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Post by compound26 on Aug 29, 2017 16:35:30 GMT -5
Did you purchased that in the regular trading hours? I think the real time quote page shows the last price of the regular trading hours. If you purchased after hours, that will only affect the price of after hours, which is shown in a separate page. www.nasdaq.com/symbol/mnkd/after-hours |
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Post by compound26 on Aug 29, 2017 16:08:48 GMT -5
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Post by compound26 on Aug 29, 2017 9:53:37 GMT -5
Everyone has a best case, worst case. My worst case is a cheap BO. I'll go with baba's 3pps. 10% chance in my mind. But that's why we bought 1.50 and 2.00 dollar calls when the stock was under a dollar:-) baba's as long as I am. Just covering all the bases:-) I'm with Nate. Really strong buy under 5. Buy under 10. I don't think about 300pps....or going under at this point. I think about how much more we are going to be worth the more exposure and market share we gain. Building a great team:-) All you have to do is look:-)) And not let the shorts blind you. IMO..Mikes got this. GL to all. Looking forward to all the fun on the way up! Reaching more PWD! Watching a baby company grow... We all got really surprised when GS first set a target price of $0.15 pre-split (which translates into $0.75 post-split). Now most longs will agree that Mannkind is totally undervalued at such a price, and nevertheless, GS successfully predicted the price. Now, GS owns two million plus shares as of 6/30, and they increased their holdings of Mannkind in the second quarter of 2017 by about 33%. www.nasdaq.com/symbol/mnkd/institutional-holdings Not a ton, but a meaningful amount. What if GS countenances that it starts to covers Mannkind again and publishes a bullish piece like the one published by equities.com?
www.equities.com/news/mannkind-mnkd-moving-forward-under-new-leadership Same stuff, but just comes out under GS' name. What if GS writes that they like the new leadership and see Afrezza has a great chance to succeed after-all and that they also see a great opportunity for Mannkind in the PAH market space. And as icing on the cake, what if they then give Mannkind a target price of $25? Think about it? What will happen? Brown Bear Brow Bear What do you see? I see GS riding their "small" holding in Mannking to $50 plus million in no time. And GS has barely sweated.  Not saying this will happen. But what I wrote above is not impossible to happen either, right? (A $25 price only gives Mannkind a $2.5 billion market cap, which is probably the fair value I will give it as of now.) And if somethings like the above happens, it can happen at any moment from now on. I am just giving one example here (and there could be many such examples) where momentum can shift dramatically, with the underlying fundamentals basically remain unchanged. I know we longs have been beaten up for so long, but things can get really interesting at any time. Hey, poor babaoriley , there is still hope, isn't it? |
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Post by compound26 on Aug 27, 2017 18:51:27 GMT -5
Certainly that is what the current label says about onset of action. So what? The newest study data submitted with the sNDA presents new conclusions: - Onset of activity for TI occurred ca. 25-35 minutes earlier than for Lispro.
- TI duration of action is about 2 hours shorter than an equivalent dose of Lispro.
- Dose-response was almost linear up to 48U TI and 30 U Lispro.
Based on what the new data reveals, the FDA would be justified in creating the new class of insulin. Novo Nordisk is also pushing for the new "ultra rapid-acting" class for its RAA Fiasp, whose onset of activity is only 12-15 minutes faster than its other RAA - much slower than Afrezza. Also, it's likely that recent medical publications touting the significance of triggering the first phase insulin response (i.e. signaling the liver to shut off production of glycogen) that a healthy pancreas releases is not a coincidence, IMO. The science will prevail. In my opinion the FDA almost has to create a new class for Afrezza and I suppose Fiasp. Not doing that is borderline dangerous in my opinion from a patient perspective. Putting Novolog in the same class as something that is SO much faster suggests to patients, and docs, that it is the same. It's clearly not. Totally agree. If FDA declines to give Afrezza a separate category, then FDA will be slapping its own face if it turns around gives Fiasp a separate category. And we can assume that Novo Nordisk will try its best to convince FDA that Fiasp warrants a separate category. |
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Post by compound26 on Aug 22, 2017 16:30:52 GMT -5
Afrezza will never, ever take off as long as it is priced way, way more than Humalog and Novalog. The management are foolish to not be able to see that. Just checked insulin costs for 90 days under my GE plan, which is administered by OptumRx. Humalog: Not covered. Novalog Flexpen: Prior authorization required. Plan pays $842.52. Employee pays $35. Afrezza: No mention of prior authorization. Plan pays $467.95. Employee pays $35. Thanks! nylefty. This confirms my observation that pricing (of Afrezza) is more complicated that what saw in GoodRx and that the major roadblock for Afrezza sales growth is the doctors' unawareness of Afrezza and reluctance to prescribe, with insurance coverage a major contributing factor. |
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Post by compound26 on Aug 18, 2017 17:20:29 GMT -5
I decided to create a separate thread to discuss the afrezza pricing issue.
