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Post by joeypotsandpans on Jan 14, 2016 16:59:12 GMT -5
Ok, I had to post this in the main area because at best it's laughable not to mention what lengths they are going to go to to discredit Afrezza. Meet the Doctors of Dinosaurs... who most will hopefully fall to the wayside. www.medpagetoday.com/Cardiology/Type1Diabetes/55663?utm_source=dlvr.it&utm_medium=twitterLast week, drugmaker Sanofi pulled out of its agreement with MannKind Corporation to sell the inhaled insulin product called Afrezza. The device, cleared by the FDA in June of 2014 on its third try, apparently flopped when it hit the market, earning only a few million dollars in 9 months on the market. MedPage Today spoke to several doctors about whether, and why or why not, they prescribed Afrezza. Jennifer Holst, MD, University of Pittsburgh School of Medicine: "I did prescribe Afrezza to some patients. Inhaled insulin is a nice option for some patients with diabetes who prefer to inhale a medication than to inject. This is the second time that inhaled insulin has come out to market, and then been pulled off. Afrezza was much easier to use than the previous inhaled insulin." Thank you Jennifer for the honest reply and interestingly enough the testimonial to the easier to use statement at the end, ironically some physicians were too lazy to understand the dosing differences.Lee Green, MD, MPH, University of Michigan Health System: "I never did prescribe it; just didn't see a need for it." Lee, I'm glad you're not my physician...you need to do a better job of staying on top of the latest and greatest meds for your patientsFilip Knop, MD, PhD, University of Copenhagen: "I guess the well-established long-term safety of injected insulin outweighs the -- in my opinion -- questionable benefits of inhaled insulin. My patients with diabetes basically NEVER complain about insulin injections. The gauge of modern needles is so small that you basically can't feel the injection. Maybe needle-phobia is a problem among US patients, but -- really(!) -- it's not a problem that my patients mention very often -- despite my often asking them." Most patients don't admit being needle phobic, Filip I wonder how many of your patients are non compliant, question for you DID YOU EVER ASK THEM IF THEY WOULD THINK THEY WOULD PREFER INHALED INSULIN IF GIVEN THE CHOICE and how many of them even are aware that it is availableHoward Weintraub, MD, New York University Langone Medical Center: "I have not used inhaled insulin. I have been more comfortable with basal insulin preparations. This would not represent any major loss for me or any of my patients." Howard do you even know WTF you are talking about, this is a prandial insulin...seriously you are at NYU Medical Center, you can't make this stuff upDavid Armstrong, MD, PhD, University of Arizona College of Medicine: "I know about this and it is an enormous shame. This is a drug with wonderful promise that will now not likely be realized. As a surgeon who specializes in preventing some of the end stage complications of this disease, I do not have occasion to prescribe it, but I do see the devastating results of diabetes and therefore am something of a customer myself!" David gets it!! and unfortunately via the end results of non compliant patients, we need David to speak in the future and maybe put him on the newly formed councilJoel Zonszein, MD, Albert Einstein College of Medicine: "I was perplexed when Sanofi made the decision to market it and I hope they've learn a lesson. As a clinician that treat individuals with diabetes I can attest that inhaled insulins, no matter how good ... have only a small place, if at all, in the current market. Joel, my son interviewed at Albert Einstein last year, if you were going to be one of his colleagues I may have been perplexed at how they admitted you to the staff. Fortunately, he opted to go elsewhere for his residency. "no matter how good have only a small place..." seriously ignorant statement."Inhaled insulins are not good for management of type 1 diabetes (where a basal and prandial regimens needs to be properly crafted for each patient by either multiple injections or CIIS pumps). Inhaled insulins are not good for T2DM as these patients need a basal regimen ... The pen syringes and needles used nowadays are excellent and almost painless -- thus, there is no need for inhaled insulins to replace these. Again, out of touch with the benefits of Afrezza and closed minded does not bode well for your patients Joel"Physicians often have a dark cloud in their mind with regards to large amounts of insulin in the lungs and if they can cause malignancy after years of use. There are also issues with the inhaled insulin as far as problems with the lungs, bronchitis, asthma, pulmonary function, etc." It is amazing to me how some attain their medical degrees, unfortunately the degrees don't show how they did during their training and education prior to getting their degrees. A student who excels and one who squeaks by in the same program end up with the same degree on the wall. At the same time there are some who think they are always right and don't have the character to continue to learn. I would love to interview some of these same so called physicians after about 3-5 yrs. from now and see what they think when you repeat some of their ignorant statements to them IN FRONT OF SOME OF THEIR PATIENTS.  |
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Post by joeypotsandpans on Jan 13, 2016 9:59:35 GMT -5
So now along with Margaret Hamburg, and countless others, Sanofi has blood on their hands....in the end I pray they all get the "careful what you wish for" right up their you know what. The statement by this parent regarding boycotting Sanofi's products speaks volumes of this epic wrongdoing by so many on so many accounts. Think how liable SNY will end up being when this is correctly priced and marketed with the proper label it deserves. It will happen and again there will be many exposed IMO in the rear view mirror. Keep the faith that ultimately Al and the Sam's out there get vindicated in the end. |
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Post by joeypotsandpans on Jan 11, 2016 10:29:43 GMT -5
Sure seems that way with a floor on the bid...action sure seems louder than words today |
