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Post by docfrezza on Dec 6, 2015 19:38:19 GMT -5
Looking forward to next month in Del Mar and SD.
Going to see the unbelievable acoustic guitarist Tommy Emmanuel.
An absolute legend.
Tommy Emmanuel is awesome!! I have seen him twice. If you have the opportunity to request ask for Lewis and Clark and/or No More Goodbyes.
I realize this is not necessarily appropriate for this board but Tommy is the best.
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Post by docfrezza on Dec 4, 2015 18:13:26 GMT -5
mnholdem, I can almost guarantee you that the attendees have to sign a nondisclosure agreement. I have sat on several of these boards and had to sign a nondisclosure for each and every one. That is routine for this type of meeting. Very few people know what they will discuss. It is highly unlikely that anything will be disclosed after the meeting. All of the pharmaceutical industry does this for advisory boards. There may be some exceptions but I have never known of one.
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Post by docfrezza on Dec 4, 2015 11:33:06 GMT -5
I also confirmed it here. If you choose to not trust my information that is your problem. I do not post unreliable information.
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Post by docfrezza on Dec 2, 2015 16:20:49 GMT -5
As I have been told the meeting is a practitioner's advisory board. This will likely involve the input of a small group of practitioners to discuss whatever topics the company wishes to discuss. What is to be discussed is not known by me. A speaker's training meeting would involve a larger number of practitioners being trained to lead presentations either locally, regionally, or nationally regarding Afrezza. This meeting is not a speaker's training meeting. I have no more information or specifics than this.
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Post by docfrezza on Dec 2, 2015 14:55:54 GMT -5
I have confirmed with my Afrezza rep that this meeting is occurring. This is an advisory board meeting, not a speaker meeting. Topics to be discussed are not known. Typical advisory board meetings are 12-15 practitioners and 4-8 members of the brand team. FYI.
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Post by docfrezza on Nov 5, 2015 15:20:57 GMT -5
Thanks to those who have posted kind words. I said it on YMB and will say it here, I will not reveal my identity. I am a PCP. I will not and have not posted anything here as fact without knowing it as fact. For any who chose to not believe me that is your choice. My identity will for now remain anonymous. When there is more information from the real world that I feel is beneficial to those here I will post it.
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Post by docfrezza on Nov 5, 2015 13:47:52 GMT -5
I am NOT the drfrezza on YMB. My name there is also docfrezza. I have not posted there recently. This message board is a much friendlier place to post my information.
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Post by docfrezza on Nov 5, 2015 12:27:26 GMT -5
I found out some new information today. This is not related to me prescribing Afrezza to patients, it should go without saying that I am doing that. What I thought each of you would find interesting is that the Toujeo/Afrezza representatives are in Las Vegas right now and are coming home later today. The pure Afrezza representatives are not there, they were there a few weeks ago. While in Vegas the representatives are getting new training specifically on Afrezza. I do not know the details of this new training. The question I would ask each of you to ask yourself is why would Sanofi be doing Afrezza specific training at this point in time if they are planning on cutting ties with Mannkind in the foreseeable future. I just can't see that happening based upon the information that I was given earlier today. I was also told that the representatives are going to get some updated training on the pulmonary function studies in the next few weeks. I do not know the details regarding that at this time. Anyway, I thought that most of you would find this information to be enlightening. I wish I had more details but do not. The information that I have been given would tell me that Sanofi at least for the foreseeable future is planning to continue promoting Afrezza. The rumors are that the TV ads will start early next year but this is nothing more than a rumor from the representatives. We shall see.
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Post by docfrezza on Nov 3, 2015 11:43:04 GMT -5
FACTS:
docfrezza is a pcp
he does post here
and reads most but not all of what is written here |
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Post by docfrezza on Oct 11, 2015 19:47:25 GMT -5
The insurance issue is real but Sanofi is helping. Sanofi is obviously working to improve coverage for all patients but that takes time, especially in today's practice environment. They have provided us with a form regarding the patient's history, lab findings, current meds, etc which is then faxed to Sanofi after which they help us with the approval process. I have one Medicare patient who can afford Afrezza so insurance is not an issue for this patient. Another Medicare patient could not afford Afrezza. The discount card (free for first month, $30/month for rest of first year) has been used by most if not all of my non-Medicare patients (Uncle Sam will not let Medicare patients use the discount cards). My nurse handles most of these details. Nothing like a good nurse and mine is one of the best.
