|
Post by stevil on Feb 6, 2016 16:29:55 GMT -5
Sorry if my post sounded kinda "preachy" just in crazy study mode right now and I was excited to share some of what I was learning while also hoping to encourage you to keep on keeping on. Hope I didn't offend you. Best of luck on your health goals!
|
|
|
Post by stevil on Feb 6, 2016 16:10:24 GMT -5
I wonder if they can start negotiating with the insurance companies, based on a future price. That would put them ahead of the game. Insurance companies may not be able to offer coverage until the price changes, but the paperwork would be in place so that they could initiate coverage at the lower price when the time comes (April 5 or later). Anyone know someone who works for an insurance company that offers drug coverage? I don't think mannkind can do anything until Sanofi deal is over. If I am wrong someone correct me. That is what Matt said, however, I wonder how strictly this is enforced. For instance, I wonder if Matt could be in talks with insurance companies and simply ask "what would happen if we lowered the cost to this". Nothing official is being done, but there's still progress. I can't imagine he can't even throw feelers out to get the ball rolling. If so, that's pretty awful.
|
|
|
Post by stevil on Feb 6, 2016 16:01:21 GMT -5
Learning just now about how white adipose tissue can be converted to brown adipose tissue. Supposedly, someone is already working on figuring out the mechanism so they can formulate it into a drug.
The idea behind it is excess glucose gets stored in white fat for storage as fatty acids. There is some kind of adrenergic response in the body that then converts the white fat, storage fat, into brown fat. Brown fat is used predominantly for heat generation. The energy from metabolizing brown fat generates heat, in a term called thermogenesis. So your body essentially burns off all the excess fat and radiates it as heat.
If we could somehow be the first company to figure this out, it would be the greatest selling drug of all time. It would make Viagra look like child's play. (might have been a bad choice of words)
Wish we had more money for R&D to do stuff like this. Not sure if Matt reads this board, but figure out how to do this!
|
|
|
Post by stevil on Feb 6, 2016 15:39:08 GMT -5
Joey,
nature might be working against you my friend, so keep that in mind. I'm learning all about leptin right now- the hormone that gets secreted by adipose tissue... When you lose weight, there is less adipose mass, thus less leptin in the system. Leptin helps suppress appetite and increase your RMR (resting metabolic rate). So it's going to be challenging for you to keep the weight off, both from a psychological standpoint (saying no to your favorite foods that cause dopamine release- ie. happy foods) as well from a biological standpoint- your body no longer is helping you...
But so glad to hear you're getting your health under control. I hope that Afrezza will help you further meet your health goals!
I just got the crazy idea that we should all get our blood work done right after consuming a pack of Sour Patch Kids so we can all have this talk with our physicians!
P.S. It was really cool that the rep was so helpful and compassionate. But also really bizarre that his opinion was such that the drug would fly off the shelves if they matched the price of other RAAs. Seems to conflict with what he said about not believing SNY wasn't holding back. I wonder what the rationale was for keeping the price high if that was the perceived biggest barrier. I know others have stated they thought SNY was sandbagging the whole time, which is highly likely, but I'm wondering if they just thought they needed to have a set price per unit to meet their expectations for some reason. Still don't get why SNY wouldn't just buy Afrezza from us if they really thought that it would fly off the shelves with a better price point...
|
|
|
Post by stevil on Feb 5, 2016 17:49:01 GMT -5
haha at first I thought that that was a really silly (but impractical) idea, but you know what, that might be exactly the kind of stuff that we need. Because it would give us a ton of free pub. It would draw a lot of attention that news outlets would want to cover it and it may even go nationwide.
|
|
|
Post by stevil on Feb 5, 2016 17:29:19 GMT -5
Why the certainty that "the company" will be sold? Seems to me that it's plausible that only Afrezza will be sold, with Technosphere retained for further development. I think if Matt has this option presented to him, and gets a decent valuation for Afrezza, this is probably what he would prefer to do. I don't think anyone at MNKD wants a buyout, and honestly, neither do I as I don't think we'll get anywhere near what we're worth if we have to go that route. I think the best case is to unload Afrezza and hope that it will give us at least 3 more years worth of survival to develop other prospects and reach milestones in our new deal which hopefully could then get us to that 5 year mark.
|
|
|
Post by stevil on Feb 5, 2016 15:54:05 GMT -5
Not only is it expensive, but if I'm remembering correctly, I think they expire fairly quickly. I can't remember if they last 1-2 years. So it would be a huge benefit if we could undercut on price as well as have the benefit of not needing to throw away good medicine simply because it expired.