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Post by joeypotsandpans on Jan 8, 2016 17:46:58 GMT -5
I see all these "investigations" by law firms. Sorry, I don't see that MNKD has been anything but a victim here, not a perp. You, as a shareholder, do not have the right to sue any party other than MNKD, and even then your rights are limited to claims under Rule 10(b), part of federal securities law. The lawyers are conducting "investigations" looking for a smoking gun they can use to bring a suit under 10(b) because that is an easy pay day for them if they can find a materially false or misleading statement by the company. Only really stupid companies with really bad lawyers make such errors in their filings. Most of the time absolutely nothing happens.
SNY expended reasonable efforts to market Afrezza, maybe they didn't take the actions you would have liked, but what they did was not commercially unreasonable, and with the slow uptake in prescriptions they had a good faith basis to discontinue the contract. Even if Sanofi didn't, they are not liable for any damages to MNKD because the possibility of damages was explicitly waived in the license agreement. Nothing to see here folks, move along.
Your definition of reasonable is vastly different than mine and quite a few others...have you read a physicians point of view like the one quoted in the LA Times or many of the current users etc. Have you interviewed the reps and gotten their opinion...point being there is quite a bit of discovery to take place before you can label "reasonable" effort...remains to be seen...this epic story is long from over |
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Post by joeypotsandpans on Jan 7, 2016 13:19:03 GMT -5
Best article from the LA Times yet, the quote directly from the physician about SNY's half assed approach is priceless and very foretelling of what will emerge down the road IMO. Matt was constrained by the board on what he could say in his brief conference call. I expect at the very least a kiss goodbye payment...read the blatantly defensive statement from the SNY spokesperson regarding their "efforts" in promoting the still mostly unknown to diabetics product...and the physicians response regarding same. If I was an attorney in the appropriate field I would be begging/knocking on MNKD's door AYFKM!! |
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Post by joeypotsandpans on Jan 6, 2016 16:23:27 GMT -5
Right now, the SNY reps have been told to not hump Afrezza. I don't think MNKD has another partner lined up quite yet. The SNY contract was dated Aug 2014 and it took six months for the launch to take off. This is normal pacing of business in the pharma business. Can it be expedited? Yes of course. But not that much. I see a lull in marketing activities for the first 6 months of 2016. No forward progress. Keep in mind, MNKD does not have the resources in place to service the market. If they were to start hiring today, It will take 6 months for the troops to start performing. Other than Desisto, who in his right mind would join a company with one foot in the grave? If MannKind signs an agreement with an established pharma company "today," why would it take 6 months for that pharma's troops to start performing? MannKind doesn't need to hire anybody -- it just needs to make a deal with another company that will put some effort into marketing Afrezza. If I were a frustrated SNY rep that knew a company that has its chit together was coming on board or bought Afrezza outright...I would definitely be strapping the life preserver on and leave the sinking french freighter, especially knowing that I was mislead and betrayed by top mgmt. The reps know the product and positive feedback from both physicians and patients and with the proper backing help it reach its full potential. Why re-invent the education wheel when you have troops already trained and educated? Not sure what's in the reps employment contracts regarding definitions with respect to non compete clauses but if I felt duped and played by the company for almost a year "trying to reach unobtainable goals" with a spattering of magazine ads and a few token "educational dinners" I would have no qualms leaving. They already have entry into the existing practices on board, smooth transition especially with an attractive player. I have to be able to trust the company I work for and they (SNY) definitely would have lost mine along with their credibility. The company seems to be in complete disarray at this point...I thought that myself when they did that charade about their new divisions strategy going forward....total dog and pony show IMO. |
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Post by joeypotsandpans on Jan 6, 2016 10:16:14 GMT -5
At what reasonable price point do you think the insurance cos. would have to instantly move to Tier 2 without hesitation? Novo did it with Levemir and Novolog to gain essentially "monopolistic" contracts with certain providers, MNKD should now use their same tactics with the superior product (save the label comments) and beat them at their own game... It's all about the $$$ to the insurance whores. I would think it's time for the scorned Mann's gloves to come off and make it not feasible for the insurance cos. to keep Afrezza off Tier 2 status anymore. Time to take this battle to the bottom line and set the price war in motion...let's see how fast that gets a resolution to this BP game that's been played. They tried the conventional approach via an inept SNY, time to go non traditional and create the push that's been waiting. Create the flood to break the gates open and get those 3 lines cranking. Better product, lower price = instant created demand and ultimate success. Yes it can be that easy if you have the better product and the wherewithal to set a price they can't refuse. Next week's conference is an opportunity to come out swinging, Matt alluded in the call yesterday that pricing is an option, I liked his last statement... "We view this as an opportunity NOT an obstacle" ....in the end Brandicourt and his so called bs dtc magazine strategy will go by the way of Napoleon and show him as the idiot he truly is for letting this holy grail that he had in his grasp get away IMO. It's a new day carpe diem I posted this 2014 article yesterday on another thread.