I had a typical Afrezza patient come in this past week. On 2 orals and a GLP-1 (injectable) with elevated A1c. Fasting blood sugars less than 120. Patient was told by me to check glucose after meals and see me in 2 weeks. My bet is that the glucose log will show elevated glucose levels after meals with near normal fasting blood sugars. Now that is a perfect Afrezza patient. Not sure exactly what I will do with the current treatment, will make that decision when the patient returns. I guarantee you that primary care practitioners see similar patients all the time. They just need to be more aware of where Afrezza fits in their practice. Like I have said before, Afrezza is a new paradigm. And changing to a new paradigm takes time. |
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Post by docfrezza on Oct 8, 2015 20:13:31 GMT -5
Most primary care practitioners target A1c<7.0. Endos use <7 or <6.5. For many elderly patients (above 70-75 years of age) even above 7 may be accepted so as to avoid the risk of hypoglycemia. Medicine is an art, there are many ways to do it. Always keep that in mind.
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Post by docfrezza on Oct 8, 2015 20:09:29 GMT -5
Please understand that in the world of primary care that I am considered a larger target than many because of the focus of my practice (cardiovascular risk management) whereas someone with another focus (pain management for example) would be a smaller target than average. The pure Afrezza rep does not call on nearly as many primary care practitioners as the Toujeo/Afrezza rep, but also remember that the Toujeo/Afrezza rep (all of the Toujeo/Afrezza reps nationwide, as best I can tell) have Toujeo as their lead product. Not saying this is right or wrong, but it is what is happening out there in the real world.
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Post by docfrezza on Oct 8, 2015 19:51:02 GMT -5
Forgot to respond to this in the post I just sent. I have 2 Afrezza reps calling on me. One has Afrezza as a sole product, the other has Toujeo and Afrezza. As best I can tell there are approximately 200 pure Afrezza reps in the USA. I do not know how many Toujeo/Afrezza reps there are.
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Post by docfrezza on Oct 8, 2015 19:48:13 GMT -5
First of all, to whoever changed the word world in the subject of this post, thank you (I incorrectly put in "worl"). I will try and answer questions as best as I can without revealing who I am. Many of you know me from YMB. I am a primary care practitioner, not an endocrinologist. At this point in time I do not want to reveal my identity. Thus far I have prescribed Afrezza more that 10 times, less than 20 times. I have no idea as to how many scripts I will write in the next year. The best A1c I have seen thus far, and there have been 2 of these, was a drop from over 12 to below 7. The amazing thing is that none of my patients have had hypoglycemia. None. That reflects the PK profile many of you are aware of. It is one thing to see a slide in a presentation or an article describing the PK profile. It is something else to see it in practice, in the real world. I talk to any practitioners that I can about Afrezza. I know of 2 that began prescribing Afrezza as a result of our conversation. The biggest pushback is either the PFT issue or their stubbornness in learning something new. Patients are typically given the 10 day sample and a script. They have all started on the prescription as the sample ran out. I have now had one patient stop Afrezza. Not because of a side effect but because of extended work travel and the bulk of Afrezza he would have to pack as a result of this travel. I want to thank those of you who research and post about Mannkind and Afrezza. This is a paradigm changing product which I certainly hope to prescribe for years to come. I will continue to answer questions but as stated previously do not want to reveal my identity and will certainly give no patient specific information.
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Post by docfrezza on Oct 8, 2015 13:49:44 GMT -5
If you go back and listen to the presentation from earlier today you will hear Matt use the words "real world". What is going on in the real world is very important. Patients are loving Afrezza. Practitioners that are using Afrezza are loving it. It is still my opinion that the biggest issue is that the marketing by Sanofi has been weak. In my opinion patients will push the initial sales by requesting Afrezza from their practitioners but as of this time many do not even know that it exists. Later, practitioners will use Afrezza because of the results they see in their practices, much like I have seen in my practice. That is the real world.
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