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Post by mnkdfann on Jan 10, 2019 11:58:29 GMT -5
The future lies in having a robust pipeline. Should Afrezza take off, great, if not, there is still a future to be excited about. So much for Al's dream, and Mannkind's primary raison d'être, in that case though. (At least, that's what I have been told / led to believe. I never met Al Mann, so I'm certainly not trying to speak on his behalf. But I always thought Mannkind's job one was to get out the cure for diabetes.)
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Post by mnkdfann on Jan 9, 2019 18:11:38 GMT -5
I saw a statistic today (from circa 2014, so it may be somewhat dated) that over half (something like 57%) of spending on pharmaceutical advertising in the States is in the form of free samples to doctors. The article went on to note that the free samples drive penetration of a new drug into the market. And that doctors with free samples were also much more likely to deviate from SOC. In comparison, DTC advertising accounted for only 15% or so of the spending.
I wonder how Mannkind allocates its advertising budget?
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Post by mnkdfann on Jan 9, 2019 16:34:04 GMT -5
The list is nice, but it would be even nicer if it told us which 'deals' have seen any movement in recent years, or are even still in place.
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Post by mnkdfann on Jan 9, 2019 11:53:46 GMT -5
Yes, I've questioned how expensive Afrezza is.. but I have no idea how much it costs to make it or what Mike C has in his mind regarding this. I hope the expense is necessary and based on integrity, not greed. I think it is a necessary pricing. But if the pricing was based on greed, it might be easier to fix.
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Post by mnkdfann on Jan 8, 2019 22:05:40 GMT -5
True enough. Still, I think most people don't know or care who made the flu vaccine or drug they take. Or which company supplied the ingredients (wheat, sugar, cheese, etc.) in the prepared food they purchase and eat. I think perhaps the only time most people really care is when something goes wrong, and there is a recall of a product based on a bad ingredient that came from a particular supplier. Everyone I know cares about that kinda stuff. If you say so, I won't argue. But I find it hard to believe everyone you know cares which companies supply, say, the wheat going into, say, McDonald's buns and like products. They _might_ care whether or not the suppliers are U.S. or not, but I doubt they care which particular grain company it is coming from.
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Post by mnkdfann on Jan 8, 2019 22:00:33 GMT -5
I agree people look for branded products. Consider the iPhone. But people consider it an Apple product, and don't think about the parts inside supplied by companies like Samsung, Micron, TI, Qualcomm, Broadcom, etc.
I can see how it could go either way with companies that license Techonosphere. I guess it is up to Mannkind marketing etc. to see if it can get people to care and recognise whether a product is using 'Technosphere by Mannkind' or not.
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Post by mnkdfann on Jan 8, 2019 21:02:26 GMT -5
In attempting to understand the difference between Treprostinil and Ralinepag, can anyone decipher what this all means: Ralinepag Potent IP Receptor Agonist PAH – Time to Clinical Events Ph3 Initiated PAH – Exercise Capacity (CPET) Ph3 PAH – Exercise Capacity (6MW) Ph3 PAH – Differentiation 1H:19 Initiatio www.arenapharm.com/pipeline/#If you google the phrases, stuff turns up on the web. CPET is Cardiopulmonary exercise testing, a global test of a patient's cardiorespiratory capacity. 6MWD (you left out the D) is an abbreviation for 6 minute walk distance. A particular exercise test. That's all I got for now.
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Post by mnkdfann on Jan 8, 2019 19:02:15 GMT -5
This is different than a needle and syringe which are not part of the ingredients in the drug you are adminstering. Even though TS is inert parients are consuming it. True enough. Still, I think most people don't know or care who made the flu vaccine or drug they take. Or which company supplied the ingredients (wheat, sugar, cheese, etc.) in the prepared food they purchase and eat. I think perhaps the only time most people really care is when something goes wrong, and there is a recall of a product based on a bad ingredient that came from a particular supplier.
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Post by mnkdfann on Jan 8, 2019 16:57:10 GMT -5
Taking the quote in context, Rothblatt was talking about 400M+ total split over FIVE different products: BEAT, INCREASE, PERFECT, Technosphere, and SPIRESTA. So Mannkind will be getting much less than that $48 million per year (everything else in your, or mango's, set of assumptions held constant).
I'll have to listen again when I get a chance because that is not how I heard it. I believe the $400M is the current annual net sales of Tyvaso. Rothblatt stated that the hope is the 5 products will generate $1 billion+ down the line. If it works out, the Technosphere platform would replace the current Tyvaso nebulizer AND be the delivery platform for the Increase, Perfect and the inhaled component of the Beat product. Spiresta is described as a complimentary product to Treprostinil Technosphere to serve as an as needed product in between regular treatments.
So it sounded to me like the Technosphere product has a possibility to replace the current $400M and be a significant component of the first 3 products in trial (BEAT, INCREASE, and PERFECT). How much of the $1 billion projection is coming from Spiresta I couldn't tell, but Technosphere's portion seemed to be in the majority.
I relistened to the relevant portions myself. Yes, 400M+ is the current net sales of Tyvaso. The call said the 5 products I listed would grow that $400M to $1 billion and more. But it's not clear to me how much of that will go to Technosphere, it wasn't said. LATER in the call, it is suggested that Ralinepag could add yet ANOTHER $1 billion in revenues to the top-line.