I think the price issue is much more complicated than some members here argued. And I recall Mike has expressed a similar view in previous conference calls.
1. Will a significant decrease of price lead to increase of overall sales (in terms of dollars)?
I think the answer is probably no, as I think the main bottleneck of Afrezza's sales growth has been the doctors' general reluctance to prescribe it, with poor coverage of insurance probably being a second factor. So, if we reduce the price by 50%, will we see sales volume pick up 100%? I doubt it.
Ultimately, the sales volume may pick up as we lowered the price significantly. However, what if sales volume does not increase much for quite some time (say several quarters) after we cut the price by half (which is a very likely scenario)? Our PPS will probably be cut in half again in no time.
2. The retail price we see at GoodRX and other places is different from the price that insurance companies and other major payors. I would think they are paying a much lower price than the retail price we see at GoodRX.
3. I think Mike and others at Mannkind do see the price issue. However, it is a complicated issue and can not be solved by a simple reduction of price across the board.
I think, however, the high price of Afrezza to the cash paying market probably will be resolved once Mannkind and One Drop finalize their afrezza subscription service. At that point, I think consumers who are willing to pay a reasonable price for subscription Afrezza with out-of-pocket cash will be able to get Afrezza (without going through the hassle of dealing with prior authorizations with insurance companies).
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Post by compound26 on Aug 16, 2017 16:00:27 GMT -5
Michael Castagna Thank you, Ray, Pat and Steve. Let me quickly just touch on the pulmonary hypertension market, it’s not something we previously discussed on an earnings call. But based on the FDA meeting we made the decision to accelerate investment behind this program and pull forward to make sure that we don't lose time on time critical path in terms of developing our next pipeline candidate. For those of you who don’t know PAH is a type of high blood pressure affecting the arteries or the lungs, and right eventual the heart. It’s estimated to impact of 250,000 individuals worldwide and is considered an orphan condition. Market size exceeded $6 billion in 2016, but his considerable commercial potential due to the premium price paid for PAH therapies. Currently just to put some context around this, the current prostacyclin costs anywhere between $170,000 to $300,000 in a patient per year. The lifestyle and the quality of life for these patients is dramatically impacted by the current treatment out there. For those of you who don't know, you currently need to take roughly 12 to 20 inhalation a day through an nebulizer and machined to get your effective dose and because of the complexity in the delivery as well as the absorption of the product, it’s very hard to get to the top end of therapeutic doses. We believe we have an opportunity here to deliver appropriate dosing in the current ranges of all upper dose ranges that will really help these patient receive tremendous benefit and get their disease under control. Today, the prostacyclin have about 45% market share and we currently labeled our Treprostinil Type 2 which will compete in this space. That is not the brand name, that is just our internal abbreviation as we refer to it. We are excited about this milestone in the company's history. We are excited for development team to get the work to start focusing on bringing this molecule forward. Many of you are able to afford to bring this forward. And I want to articulate that the early phase development of these programs do not cost a lot of money, they take more time. And the capital putting toward this is worth it because I don't want to lose another 3 to 6 to 9 month in time and in a critical development and way, which this to me, we haven’t shared timelines, but as we get through the single ascending dose study and build our confidence around to potential this molecule we will share updated timelines for potential launch. But obviously we are moving faster, because we believe there is an opportunity. Mike was playing fast and loose with the numbers. The US population of PAH patients is estimated to be between 10,000 and 20,000 according to the American Thoracic Society (see: www.thoracic.org/patients/patient-resources/breathing-in-america/, chapter 17), not 250,000. Using the higher end estimate for US PAH patients and the higher end of annual prostacyclin costs you can get the $6 billion estimated annual market. 