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Post by stevil on Jan 14, 2016 20:10:30 GMT -5
stevil , I disagree, I believe if Sanofi would have given the PWD the opportunity to choose, by advertising just 1 TV commercial so more PWD knew about afrezza, the script numbers would have looked quite a bit different. I also find it completely unprofessional and unexceptable that the very day Sanofi notified MNKD they were ending the partnership, Sanofi Canada flat out lied to a PWD that asked them when afrezza would be available in Canada, (see my thread Sanofi Canada) to view the tweet. Also, keep in mind that I was one that defended the slow launch by Sanofi, and also defended the decision not to advertise via TV until after Healthcare Providers and patients were educated, (boy do I feel stupid !!) I hope sanofis shareprice continues to fall and PWD boycott the company. I wouldn't piss in their ears if their brains were on fire. Just my opinion of Sanofi, I enjoy reading your professional input. Boycott Sanofi Thanks Rick (I think your last sentence was genuine), I'm not a fan of SNY but I don't share the angst many on here have of them. I think they could have handled the process much better and probably should have communicated much better with MNKD. From all we know, maybe they did. Matt gave off the impression that it wasn't a huge shock when SNY cancelled the agreement. If SNY pays for the divorce and gives MNKD a decent chunk of cash, there really isn't much we can complain about in my opinion. We can say that SNY didn't do all they could to market Afrezza. I would agree with that. But it was their prerogative to decide whether they wanted to go forward with it. And as I said earlier, I believe that they figured the juice wasn't worth the squeeze. I don't know how much commercials cost to air, but I have a friend who works in the film production industry and he told me that even cheap commercials cost about $50k to produce from a filming/editing standpoint. Who knows what other costs go into it with the marketing team, the materials, air time on the station etc. You can't really fault them for not wanting to dump more money into Afrezza if they didn't think it would return to them what they wanted. Plus, it didn't fit their business model and vision. It just never made sense to me that SNY would swoop up MNKD to sandbag them when MNKD was never going to take Afrezza all the way on their own anyway. All SNY did was waste their own time and money if they were going to put us right back in the same spot they found us a year earlier. It didn't really hurt MNKD at all except for the tainted reputation we now have and the potential of signing with a better partner. But I believe SNY had genuine interest when the deal was inked. As anyone here who has been following the stories know, the main characters changed, so the plot changed. I don't really see anything evil or malicious about the way SNY conducted their business. They terminated basically at the earliest time that they could. If they'd wanted to, they could have dragged us into bankruptcy.
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Post by stevil on Jan 14, 2016 19:57:52 GMT -5
factspls88 - I'm not sure about the writer but they also have it listed under Cardiology stevil - I know a few doctors and have seen first hand on how they can be biased towards certain companies/treatments as some do research, speeches, etc and are compensated. So don't bite the hand that feeds as they say. I wouldn't debate that point with you at all. I believe that you are speaking the truth. I'm just saying the vast majority of physicians are not unethical to this degree and truly seek their patient's well-being. It is still a solid profession. The only way the argument that docs are avoiding Afrezza because they don't want it to cut into their business can hold water is if SNY specifically targeted the docs in their back pocket. This clearly did not happen, at least not exclusively. There have been several docs that have become enamored with it. Also, it is now illegal, as Liane has even testified, that any kind of kickbacks are illegal. I'm not sure if your story is recent, but even if it is, this could not be a widespread phenomenon. There is way too much risk involved. If a manufacturer ever got caught paying off docs, I'm sure the FDA or whoever the governing body is would make their punishment so immensely severe as to make a poster child out of them. They'd have to.