INSULIN STICKER SHOCK.
insulinnation.com/treatment2/medicine-drugs/understanding-insulin-sticker-shock/
Seems that big Pharma really has a monopoly on product and pricing. It would be great to underprice them and deliver a better product. We go screwed by Sanofi. They knew that the could kill Afrezza by over pricing the product in the market. MannKind needs to find a way to get back into the market with a good company and a distribution network and sell it as cheaply as the can. perhaps even pricing if the can close to generic pens. Put the pressure on the big boys. I hope they figure how to get engaged with a company that understands that market. Like Teva or Perigo. There are others in that space.
I hope we have a play and the can move it forward. I know we produce the product but do we also package it? It seemed to me that we shipped it off to get finished? Does anybody know that answer?
KC, I'm sure we'll find out a lot of those answers coming out in the next weeks, months...starting with next weeks opportunity to hit the road running. Matt knows where their economic tolerance price points are so what's truly feasible and strategically plausible I'm sure will be discussed among mgmt. soon enough and most already likely has. My point of the thread is that this company is still a viable game changer and a fighter...Matt's words or something to the effect (and I'm paraphrasing) it's not the first time we've faced perceived adversity and we've overcome them each time. Do we have the better mousetrap? Absolutely IMO as well as and more importantly current users opinions. Reminds me of a case study I did back in school...an upstart airline with a new approach and pricing model to current standards. The new entrant came in and was so cost effective with a different approach in customer service. The existing carrier tried to drop their price to compete and eventually failed due to their cost structure. The new carrier continued to flourish and is one of the most loyal employee vested success stories still today. The new carrier at the time was Southwest, the existing was Braniff, the market I believe (from recollection) was Dallas - Houston. Southwest was a very disruptive "little engine that could" that didn't care about travel agencies, assigned seating, joking with passengers and making travel fun, union labor, etc etc and look where they are now. Different industries but same philosophy... take care of the customer (patient) and the rest should take care of itself...sound familiar, unfortunately SNY never really marketed to the masses the way they should have in creating proper patient awareness. |
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Post by joeypotsandpans on Jan 6, 2016 9:36:19 GMT -5
MnHoldem's Support Plan for U.S. Commercialization of Afrezza:
1. Lower the price to below current RAA insulin (Novolog, Humulog);
2. Prove superiority via FDA-approved postmarket trial ASAP; 2a. Fund university studies to confirm previous studies demonstrating 40% effectiveness of early insulin treatment for remission of disease;