20,000 x x $300,000 = $6 billion. However, if MNKD is going after the prostacyclin market, it would be 0.45 of this or 0.45 x $6 billion = $2.7. Actually it would be much less than this because we used the high end of the estimates for both number of people in the US with PAH and the cost of the drug. A more realistic estimate would be, assuming MNKD gets 75% of the prostacyclin market, 0.75 x 0.45 x 15,000 x $170,000 = $860.6 million Not a quite a blockbuster drug in this patient population (certainly not as impressive as $6 billion), but close. Even if MNKD is expected to lower the cost of treatment as well as improve outcomes, it is still not a bad market potential for a pipeline that could quickly produce several such products. Mike was talking about a global target population, while you are talking about the US target population. "It’s estimated to impact of 250,000 individuals worldwide". If your number is close to accurate, then Mike's number is very conservative. And I do not think $860.6 million sales is anywhere underwhelming. And even if Mannkind does 1/10 of it, say $80 million a year, if Mannkind can get $20 million a year of profit out of it, and you give it a 20 time PE, that alone will give you a market cap of $400 million. Remember that our market cap has been hovering around $100 million for a while. So if we can indeed generate a sale of $800 million a year and if we can get $200 million a year of profit out of it, and you give it a 20 time PE, that alone will give you a market cap of $4 billion, which will translates into a PPS of $40. You are not happy about that? How about Mike finding some partner who is willing to provide a $50 million upfront fee for a PAH partnership? Mike, let's do it. |
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Post by compound26 on Aug 9, 2017 9:50:09 GMT -5
Yes WS has been right. SNY dumped us.Things were bleak. Stocks are a screaming buy before WS gets it. IMO When we get over 500 scripts WS may re-think things and reverse their estimates. Yes, totally agree. Mike commented that, had SNY kept their feet on the gas pedal, Afrezza can easily achieve $30-50 million sales in the first 12-18 months of launch. |
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Post by compound26 on Aug 8, 2017 15:39:36 GMT -5
oldfishtowner agree with your comments. I was just playing with the numbers a bit to show that: 1. if Mannkind can get sustained script growth at current rate, there is a clear path to break even in the near future;
2. additional capital raise can be quite limited if we achieve goal number 1 above;
3. the needed dilution probably will not be that worrisome to shareholders if we achieve goal number 1 above; and
4. if we achieve goal number 1 above, as we move much closer to breaking even (or the ability of breaking even), our PPS will be much higher and therefore making fund-raise much easier and less painful to shareholders.
Therefore, at some point, even though we do not break even, if our PPS is much higher and we have pretty good cash reserve, it is not that important whether we break even or not.
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Post by compound26 on Aug 8, 2017 15:23:39 GMT -5
Every time I play with compounding, it amazes me. For your entertainment, I present you with the results of my playing MNKD numbers.
Assumptions:
Growth rate: 5% weekly. Retention rate on new prescription: 50% of new prescriptions after 4 weeks. Retention rate on existing refills: 50% of new prescriptions after 4 weeks.
So, my new prescription is 5% higher than the previous week. My refill is the sum of 50% of total prescriptions 4 weeks ago.
Facts:
new prescriptions: 184.75 (4 week average up to 6/30) refill prescriptions: 152.75 (4 week average up to 6/30) price: 773.33 (4 week average up to 6/30) -- Surprise#1 We are NOT cheap at all.
Rough facts:
Cash on hand at 6/30: 30M (?) Cash burn: $7M a quarter amounts to $7M/13 weeks. Add back $261,000 weekly revenue now, expenses is $799,462 per week.
With these numbers, I was trying to find out when we will run out of cash.
To my surprise, I could not. My spreadsheet tells me that Surprise#2 WE WILL NEVER RUN OUT CASH! In fact, our cash balance will reach its lowest point on week of 12/22/2017 at $21,753,908.50. Our maximum cash draw down was only $8.2M. We start to clime after that, just ready for Xmas.
Surprise#3: Our cashflow positive point can be achieved by selling only 1034 prescription.
My questions for these interested: Do you think this is a realistic scenario? If not, which number will you challenge? Suggestions, critical ones included, are welcome.
Merry Xmas! Have a feast, but don't forget your Afrezza.