|
|
|
Post by stevil on Feb 5, 2016 13:15:41 GMT -5
That's not how good business is done though. It's the guys who can swindle their way into the best deals that make the best businessmen. Negotiation skills are what separate the good from the elite in my opinion. Case in point- see Apple and Samsung. They're notorious for screwing their partners. They pay them pennies on margin because they can. Same with Walmart. Their partners don't enjoy the profits. They basically say, we'll give you like $0.03 profit per unit sold. If you don't like it, we'll find someone else who will. MNKD doesn't have that bargaining power right now... Anyway, don't want to argue with you... There may be others waiting in line, but they haven't knocked each other over trying to reach a deal with us. So it's hard to know how much interest, if any, there really is. One would have to assume there either isn't much interest or the sharks have smelled blood in the water for some time and are just circling us waiting for us to go belly up. Just my opinion. different context/scenario I never realized how argumentative I was until I joined this board haha. Go ahead and pm me if you want to keep talking about it. The point I was making is that good business isn't paying full or even fair value for what something is worth. It's about paying as little as possible for it and keeping all the profit for yourself.
|
|
|
Post by stevil on Feb 5, 2016 12:19:00 GMT -5
For any partnership to be worthwhile for us, the milestones would have to reach (just throwing out a number) $500 million or so. So you can put that directly toward the acquisition cost. Throwing out another number of $2billion to acquire it, if milestones reached $500 million worthy, it means the drug was doing well. So they can partner and make 85-90% profit, or they can wait and make 100% for the life of the drug by waiting a little longer. If I was a CEO, I'd wait. unless you are the only one in the line waiting.. I usually tend to pay fair value for what I want with in my means and get done with it rather than waiting. That's not how good business is done though. It's the guys who can swindle their way into the best deals that make the best businessmen. Negotiation skills are what separate the good from the elite in my opinion. Case in point- see Apple and Samsung. They're notorious for screwing their partners. They pay them pennies on margin because they can. Same with Walmart. Their partners don't enjoy the profits. They basically say, we'll give you like $0.03 profit per unit sold. If you don't like it, we'll find someone else who will. MNKD doesn't have that bargaining power right now... Anyway, don't want to argue with you... There may be others waiting in line, but they haven't knocked each other over trying to reach a deal with us. So it's hard to know how much interest, if any, there really is. One would have to assume there either isn't much interest or the sharks have smelled blood in the water for some time and are just circling us waiting for us to go belly up. Just my opinion.
|
|
|
Post by stevil on Feb 5, 2016 11:05:18 GMT -5
I think we're in a precarious position because why would someone partner with us at this point when they could get the whole thing for comparatively pennies on the dollar if we go belly up? I guess it's a game of chicken at this point. Does someone want the sure thing and partner with us or are they going to take their chances that they'll get a sweeter deal by waiting it out? I hate to say it, but we might need to prove we can stand on our own feet before finding more partners. At least for Afrezza. They can partner with us right now for pennies on the dollar with our sp under $1. Why would they risk a potentially higher price at a time in the future if MNKD survives and starts to grow in its own?. Quite a risk to take in order to save very few cents. For any partnership to be worthwhile for us, the milestones would have to reach (just throwing out a number) $500 million or so. So you can put that directly toward the acquisition cost. Throwing out another number of $2billion to acquire it, if milestones reached $500 million worthy, it means the drug was doing well. So they can partner and make 85-90% profit, or they can wait and make 100% for the life of the drug by waiting a little longer. If I was a CEO, I'd wait.
|
|
|
Post by stevil on Feb 4, 2016 20:01:53 GMT -5
I think we're in a precarious position because why would someone partner with us at this point when they could get the whole thing for comparatively pennies on the dollar if we go belly up? I guess it's a game of chicken at this point. Does someone want the sure thing and partner with us or are they going to take their chances that they'll get a sweeter deal by waiting it out? I hate to say it, but we might need to prove we can stand on our own feet before finding more partners. At least for Afrezza.