3. Raise price of Afrezza based on superiority data.
#1 may lead to better Tier coverage
#2 definitely will lead to better Tier coverage
#3 by then, market penetration and demand for Afrezza will prevail... just don't raise the price too much! Hell MN, I would shoot for Tier 1...I dont believe it has to be generic to be Tier 1 rather just least expensive in its class and for now that's RAA's. Now that would be fun to watch play out...wouldn't it |
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Post by joeypotsandpans on Jan 6, 2016 9:31:28 GMT -5
It's not "directly" competing with those as they're not prandial, but haircutting 20% under current Novolog, Humalog should be a nice wake up call to providers, competitors, physicians, and patients. Time to stir up the hornets nest. But doesn't it undercut prandial's and/or basil's by having to use less? That's why I put the quotes around directly as those are claims being made by some current T1 users but still would need to be substantiated medically via trials I would imagine. In due time my friend |
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Post by joeypotsandpans on Jan 6, 2016 9:02:47 GMT -5
I'd find the price of Toujeo or Lantus, match it, and cut it by 15%. Create demand first, get good results, create patient loyalty and then look to raise prices later, GRADUALLY. 100% of 50 is still better than 35% of 100. That's what I would do if I were MNKD. It's not "directly" competing with those as they're not prandial, but haircutting 20% under current Novolog, Humalog should be a nice wake up call to providers, competitors, physicians, and patients. Time to stir up the hornets nest. |
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Post by joeypotsandpans on Jan 6, 2016 8:50:43 GMT -5
At what reasonable price point do you think the insurance cos. would have to instantly move to Tier 2 without hesitation? Novo did it with Levemir and Novolog to gain essentially "monopolistic" contracts with certain providers, MNKD should now use their same tactics with the superior product (save the label comments) and beat them at their own game... It's all about the $$$ to the insurance whores. I would think it's time for the scorned Mann's gloves to come off and make it not feasible for the insurance cos. to keep Afrezza off Tier 2 status anymore. Time to take this battle to the bottom line and set the price war in motion...let's see how fast that gets a resolution to this BP game that's been played. They tried the conventional approach via an inept SNY, time to go non traditional and create the push that's been waiting. Create the flood to break the gates open and get those 3 lines cranking. Better product, lower price = instant created demand and ultimate success. Yes it can be that easy if you have the better product and the wherewithal to set a price they can't refuse. Next week's conference is an opportunity to come out swinging, Matt alluded in the call yesterday that pricing is an option, I liked his last statement... "We view this as an opportunity NOT an obstacle" ....in the end Brandicourt and his so called bs dtc magazine strategy will go by the way of Napoleon and show him as the idiot he truly is for letting this holy grail that he had in his grasp get away IMO. It's a new day carpe diem |
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Post by joeypotsandpans on Jan 5, 2016 19:21:28 GMT -5
If you're in a bad marriage, usually both parties know it well ahead of the separation or divorce and so do the "other parties" involved. I would be extremely surprised that the whole situation was not vetted by the announced CEO ahead of time and he walked in blindly to all the baggage that is there already.
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Post by joeypotsandpans on Jan 5, 2016 18:31:22 GMT -5
joeypotsandpans , I still think in a few years Afrezza will be a paradigm shift in the treatment of diabetes and Sanofi will be known for the one that got away. Amazing how short-sighted they can be. Liane, nothing amazes me any more...(except having Oregon vs TCU and being up 31-0 at halftime...but that's a whole different conversation... private joke lol)....first abortion (for lack of a better term) of how to market/educate about inhalable insulin was Pfizer (even though they had a much inferior product they screwed it up), second Sanofi, the third time should be the charm with the "one that gets it" so to speak. |
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Post by joeypotsandpans on Jan 5, 2016 17:43:59 GMT -5
directly by Mannkind via internet? Before you think that is a serious statement it isn't but is said tongue in cheek with purpose....no insurance coverage WAS a huge obstacle, now there may be other opportunities as have been mentioned previously. When one door closes another opens and can be a better one. Fwiw, response from SNY rep, "we will continue to promote the product until 4/1. Then they (SNY) will transition the rights back to Mannkind. The product will remain on the market. I don't know who will promote it after that. I've communicated to my local team asking them to maintain a positive attitude with our customers about the benefits of Afrezza, regardless of the decision. I believe in the product and still want it to succeed." This wouldn't be the first time the French may end up with egg on their face along with Olivier Brandicourt for not ever giving the best prandial insulin its due. Did I read somewhere that Chris Viehbacher is working with venture funds somewhere here in the states...what an opportunity for him to pay back SNY with some embarrassment. Since there were some sports analogies previous I would throw this one out there...it could be like when the Red Sox traded the Babe to N.Y. ...https://en.wikipedia.org/wiki/Curse_of_the_Bambino After which it would be a premier case study used in business schools on how not to market a hugely viable/needed product, example SNY |
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Post by joeypotsandpans on Jan 5, 2016 14:57:58 GMT -5
where's joeypotsandpans and his pizza guy? Joey is right here and so is his pizza guy...in fact pizza guy does not even know today's news for that matter For the record neither has sold a share or option and may be adding depending on today's CC. Perhaps you read Joeys thread titled are you mentally prepared for a material event? |
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