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Post by mnkdfann on Jan 8, 2019 15:35:02 GMT -5
Martine Rothblatt is awesome, great presentation Paraphrasing... "We're pretty confident that the 400M dollars a year we're doing with Tyvaso will grow to a 1B dollars a year or more" Technosphere Treprostinil will replace Tyvaso and will be able to be used in combination with Tysuberprost, and will become the only FDA approved treatment for people with PH w/ ILD and PH w/ COPD. Also, Samumed's small molecule for IPF is specifically designed for inhalation. Rothblatt didn't say what inhalation delivery system they were planning to use, but common sense points at MannKind. At low double digit royalties, that $400 million translates into roughly $48 million per year and at $1 billion in sales that is $120 million per year to MNKD. Assuming these revenue targets ($400 mm) will continue to be achievable, that equates to over $1 billion dollars in market cap for MNKD on this product alone. Taking the quote in context, Rothblatt was talking about 400M+ total split over FIVE different products: BEAT, INCREASE, PERFECT, Technosphere, and SPIRESTA. So Mannkind will be getting much less than that $48 million per year (everything else in your, or mango's, set of assumptions held constant). In comparison, Rothblatt said Ralinepag was expected to add $1 billion to the top line on its own.
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Post by mnkdfann on Jan 8, 2019 15:26:35 GMT -5
So if the new TS drug replaces the current drug and does just same revenue of about $450m per year in sales with low double digit royalties, of say 12%, mnkd should see a little over $51m in revenue w very little costs against it. Now multiply that by several molecules and we have a very nice balanced revenue stream that is ongoing and growing. Anyone know if in UTHR’s call Ralinepag was mentioned and how it would be used? Where will ARNA’s Ralinepag that UTHR paid 800M for shortly after their deal with MNKD for Treprostinil will fit in? It is also used to treat pulmonary hypertension. I am spot listening to the call now. Yes, it was mentioned and included in the slides. There, ARNA’s Ralinepag is described as "Potential 'Best-in-Class' Asset for PAH." And that it targets the same 'PH Who Group 1' as Treprostinil Technosphere. Slides are here, but you may have to sign up first: jpmorgan.metameetings.net/events/healthcare19/sessions/23947-united-therapeutics-corp/webcast
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Post by mnkdfann on Jan 8, 2019 10:19:34 GMT -5
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Post by mnkdfann on Jan 6, 2019 14:45:49 GMT -5
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Post by mnkdfann on Jan 6, 2019 11:12:57 GMT -5
I have commented in another post on another thread that I think the sales of Afrezza will struggle. I said that in Jan of 2018 and I reiterated it for 2019. Sayhey is right in much of what he writes. We at Vdex have encountered loads of resistance to Afrezza and in particular our use of Afrezza, from those most immersed in the diabetes communities. Yes, the endos will be the most resistant. They know it all, they think. Consider this story that happened in our Espanola, NM office: We had a patient come in with an HbA1c of 14+ (our in-office meter only goes that high - with CGM you can actually get higher readings). We put the patient through our protocol and in a little more than a month had her down to an HbA1c of 7. The patient was thrilled. She went back to her endo and that endo took her off Afrezza, said what we were doing was irresponsible, and forbade her coming back to us. Yes, forbade her. The patient called us and told us all this. Remarkably, that patient wouldn't return because she was afraid of her doctor. I naively thought the doctor might be happy to see his patient drop 7+ points in HbA1c with no hypos, sleeping and feeling better. I thought that endo might call us asking how we were doing it. He might ask us to see others of his patients. He might refer us to others. I couldn't have been more wrong. The doc never reached out to us and in fact, bad mouthed us to other physicians in the community. Espanola's small so we eventually heard all about it. Its heart-breaking to be witness to stories like this, but its out there. There is just so much resistance to Afrezza. This is why I'm skeptical about more TV advertising suddenly causing script numbers to soar. . Terrible shame. Maybe someone can call the medical board that oversees Espinola, and report the doctor. The allegation may not be as obvious a violation as in a wrongful death malpractice but it could light a fire under this dr. Unfortunately another doctor playing God, and we know how that usually turns out. I'm not a medical doctor, but some quick googling turns up reasons why a doctor could be upset with a one month drop in HbA1c from 14+ to 7. E.g., on a page at forum.diabetes.org.uk, there are comments that going "totally over the top and reduc[ing] your HbA1c too quickly" may be very bad "as the sudden changes can cause problems particularly in the microvascular area (i.e. things like retinopathy or nephropathy, even neuropathy". What I think (remember, I'm not a medical doctor) are related journal references are given below. If the above is accepted medical wisdom in the U.S. (IDK, is it?), then a complaint might backfire. www.ncbi.nlm.nih.gov/pubmed/29217386bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-017-0213-3This may suggest that a gradual lowering would be better received by the medical community.
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Post by mnkdfann on Jan 5, 2019 11:43:00 GMT -5
Those incentive trips are put together well in advance of when they take place. No idea if there really was a trip to Hawaii but if there was, it was booked at least 12 months prior. In Pharma, the next years incentive trip is announced during the annual meeting. Did Mannkind announce its trip at last year's annual meeting? If so, wouldn't we have heard about it? Proboards members were there, IIRC. Mannkind is a very small company. Its sales force is not as stable as those at larger pharmas. I suppose Mannkind could have planned its trip so far in advance. But I can also see how it might have waited until mid-year to announce it. Since the number of people involved would have been small, bookings would not really be an issue.
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