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Post by stevil on Jan 14, 2016 16:02:52 GMT -5
I have to agree. I can't speak for the drug and needle manufacturers- I'm sure they might be unethical, but I can say for certain that physicians do not view medicine in that way. Physicians will always have a job. There will always be some health crisis that needs an educated opinion and guidance. I'm sure you're well aware that the number of diabetics are growing. Prescribing Afrezza will not put any endos out of business. While there are certainly a few bad apples who are only in it for the money, I can tell you the vast majority will do whatever is in the best interest of their patient. We take an oath for crying out loud I won't go as far as to say conspiracy theory but I will say that some of these Docs weren't educated (for whatever reason) on the benefits of Afrezza judging by the quotes that Harry posted. If they think Afrezza is all about going needless than they really don't know the real benefits for their patients. I'm somewhat in agreement with you. I think the docs that got educated by reps SHOULD have known better. But there were a lot of continuing education magazines and other ways of distributing information about Afrezza that likely educated the docs. I would be surprised if these docs were greeted personally by the reps. And really, that's not SNY's issue. It's a label issue. Sure, they could show the info and graphs on afrezzapro.com, but they're still limited in what they can say about Afrezza. I very well could be wrong. I just don't think SNY sandbagged Afrezza. Not as badly as people think. I don't think they gave it much of a shot, but I do believe that they would have taken it if it had been wildly successful with what they did do. I just think they dropped it very early on because they didn't think the juice was worth the squeeze. Just my $0.02
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Post by stevil on Jan 14, 2016 15:54:10 GMT -5
There are three drug candidates for TS under consideration. Palonsetron (for Chemo), Epinephrine, and a third for pulmonary hypertension. All three put together are only a fraction of the insulin market. Except for Epinephrine, the drugs will have full clinical trials. Missing from the list is MNKD's pain med. Also missing are large volume drugs. I think this is why it has taken so long to get a TS deal. MNKD went through the list of high volume drugs and found no buyers. Now they are down to the orphan drug volume level. I can't see any of the opportunities generating a large up front payment. MNKD needs cash now. Was hoping some of the more established docs could speak up to what they think about the potential here. I find myself in the same camp, unfortunately. All of the medications on here are already on the market, some in somewhat cheap formulations. I thought I remembered seeing vancomycin on the list? This would be helpful because they wouldn't require an IV, but aren't patients usually admitted anyway if they're infected with an agent that would require them to take it? I don't know enough to know if it would be as simple as writing a script and then allowing them to go home. It's one of those things that sounds good on paper, but doesn't really fill a need. Unless someone on here can speak up and correct me? Then, the vast majority of these are niche drugs. These are great to develop the pipeline, but horrible right now if we're counting on them to get us through our financial crisis. It sounds to me like Matt's greatest hope is that these will simply instill confidence in the company and raise the share price to do another offering. I didn't get the impression that he was counting too much on upfront payments, although I'm sure he's hoping for them ha. I was really hoping MNKD would develop their own novel medications. Really, after I think about it, there aren't too many medications that need quick absorption. Mainly cardiac related meds. Epi would be one of them, but as another posted added, it worked quickly in the pen. And I raised the issue in another thread that a few of the biggest problems with anaphylaxis is a swollen tongue/throat and difficulty breathing. I'm not really sure I would want to prescribe an inhaled medication as the sole means of treating anaphylactic shock. I think I'd still want a pen as a backup just in case they didn't take it soon enough before their tongue/throat swell, and bronchioles close up. Unless there is a study that shows it's just as effective under those scenarios...
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Post by stevil on Jan 14, 2016 15:31:16 GMT -5
No they (BP, Endos, needle manufactures, pen manufactures, etc, etc, etc,) are terrified of the potential and what it could do to their revenue. The conspiracy theory? Not true. I have to agree. I can't speak for the drug and needle manufacturers- I'm sure they might be unethical, but I can say for certain that physicians do not view medicine in that way. Physicians will always have a job. There will always be some health crisis that needs an educated opinion and guidance. I'm sure you're well aware that the number of diabetics are growing. Prescribing Afrezza will not put any endos out of business. While there are certainly a few bad apples who are only in it for the money, I can tell you the vast majority will do whatever is in the best interest of their patient. We take an oath for crying out loud
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Post by stevil on Jan 13, 2016 22:42:16 GMT -5
wow.. thanks so much for the recap .. it all sounds so positive and finally MNKD is telling us something .. I especially like the part where they say "Afrezza and MNKD are here to stay"... what a relief coming from the mouth of the new CEO .. now I think I may consider doubling what I own.... and maybe in a year or so my dad can be back on Afrezza ...
Please tell me you aren't serious? doubling your position only because Matt said positive things? Please be wiser than this ha. Our situation has not improved since yesterday. This is still a long shot. It just looks like MNKD employees are motivated and hungry to take it head on. Unless your position is relatively small, please don't double it yet. Wait until we at least get on stable ground. There are better places for your money until that time.