@sportsrancho since you asked, here are my thoughts. My understanding is that the sales amount reported by Symphony and IMS is not the real revenue that Mannkind receives. At least, the sales amount they report does not take out rebates that Mannkind has to be pay the payors. See this Forbes article for more detail. So I would prefer use the net revenue reported by Mannkind. I do not know what constitutes "net revenue" for Mannkind's case. But seems like this explanation makes senses to me. Assuming this is true, this means the net revenue reported by Mannkind already takes into account all the discounts it offered to users. Per Mannkind's 1st quarter conference call transcripts, "our total net revenue for the first quarter of 2017 was $3 million which included $1.8 million from the sale of surplus bulk insulin to a third-party and $1.2 million of recognized Afrezza product dispensed to patients, after giving effect to gross to net adjustments of $0.4 million." So my understanding is that Mannkind's net revenue for selling Afrezza in the first quarter was $1.2 million, after taking out $0.4 million rebates to the payors. Based on the Symphony reported scripts numbers maintained on this site, we note that the TRx for the 1st quarter is 3,203. A total net revenue divided by 3,203 results in $375. So we can assume Mannkind gets $375 out of each script. Based on a cash burn of $7.5 million/month and $90 million/year, it appears we will need 4,615 TRx per week to break even.However, even though we are currently pretty off from break even right now, I am pretty optimistic about Mannkind's future. Since Mannkind is only using 1/5 of the sales force of Sanofi and with Mannkind having a far less swagger than Sanofi (in terms of its influence on the behavior of doctors), a TRx above the Sanofi high watermark (627/week, with a weekly revenue of $370,000) will represent a meaningful success and milestone. I think we are not that far from reaching that point. As we approach 1,000 and 2,000 scripts a week, the revenues we get from the sales will meaningfully extend our runway and reduce the burden for future financing to extend the runway. Also at that point of time, PPS will be meaningfully higher, which makes future financing much easier. Additionally, any sales of Afrezza overseas, though may be at a lower price level, will also meaningfully reduce the required break even U.S. domestic weekly TRx stated above.
An update of the above calculation based on the second quarter numbers: My understanding is that Mannkind's net revenue for selling Afrezza in the second quarter was $1.8 million. [They reported 1.5 million, but said there was a 0.3 million one-time fee to wholesale distributor that would not occur in the future. So we can deem the actual revenue for the 2nd quarter as 1.8 million, rather than 1.5 million]. Based on the Symphony reported scripts numbers maintained on this site, we note that the TRx for the 1st quarter is 3,836. A total net revenue divided by 3,836 results in $469. As the management explained, they are getting more revenue per script for various factors. So we can assume that going forward Mannkind gets at $469 out of each script. Assume a cash burn of $7 million/month (the management noted that cash burn for the second quarter was further reduced to $6.9 million per month if I recall correctly) and $84 million/year, it appears we will need 3,444 TRx per week to break even. However, even though we are currently pretty off from break even right now, I am pretty optimistic about Mannkind's future. Since Mannkind is only using 1/5 of the sales force of Sanofi and with Mannkind having a far less swagger than Sanofi (in terms of its influence on the behavior of doctors), a TRx above the Sanofi high watermark (627/week, with a weekly revenue of $370,000) will represent a meaningful success and milestone. I think we are not that far from reaching that point. As we approach 1,000 and 2,000 scripts a week, the revenues we get from the sales will meaningfully extend our runway and reduce the burden for future financing to extend the runway. Also at that point of time, PPS will be meaningfully higher, which makes future financing much easier. Additionally, any sales of Afrezza overseas, though may be at a lower price level, will also meaningfully reduce the required break even U.S. domestic weekly TRx stated above. |
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Post by compound26 on Aug 8, 2017 15:10:43 GMT -5
Based upon your rough numbers, that would be about 5400 per week. The revenue/script you are using is Gross revenue. On the cc, Mike said the GP% was 60% to 65%. what calculation did you use in determining each trx is $767? for a 4 week rx? not even the largest unit titration pack was showing up on good rx at that price. if that price per month... is the calculation result? something is wrong? Did I miss understand?
