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Post by compound26 on Sept 29, 2015 17:18:13 GMT -5
After being denied in June, I have just been approved for Afrezza by Caremark. My monthly cost will be reduced from $160 to $200 (depending on dosage) to “$0”. Just might have an impact on the script count! I am a Type 2 & my A1C went from 7.0 to 6.4 in 90 days and it is continuing to move lower. Prescription written by my GP, not an endo. All good… lakefox333, that's great. Congratulations on the excellent A1C and nice trend (of continuing dropping A1C). Your patience and perseverance in educating and convincing the insurance company is greatly appreciated! Every case like yours is helping to set precedents for the insurance companies. With a sufficiently large database of users like you, better insurance coverage for Afrezza will come. |
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Post by compound26 on Sept 28, 2015 17:05:55 GMT -5
It's nice to see you back here Fugacity  Fugacity, glad to see you back. Look forward to see more number crunching from you. |
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Post by compound26 on Sept 27, 2015 17:33:37 GMT -5
We need to find out a way to point that out to the website. This is seriously misleading. I just sent an email to the editor: editor@everydayhealth.com
Thanks, I have also sent an email to editor@everydayhealth.com. |
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Post by compound26 on Sept 27, 2015 13:05:43 GMT -5
We need to find out a way to point that out to the website. This is seriously misleading.
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Post by compound26 on Sept 24, 2015 14:15:01 GMT -5
I am going with the theory that sanofi is is intentionally dragging its feet, doing the absolute minimum contractually, to crush Mannkind down so as to eventually buy in at a cheap price. I think they did the same with regeneron, when the partnership was made with Sanofi, REGN was about $15, I believe, by the time Sanofi bought into REGN, REGN was under $5.... Was likely brutal for REGN stockholders shortterm, but all turned out fine in the long run. Anyway, that's what I keep telling myself. Just for fun, when the partnership was made with Sanofi, REGN was about $15, I believe, by the time Sanofi bought into REGN, REGN was under $5.... When the partnership was made with Sanofi, MNKD was about $11, I believe, .... one third of that is $3.67, we are now at ...... We are about there.  |
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Post by compound26 on Sept 24, 2015 13:06:51 GMT -5
YMB is always full of rumors. A while back (about 15 years ago), there was a message in YMB claiming "Warren in Hospital-Critical! I just saw on CNBC that he was admitted to an Omaha hospital ... serious condition ... confirmations?". Buffett was in his study reading and calls pouring from all over the places asking about his health. Of course, PPS of BRK was down significantly. And BRK had to issue a public statement declaring that the rumor had no truth at all. Just hate anyone who purposefully spread any rumor like this. As human being, they are probably at the same level as Martin Shkreli is. Web Rumors About Buffett's Health Depress Shares of Berkshire HathawayWarren In Hospital-Critical! |
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Post by compound26 on Sept 24, 2015 12:30:17 GMT -5
MNKD is often up on Thursdays. There may be some anticipation of a surprise uptick in scripts on the upcoming Friday. Though, recently, the scripts have been generally uninspiring.