|
|
|
Post by stevil on Feb 4, 2016 18:16:46 GMT -5
I can see emarketing being really successful in the future, but I'm not sure its time has come yet. I'm not nearly as tech-savvy as some of my classmates. They're able to organize all of their notes onto their ipads. The best I can do is use a stylus to write on mine. Anyway, the reason I see emarketing being successful in the future- even apart from the billions of dollars it would save- is that the younger generations don't want printed paper anymore. It's clutter. Even for the books that I read, I use digital copies. you can use search functions and other handy things... It's just quicker than having to go to an index, thumb through the alphabet, find that page number, go back, you get the point. If there's one thing I've learned since starting medical school it's how to be more efficient in everything that I do. I almost make a game out of cutting corners.Ok, sorry... rambling... So why I think emarketing will be the wave of the future, if done properly, is that it allows physicians to have some control over what they research. They can be given lists of pathologies and click on the ones that interest them and have a whole slew of drugs and their mechanisms pop up. I guess I'm not there yet, but I imagine I'll need a brief refresher on some of the mechanisms when I get to that point. All that information would be accessible right at the hands of the doctor. If the marketing company does it right, they should be able to add visual effects (but nothing elaborate that will waste time or distract) to keep things vivid and interesting. So everything would be in one place as well as allowing the physician to peek at his/her own leisure. I'm pretty sure I'd be more interested in drugs if I had a digital catalogue that had charts and graphs and empirical data that was easy to find and access. I'd want to stay up on the "latest and greatest". Anyway, just my opinion... yes... people are consuming things online or electronically, but that doesn't translate into some miracle new cheap way of marketing drugs. I for one, no longer subscribe to any paper magazines... I read them all on a tablet. To whatever extent I paid attention to ads in the print edition I suppose I now do with the electronic versions... and I suspect the publishers get roughly the same ad revenue based on the number of distributed copies. That isn't some revolution, and really is just a minor tweak to the ad model. Are banner ads going to be the revolutionary emarketing that changes things? I've seen them here. It appears that the site Tudiabetes only uses googleads for placement so presumably Afrezza ads might pop up there occasionally... but even if somehow ads targeting for those kind of sites is improved and shown more often, what percentage of PWD population really participates in those on a regular basis. I would think the articles they've written would have already done about as much for awareness as would be possible with ads. As for as catalogs of drugs for doctors... I believe that already exists as apps for tablets and phones. I'm sure Afrezza is included. I can see where perhaps there is some cost savings to be had via electronic marketing to docs... such as targeting professional endo organizations with webiners vs free lunch talks... but the reason the free lunch is given is that the food and the networking opportunity makes it more likely a busy doc will bother sitting through the talk. Personally I liked the idea of an Afrezza bus going to various diabetes events. Marketing in the real world and targeted at people that aren't treating their diabetes like something they only think about once every 6 months when they have to go and get scolded once again by their doc for creeping A1c. As for bold... thank goodness no human organs are square haha! that was funny No surgery in my future... I don't have the stamina or time for that. I want to still have a somewhat "normal" life. So don't worry, I won't be cutting any of your corners Anyway, the kind of marketing I was talking about was somehow having all of the drug companies agree to have all of the drugs in one place... There are already catalogues with all of that stuff. I just tried logging into my epocrates account, but I can't remember my info because I haven't used it on my new phone yet. There are databases that have all of that stuff like you said. And they give contraindications and brief descriptions of mechanisms of action. Unless they've updated it or it's available on the paid version, it doesn't really offer any data as far as efficacy (doesn't make claims like Lipitor lowers cholesterol better than Zocor or Pravachol, etc) or speed of onset for pain meds, etc... like graphs and charts would be really helpful to see those things as would a more detailed mechanism that would show why a certain drug is more specific to a particular ailment and would cause fewer side effects, etc. None of that information is listed in epocrates. I completely agree with you regarding banner ads and internet ads for targeting customers. I feel like their best bet is to make videos on youtube and somehow find a way to attract viewers that way. Even though I usually skip ads, youtube and other sites make you wait 5 seconds before you can and every now and then I find myself watching one without knowing it. But it's that damn label again that will prevent us from making a good video that can capture attention quickly. We can't make claims yet that will pique interest.
|
|
|
Post by stevil on Feb 4, 2016 15:54:37 GMT -5
Sanofi's own Pascale Witz was published recently (the article is posted here somewhere) stating that a new patient-driven model is needed today and that the old sales & marketing strategies are rapidly becoming obsolete.
eMarketing has grown so large. Take "Cyber-Monday" as a great example. Every retailer used to talk about Black Friday as the day "we'll finally be in the black." I believe that it was either last year or the year before that electronic sales on Cyber Monday exceeded Black Friday sales.