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Post by stevil on Jan 13, 2016 20:45:51 GMT -5
I had the same thought when I was listening. I can only imagine people would much rather come to work under Matt than Hakan. Hopefully this isn't temporary and Matt/staff don't get burned out, but you can tell that he has the ability to light a fire under someone's ass. He seems fairly well organized and is a good speaker. Seems to be able to cast visions. Let's hope he gets some major revelations on how to swing this pendulum the other direction and MNKD the resources to pull them off!
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Post by stevil on Jan 13, 2016 20:39:11 GMT -5
I think Matt was careful about not taking full credit for the clinic initiative (as in, SNY was involved in the discussions). I am adding shares for several reasons, the clinics are interesting, but will take time. It will help with awareness, but let's wait for proof of concept. Most insurance plans require PCP referrals to specialists, so there will still be a process, and there will probably be more than a handful of PCPs who will not refer to an urgent care center clinic. Having nothing to do with Afrezza and everything to do with public health, convenient access to diabetes care is important. Just because these clinics will be co-located with an urgent care center does not mean that the service being provided is urgent care. It would be more akin to primary care. The "urgent care" setting (such as in a Walmart) just gives the diabetes clinic visibility - taking health care directly to the patient. These could be staffed by a nurse practitioner, with a link to a physician or even an endo as needed. Many insurance plans would not need a referral to be seen at such a facility - specifically - regular Medicare needs no referral. A lot will depend on what plans these centers contract with. The key, though, is providing comprehensive basic diabetes care without bias toward a specific product. How does one do that while being sponsored by an insulin company? Does any governing agency oversee this? Then, if audited, how do they prove/disprove "care without bias toward a specific product?" Do they have to have matching script count % for every kind of insulin to keep governing body off their back?
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Post by stevil on Jan 13, 2016 19:18:41 GMT -5
Is the audio going in and out for you guys you? it was earlier but it's been constant since the Q&A session started.
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Post by stevil on Jan 13, 2016 19:03:03 GMT -5
I only heard the bit about inhaled epi? Were any of the others discussed? I kind of hope that we're not pinning our hopes on inhaled epi. While kids are usually the ones that need to carry the pens around with them the most, anaphylaxis usually includes a swollen tongue/throat (would probably occlude the particles from entering lungs) and restricted breathing, making inhalation problematic. Really hoping we don't put too many resources into this one as I don't see it really going anywhere.
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Post by stevil on Jan 13, 2016 18:53:34 GMT -5
Props on that, Rob. Might be too late to make friends on here, but I try to give credit where it's due. Well done.
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Post by stevil on Jan 13, 2016 18:52:17 GMT -5
Just got home from class about 15 min ago, Matt sounds very well-prepared and confident. I really like that. Makes me feel better about holding.
I also like how he seems to really be emphasizing the whole "more communication and transparency" idea. Sounds like he really feels compassion for his stockholders. Another HUGE plus. Let's hope he delivers and isn't feeding us a bunch of lip service.
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Post by stevil on Jan 13, 2016 11:02:47 GMT -5
My bet is that shorts are covering. They don't want to be like the gofundme guy and get trapped if we somehow get a favorable buyout. Like others have stated, there's not a whole lot of milk to squeeze out of this cow.
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Post by stevil on Jan 9, 2016 23:36:59 GMT -5
I don't really think it's that good of an idea either, unless they could somehow not push Afrezza onto the doc. Simply mentioning that they had already started Afrezza and wanted to continue taking it, then asking if it could be prescribed so they could stay on it would be the farthest they should go. Maybe asking them if they wouldn't mind researching it before the next appointment in case they had any questions for them... I can't imagine that it'd go over well if they walked into the office and started talking down to a physician to "educate" him/her. Most have egos and wouldn't appreciate that. Hopefully the doc will be curious and will ask questions. Under no circumstances would it be wise to ask the doc to prescribe for other patients.
To answer the other part of your question, this may not come as a cheap request. The billing code for a new patient is considerably higher than a follow up. The main reason behind the markup is a physician is supposed to do a complete history and physical whenever they take on a new patient, so the appointment length is considerably longer.
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Post by stevil on Jan 9, 2016 23:25:49 GMT -5
Technosphere pain medication would not be any faster than intravenous (IV) pain meds. Both put the medication directly into the blood.
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