Afrezza: Los Angeles Times Article 3rd June, 2015

LA Times June 3rd, 2015 :
MannKind’s inhaled insulin drug proves hard for diabetics to get

http://www.latimes.com/business/la-fi-mannkind-drug-20150603-story.html#page=1

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Interesting. Mostly a business article but better than most about focusing on aspects besides the fact that it eliminates injections (“ew, injections!”), which it doesn’t anyway and is actually to me the least significant thing about it. I almost wish “inhaled insulin!!!” wasn’t part of it, since it’s the different way the stuff behaves that’s its real significance, not the fact that it can be administered without icky needles.

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^^^ ditto what DrBB said! Also in the article, this quote: “The nice thing about Afrezza is it works instantly for me,” said Goldstein, 66, who has had Type 1 diabetes for more than 15 years. “I take my puff after I’ve been eating awhile, and my blood sugar never goes really high.” may be true but if Goldstein has her basal set properly then this would be true for ‘mealtime’ injected bolus insulin as well. At least there was some information about the cost, I’ve been looking for some comparison so yay.

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The cost is probably higher than reported, if the experience of the high profile people tweeting is anything to go by. Eric Fenar, who is among the most vocal, was reported as saying at the MannKind shareholders meeting that he is using 4 boxes a month. That is about a thousand bucks’ worth of insulin, and if you think insurers are going to pay for that, when there is no peer reviewed data pointing to better outcomes than using a pack of pens, I have a bridge to sell you convenient to NYC.

The problem comes in that they only give you 90 doses per box, so even if the size dose is right you can only cover 3 meals a day. No snacks. No corrections. And since the insulin is so short acting, you are likely to need corrections at 2 or 3 hours to cover the rest of the glucose from your meal.

For early Type 2s who really just need that first phase insulin replaced, the stuff looks like it could be really good, but the problem is doctors aren’t going to be putting Type 2s on any insulin early, since they have been brainwashed that they should put them on the GLP-1 drugs first in the erroneous belief these will grow back healthy beta cells. So they are only putting older, very late Type 2s on insulin who have lost their insulin producing capacity and would be needing those correction doses too. But since doctors are told to prescribe one dose per meal, they won’t be suggesting these patients use corrections. So they will get crappy numbers, and insurers will get confirmation that there is not advantage to Afrezza.

Why is it that so few doctors seem to understand what first and second phase insulin are all about? The info is out there. We are paying them a lot of money to supposedly know more than we do about diabetes. But they don’t.

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The only real inconvenience I encountered with getting it was the pharmacy had trouble getting it processed because the doctor wrote a quantity that wasn’t available, which caused a delay— just a new drug type issue… That and getting off my butt to do a PFT… Which I actually ended up doing long after I got the prescription, but it was a bit of a hassle and I kept putting it off, and totally understand how some people just don’t want to jump through a hoop.

I still have pens if I ran out of afrezza, and can still get more… Both my primary and my secondary prescription plans covered it so it didn’t cost me a dime. I initially shared your concern about the prescribed quantity being to rigid and not flexible, but it hasn’t really become a problem at all for me.

It has changed my life in terms of management… I’d pay cash for it if I had to instead of go back to just novolog…
I say it changed my life as a t1 who managed to keep A1C in the low 5s without any real hypos… I can only imagine how liberating it’d be for someone who thus far hasn’t been able to avoid the BG roller coaster

Ps I sold my shares of MNKD,
, just because I’m not sure what to expect for the company itself… But I assure you afrezza is an amazing thing and if mankind doesn’t have what it takes to get it to market they’ll just have to sell out to someone who does.