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Post by compound26 on Sept 24, 2015 12:01:45 GMT -5
My question is, with all the issues (spirometry, label, insurance, dr education) that have impeded the Feb launch of Afrezza, should SNY have delayed the launch until some of these issues could have been resolved? Since the share price has dropped considerably after such great things (ad com, FDA approval, SNY partnership) would it have been wiser to resolve those issues then launch with a big bang (including TV ads)? First, neither would Sanofi and Mannkind have expected the launch to be this slow, even with these obstacles. Remember Matt said the scripts were 8 weeks behind (I recall he probably said it in June). I guess he was referring to 8 weeks behind Sanofi/Mannkind's expected scripts. Second, neither would Sanofi and Mannkind have expected the PPS of Mannkind to have dropped so much after the launch. Third, Sanofi wouldn't care much about how much the PPS of Mannkind fluctuates (or drops). |
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Post by compound26 on Sept 22, 2015 9:45:36 GMT -5
Assuming this is the case, I am fine with the number on the sales force ( 200). That means we have an average of 5 reps in a state, with a big state having 5+ and a small state having 5-. I'm not a math wiz, but when I divide 200 reps by 50 states I get an average of 4 reps per state, not 5. nylefty, you are right. Thanks for pointing that out! I will fix my post on that. |
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Post by compound26 on Sept 21, 2015 23:11:39 GMT -5
Does this sound reasonable? Train the Trainers (Endo, Speakers Bureau) to be followed by Train the GPsby lakers_w • Sep 18, 2015 12:44 PM Flag Break Through 2.0 in MGM Grand We'd 9/16 9-12 AM: Train the Trainers (Endos, Speakers' Bureau) Sanofi Breakthrough 2.0 - MGM Las Vegas I spoke to Matt last week, and he confirmed that SNY was having training in Vegas this week. He is currently in Europe at the EASD. Will be back on the 25th. It is my understanding that the SNY reps that call on GP's will be having their own training soon. I believe that David Kliff was spreading FUD claiming that 2/3 of the reps that were training this week were being asked not to attend. SNY made a decision to have the GP reps, the 2/3 in question (700) have training at their own meeting, since they already had a meeting coming up.mnkd.proboardsDOTcom/user/336/recent#ixzz3m2XMiwLU By obamayoumama Matt will attend 9/22 JAC in Paris, where the World Launch Plan will be presented. Matt will be back on 9/25 after Note conversion completes 9/24. Some asks as CFO he should focus on the conversion. Yes, he focuses on it by being where the source of money is. |
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Post by compound26 on Sept 21, 2015 23:07:15 GMT -5
This article is a month old. The author also believes Afrezza is a niche drug meant for people scared of needles. I would take 200% with this shitty share price right now though. In my view, the author is quite bullish on the product (Afrezza), even though its valuation of Mannkind is relatively conservative. In the valuation part, the author actually has the following assumption: if the insulin market continues to grow at the same CAGR over the next five years, Afrezza’s addressable market would be around $17 billion by 2025, which is when it could achieve peak sales. In the bullish scenario, Afrezza achieves peak sales of $6.80 billion based on 40% penetration rate. That does not sound like a niche product to me. By the way, there already is a thread discussing this article: MannKind And Afrezza: Can The Drug Cure The Company? |
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Post by compound26 on Sept 21, 2015 12:43:57 GMT -5
funny because Sanofi is practically giving away Afrezza for the first few scripts and even that isn't generating much interest in the drug. I wouldn't be surprised if it is his way to "negotiating" with the insurance companies for a better price. The huge price increase is the initial shock and awe from Touring to the insurance companies to come to the bargaining table to renegotiate pricing. Sanofi is only giving a modest discount. Since our insurance doesn't cover it, we only get the discount, which still leaves us with nearly $400 a month in cost for this. Is it worth it? Of course, and we can't wait until it is covered by our insurance company. But, clearly, they aren't "giving it away". Until the insurance companies get on board, which will require either an upgrade in the labeling or a discount to the insurance companies, many of us will be stuck with the difficult decision of whether or not to pay for this drug ourselves. I believe suebeeee1 is correct. Per this post started by Rozale, the discount card that sanofi gives to make sure your copay does not exceed $30 is only good for the first $125. |
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Post by compound26 on Sept 21, 2015 12:35:34 GMT -5
Rob. I do think he is over thinking the process. I also wonder when a person's ego is involved they are unlikely to ask questions when they don't understand the answer. I'm glad to hear you say that most doctors do understand.. that's what I'm invested in. thekindaguyiyam, FWIW, here is someone (who supposedly is an Afrezza prescribing physician) commenting on this issue. docfrezza • Aug 5, 2015 11:11 AM I have no idea if you are really a prescribing practitioner. All I can say is that in the real world Afrezza takes less time to prescribe and correctly instruct the patient than the injectable rapid acting insulins. If Afrezza prescribing takes you more time then perhaps it is not the patients that need instructions, perhaps it is you. Have a talk with your representative. Afrezza is easy to prescribe. And very easy to educate patients in its use. Sanofi is providing practitioners with more than adequate educational materials for the patients. |
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Post by compound26 on Sept 21, 2015 11:42:35 GMT -5
Just found out from my friend who attended:
Total count of reps in Vegas was just over 200. These reps only sell Afrezza.
(Frankly, I thought it would be more).
