I take metformin and had GI upset the first week. I expect I can go off of it when I lose some more weight and stick to a diet low in fast carbs.
I think they made mistakes. It was a different drug and the climate was different. ACA has dramatically changed the medical industry. Exhubera probably would have been successful if they gave it some time and improved the delivery device. Some companies are myopic.
OK so in 6 months it will be a year. I expect new scripts to get to a thousand by then. But it will take another year to get to 10K per month the way I see it. I just don't think that script count is a good measure of whether the drug will be accepted in practice at this point in time. Managing diabetes isn't anything like prescribing lipitor after somebody has a stent placed.
Sales won't ramp up until the comfort level with using it rises sufficiently for doctors to prescribe it as the first supplemental insulin instead of a long-acting injection. This will take years, not months. Doctors are risk averse and egotistical. They will stick with what they know rather than get in trouble trying something new. And pushy salesmen just make them more skeptical. What will change their attitudes is case reports in their journals and med school textbooks along with reports from their colleagues. But once they see good results for themselves they will become enthusiastic. The best place to target detailing is in medical school institutions where new doctors will be trained on how to introduce insulin therapy.
good question. straight answer is it can't, directly. It can only supplement the pancreas when it has become exhausted from overwork. There is suggestion and hope that resting the pancreas may improve or prolong its ability to produce insulin. And by lowering the average insulin concentration by supplying a fast acting form it *may* improve insulin sensitivity. With insulin, you become tolerant with larger amounts being needed over time to produce the same therapeutic effect.
The current practice is to give long acting insulin when the pancreas poops out to the extent that metformin no longer controls blood sugar. This is not optimal, since it further reduces insulin sensitivity by providing more insulin than is needed (hence causing hypos) during most of the day, and not enough at mealtime. This practice is due to the convenience of taking a shot once a day and then drinking orange juice to correct the ensuing highs.Afrezza has the potential to alter the standard of care, by inhaling it at mealtime instead of injecting slow insulin every 24 hours. We won't see it being used that way until doctors are convinced in practice that it is a safe and effective alternative to long acting insulin after metformin no longer controls blood sugar adequately. The first target is to replace fast acting injectables in patients who require basal and prandial insulin (end stage disease and T1)
The mechanism of metformin is poorly understood. But it does not stimulate the pancreas to secrete insulin. It acts primarily on the liver to inhibit gluconeogenesis.
So the 200 million registration filed 2/26/15 was for what? Would a long holder be selling at 33? Seems like shorting or the company is selling to me. It seems out of character for the stock to sell off on this news.
No money no pipeline. What if SNY cancels the partnership and MNKD re-aquires 100% of the rights? This would mean that the lion's share of marketing has already been done, the reason for partnering. Have your cake and eat it too.
The irony is that NFLX trades in the stratosphere on the same value proposition; that it will be profitable in the future because of the disruptive nature of its product.
it should not be surprising. The national bid/ask are not very relevant when 50% or more of the trades execute against dark pools of liquidity. This is like me any you agreeing on a phone call the terms of a trade. The negotiations are not seen; only the trade itself.
Can you give us a clearer picture of his disease state, i.e his insulin use and how Afrezza now fits in? He's T2 I presume?
I think that's the problem. In lieu of compelling P3 trials designed to show superiority physicians will have to see for themselves how it works better for T1 prandial and as first line in new T2. You can't "sell" someone on the notion they can switch brands. What has to happen is for pioneer patients to have excellent results. Nothing will impress physicians more than surprising benefits in their own practice. I think Sanofi gets this. The only way the product can fail is if it has a runway that's too short.