If MannKind get themselves a top-notch marketing executive who really understands eMarketing, I think it's very possible to introduce Afrezza to millions of diabetics and thousands of physicians who, up until now, haven't even heard of it.
If Matt can hire the right person for the job, I think that MannKind can use eMarketing to rapidly grow Afrezza sales. That sales growth will drive share price up. It's pretty hard to argue against the idea that sales has always been the key to survival. Insurance coverage is a huge issue. We're all hoping that that was a significant factor in around 2/3 of patients not continuing Afrezza after trying it. No emarketing solves that. We've had some online, we've had magazines and we've had direct mail. Unfortunately there is little that can be done in the world of drugs in emarketing that is likely to catch on like wildfire. Too many FDA restrictions. Even take the amazing results the early adopters have had... they are tweeted and the really outstanding ones might get 40 retweets. More than one of the doctors that participate here have stated that they are skeptical that emarketing or social media is something that would sway many doctors. Do you REALLY think that smart drug companies would still be spending billions on marketing/sales... if a shoestring budget and some 25 year old that knows how to market shoes online would achieve the same thing? Rapid Afrezza sales are a long ways off and will not come cheaply. I think the best we could hope for is some targeted approach (perhaps the "clinic") that can rebuild confidence in Afrezza... great patient results and clarifying that a majority don't drop use after trying because of flaws in product... then we might get the money needed to really do marketing/sales. I can see emarketing being really successful in the future, but I'm not sure its time has come yet. I'm not nearly as tech-savvy as some of my classmates. They're able to organize all of their notes onto their ipads. The best I can do is use a stylus to write on mine. Anyway, the reason I see emarketing being successful in the future- even apart from the billions of dollars it would save- is that the younger generations don't want printed paper anymore. It's clutter. Even for the books that I read, I use digital copies. you can use search functions and other handy things... It's just quicker than having to go to an index, thumb through the alphabet, find that page number, go back, you get the point. If there's one thing I've learned since starting medical school it's how to be more efficient in everything that I do. I almost make a game out of cutting corners. Ok, sorry... rambling... So why I think emarketing will be the wave of the future, if done properly, is that it allows physicians to have some control over what they research. They can be given lists of pathologies and click on the ones that interest them and have a whole slew of drugs and their mechanisms pop up. I guess I'm not there yet, but I imagine I'll need a brief refresher on some of the mechanisms when I get to that point. All that information would be accessible right at the hands of the doctor. If the marketing company does it right, they should be able to add visual effects (but nothing elaborate that will waste time or distract) to keep things vivid and interesting. So everything would be in one place as well as allowing the physician to peek at his/her own leisure. I'm pretty sure I'd be more interested in drugs if I had a digital catalogue that had charts and graphs and empirical data that was easy to find and access. I'd want to stay up on the "latest and greatest". Anyway, just my opinion...
|
|
|
Post by stevil on Feb 1, 2016 3:47:14 GMT -5
I really hope MNKD stays around long enough for this drug to gain traction. It would be nice if Al got to see it blossom as well before he leaves us.
-not soft bashing. Sorry for not adding anything original. I just really hope this drug doesn't get buried and as mnholdem added from Al's words, "This will revolutionize diabetes".
|
|
|
Post by stevil on Feb 1, 2016 3:43:22 GMT -5
That is an awesome test of Afrezza's viability under extreme conditions. Too bad the stock, MNKD, doesn't have that same toughness. And it might be telling that Afrezza might just be able to survive much longer than Mannkind can. We still remain in the danger zone and the reality is that Afrezza's ability to withstand the heat and stress of temp changes has no bearing on the success of it if Mannkind can not find a way to get it to those who need it in an affordable manner with doctor and insurance company consent. One thing that did stand out to me is why did he bury it in the dirt? Soil would act as a buffer against the changing air temp. He should have just left it out in the open and not had buried it. And I would still love for him to do more food challenegs, sort of like the "will it blend" series but "Will Afrezza work with XXXX food? Let's see!" You're right about the soil acting as insulation but he pointed the thermometer at the soil both times. So it's safe to say that it was at least 80 degrees during those 3 and a half months. It would be interesting to see if it could survive in the Sahara, but that should be quite sufficient for room temp and short walks outside. Wasn't there another person, maybe afrezzauser, who left their Afrezza in their car for a couple weeks during the CA summer?
|
|