a prescription often time is for several packs of Afrezza. Did you ever see people post pictures about their prescriptions? |
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Post by compound26 on Aug 8, 2017 12:55:51 GMT -5
The management said the cash burn rate for the 2nd quarter was 6.9 million per month, if I remember correctly. So I use 7 million as the baseline. And the management projected the future burn rate for the 2nd half of 2017 will be 18-24 million per quarter, which translates into 6-8 million per month. So I think a 7 million/month burn rate assumption is about right. Per Mike C:
"We expect our current capital depending on which we handle the Deerfield debt to get us pretty close and into 2018"
Yes, I remember Mike's discussion about that. So, to be conservative, I have assumed that we need to raise cash to cover the last two months of 2017. |
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Post by compound26 on Aug 8, 2017 12:41:34 GMT -5
I may be wrong ... but, I believe that they mentioned that the burn rate is lower and they have enough cash till early 2018. I will listen to the cc again. The management said the cash burn rate for the 2nd quarter was 6.9 million per month, if I remember correctly. So I use 7 million as the baseline. And the management projected the future burn rate for the 2nd half of 2017 will be 18-24 million per quarter, which translates into 6-8 million per month. So I think a 7 million/month burn rate assumption is about right. |
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Post by compound26 on Aug 8, 2017 12:32:46 GMT -5
Based on the 2nd Quarter 2017 conference call, my understanding of the projection is for a 9 to 14 million gross (and 6 to 10 million net) for the second half of 2017.
I think they are basically forecasting a 50% growth quarter over quarter.
So here is the what they are projecting, in terms of net revenue growth:
1.2 (1st quarter)
1.8 (2nd quarter) [this quarter they reported 1.5 million, but says there was a 0.3 million one-time fee that will not occur. So we can deem the actual revenue for the 2nd quarter as 1.8 million, rather than 1.5 milloin].
2.7 (3rd quarter)
4.0 (4th quarter)
And that is 6.7 million (2.7 million + 4.0 million) net revenue for the 2nd half of 2017. Right in between the projection (6-10 million net revenue for the 2nd half of 2017).
If they can do that, I will be pretty happy.
If they can continue to grow 50% quarter over quarter, here is what it will look like for 2018:
6 (1st quarter)
9 (2nd quarter)
13.5 (3rd quarter)
20 (4th quarter)
And if the trend can continue in 2019:
30 (1st quarter)!!! We will be well above the cash break even point if we can reach 30 million a quarter.
And that is 48.5 million net revenue for 2018. Plus 6.7 million for second half of 2017, we will get 55.2 million in net revenue based on the above projections. Based on a cash burn rate of 7 million, that is about 8 months of cash burn. Assume our current cash can last till end of October 2017, there will be 14 months from there till end of 2018. 14-8=6
So excluding any repayment of debt and assuming Mannkind can sustain a 50% quarter over quarter growth on net revenue, we will need to raise cash for 6 months to get through 2018. And 6 months' cash burn is 6 x 7 = 42 million.
And that 42 million can be divided among several sources, debt, equity, partnership of TS pipeline, international licensing of Afrezza, and sale and leaseback of the Danbury facility.
Can Mannkind do that? Let's see!
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Post by compound26 on Aug 8, 2017 11:54:28 GMT -5
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----------------------------------------------------------------------------------------------------------------------------------------------------------------- Afrezza a net revenue of 1.5 second second quarter. 1,196 first quarter. = 2.7 million afrezza net revenue for the first half. projecting to 9 to 14 million next quarter. ---------------------------------------------------------------------------------------------------------------------------------------------------------------------
We also forecast our operating cash burn which is exclusive of debt principal payments to between $18 million to $24 million per quarter in the second half of 2017. We continue to work with our advisors [Greenhill] company and recapitalization options as this is our priority for the second half of 2017 along with the driving Afrezza sales growth.
, I think you are getting the numbers mixed here seriously. "9-14 million net revenue for the next quarter" is not what Mannkind is projecting and is not going to happen! Think about it, in the last quarter, the net revenue grew 29% and gross income grew 60%. From 1.5 million to 9 million, you are asking for a 500% quarter to quarter growth. From 1.5 million to 14 million, you are asking for a 833% quarter to quarter growth. My understanding of the projection is for a 9 to 14 million gross (and 6 to 10 million net) for the second half of 2017. I think they are basically forecasting a 50% growth quarter over quarter. So here is the what they are projecting, in terms of net revenue growth: 1.2 (1st quarter) 1.8 (2nd quarter) [this quarter they reported 1.5 million, but says there was a 0.3 million one-time fee that will not occur. So we can deem the actual revenue for the 2nd quarter as 1.8 million, rather than 1.5 milloin].
2.7 (3rd quarter)
4.0 (4th quarter)
And that is 6.7 million (2.7 million + 4.0 million) net revenue for the 2nd half of 2017. Right in between the projection (6-10 million net revenue for the 2nd half of 2017).
If they can do that, I will be pretty happy. |
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