for their young, meaning that they will advertise for it over their vast sphere of influence- browser ads in Chrome, YouTube ads, etc. I also don't yet believe that Google is involved, but if they are, it will be very, very big news.
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