Assuming this is the case, I am fine with the number on the sales force ( 200). That means we have an average of 4 reps in a state, with a big state having 4+ and a small state having 4-. Based on this article, the 100th largest city in the US has about 200,000 people. That means for each of these largest cities, there will be at least one rep covering it. In the bigger cities, we apparently have more than one reps covering them. It appears it will take some time for each rep to visit each of the endos and PCPs he/she covers, but if there are 5 of them covering a state, it is doable. I think Sanofi is taking a slow and steady approach, that works and I think that is a prudent approach. This will ensure that Sanofi won't be pressured to see significant sales of Afrezza in a short time frame (as compared with Pfizer in the case Exubera). That will in turn give Sanofi's Afrezza team sufficient time to carry out their strategic plan step by step, without hurry or pressure.I think Pfizer was too aggressive with Exubera (i.e., they had too many people working on the sale, but did not give it enough time; with too many people on the sale, the cost of promoting it was very high to Pfizer). Per this article (of MAY 11, 2007), "Bloomberg News reports that some 2,300 Pfizer sales representatives have been promoting Exubera to more than 5,000 doctors. But Pfizer has also hired approximately 900 additional, part-time diabetes educators to explain the product to doctors and patients, and more will be added, although the company wouldn't say how many." So in total, at one point Pfizer had 3,000+ people promoting Exubera, yet within five month of this article, Pfizer abandoned Exubera. Apparently, Pfizer put in too many people, but did not give enough time. So if Sanofi has 200 rep on Afrezza now and Pfizer had 3,000+ people promoting Exubera, cost wise, just looking at the headcount cost, Pfizer was running a 10+ times that of Sanofi. The cost of Pfizer promoting Exubera (again, just looking at headcount) for 1.5 years was equivalent to Sanofi promoting Afrezza for 15+ years. Assuming a drug company runs a $100,000 (a random number picked just for illustration purpose) headcount cost for each rep, at 200 people, Sanofi runs at $20 million per year for headcount cost for Afrezza, and at 3,000+ people, Pfizer ran at $300 million per year for headcount cost with Exubera. Now I see why Pfizer did not give Exubera more time. It was too expensive for Pfizer to continue the program at that scale much longer. The more I looked at the numbers, the more I think Sanofi's approach is the more prudent approach. |
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Post by compound26 on Sept 21, 2015 9:30:19 GMT -5
As memory serves, the relevant legislation pertains to the Part D prescription drug act provisions of Medicare. I seem to recall that drug companies successfully thwarted efforts to control how prices are established to prevent "Free market" interference. Part D legislation precluded the ability of the government to negotiate reduced prices based on volume. Of course, when there is a virtual monopoly on the treatment for a rare drug, insufficient competition exists to keep the prices humane and only ethics are then in play. What is the practical and moral difference between holding a gun on someone and demanding their money in exchange for their life, or demanding a ransom for a life saving drug? I call it legalized extortion, and it's repugnant and inconsistent with a civilized society. It's emblematic of a growing list of injustices that is creating a tinderbox in the USA. This excerpt from an article on Part D may help to underscore the above: Estimating how much money could be saved if Medicare had been allowed to negotiate drug prices, economist Dean Baker gives a "most conservative high-cost scenario" of $332 billion between 2006 and 2013 (approximately $50 billion a year), and a "middle-cost scenario" of $563 billion in savings "for the same budget window".[27]
Former Congressman Billy Tauzin, R–La., who steered the bill through the House, retired soon after and took a $2 million a year job as president of Pharmaceutical Research and Manufacturers of America (PhRMA), the main industry lobbying group. Medicare boss Thomas Scully, who threatened to fire Medicare Chief Actuary Richard Foster if he reported how much the bill would actually cost, was negotiating for a new job as a pharmaceutical lobbyist as the bill was working through Congress.[28][29] A total of 14 congressional aides quit their jobs to work for the drug and medical lobbies immediately after the bill's passage.[30]Not surprisingly, Shkreli "trained" under Jim Cramer. His standing in my book places him at a level one notch below whale turds. Chris, funny you are speaking of whale turds. See this article: Sperm Whale Shit Will Make You Rich. Sorry, this is really off topic. |
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