Sanofi ending its Afrezza partnership with Mannkind


#83

I happen to know a thing or two about MediXXX and insurance. When a person can get ‘around’ with getting cards and money just be aware that their benefit can be reduced or even discontinued. I also know lots of stuff about discount programs and there is a reason why all of these require your own name, data, etc. I don’t care whet insulin folks want to use. I think it’s nice if you want to help Eddie, just make sure that the help causes no harm.

I am ever interested in partnerships and companies that provide drugs and services to diabetics. This thread was not about another How Great Afrezza is… it was about the ending of a partnership that will surely cause some issues for new and current users.


#84

Although my DD is a type 1, the real money to be made with this insulin is in the large Type 2 market. And there are so many Type 2s who are afraid to start insulin, either they are needle phobic or just afraid of using it. Mannkind should be targeting the Type 2s. Type 2s are insulin resistant and typically need to use a lot of insulin. Which would give me pause if I were a Type 2, just knowing the nature of the drug,I would be afraid to start because of the lows. But with Afrezza there are a lot less lows… Very few, in fact. So forget about the Type 1s for now. Market the drug to the Type 2s. If it is not too late to do so. Type 1s are a very small percentage of this market and it matters little if they wish to try it. Type 2 strikes later in life, usually. An older and wiser population.The only criticism I have is for Sanofi. I can only think this was deliberate. Their fast acting insulin is Apidra which pales in comparison to Afrezza. Afrezza was a threat to their existing insulin market. And I can only assume Al Mann was desperate at the time he made the deal with Sanofi because surely he realized he was putting this insulin in the hands of a competitor. They bought the rights and SAT ON IT. As for Smart Insulin, Merck bought it and sat on it because it was a threat to Januvia. But they are working on it now because there are two other companies who may beat them to market with their own Smart insulins. I will boycott Sanofi as soon as we can. If Afrezza goes out of business, we will use the new Novo fast acting when it comes to market. She is using Tresiba. We will never use Toujeho.


#85

Sanofi has indeed deliberately kept Afrezza on the shelf just long enough until they were sure the drug would not be able to stay on the market. They did not advertise. They did not send their sales reps out to a large number of endos, did not show them how to do the lung spirometry tests, deliberately insisted on their “slow launch” strategy, which turned out to be a :no launch strategy. Why would they promote a drug they are in direct competition with? Promotion was done by Sam Finta and other early adopters. So Sanofi has bought themselves a few more years of blood money. But there are advances they will not be able to keep off the market. Bring on the Smart insulins. Sanofi is losing money on the U.S. diabetes market even without Afrezza. This should have been marketed first overseas, perhaps. Karen, you can bing all you want to. The product DOES meet a need every diabetic has… and that is to bring down their blood sugar after eating or if high WITHIN ONE HOUR, NOT THREE like Apidra; NOT FOUR like Humalog, NOT FIVE like Novolog. In ten years our DD has tried them all. And there is NOTHING LIKE AFREZZA out there, whether injectable or by any other method… except perhaps intravenous IV drip, which of course, you can’t really walk around with. There is a DIRE NEED for the speed and safety of this insulin. You can Google, you can bing, but we have TRIED IT and we have seen with our own eyes how it works.


#86

Intravenous injection of insulin is not something I would ever try. I’ve spoken of it and people find the subject hard to inject into thought process. But I think the speculation is interesting. Pure speculation I admit. These were some interesting statements I pondered. Afrezza is insulin of standard variety not a new analogue. The unique properties are because the insulin is delivered directly into the blood through the lungs. Another speculation has to do with the use of the lungs for drug delivery. Speculation here is appropriate because very little is known about inhalation of drugs. But inhalation in my mind is connected to huffing and smoking. Those are unhealthy activities. The only therapeutic inhalation drugs are drugs that are designed to affect the lungs. Of course I may be completely mistaken. I frequently am. I do enjoy your responses and feeling connected with other diabetics.


#87

The crack about the intravenous insulin was sarcasm. Intravenous IV drip is regular insulin, is instantaneous and must be accompanied by a simultaneous IV dextrose drip so you can titrate between the two It is only used by medical professionals during surgery, or usually right after a Type 1 diagnosis. But these drips will show you it is not the insulin it is the delivery system. IV drip keeps blood sugar super stable, if the RNs know what they are doing. And inhalable insulin is regular insulin but delivered into the lungs it is a different animal; speedy quick. There was a bucal insulin which may have been fast, not sure, Oral-lynn. You can only get it for compassionate use, last I heard. Not sure how fast that is, but through the mucous membranes of the mouth, probably pretty fast


#88

I have been reading the board. The discussion regarding Afrezza.
The interesting thing that isn’t being talked about to my minds eye is,
Afrezza keeps blood glucose from going up in the first place. That is why users are so happy I think.


As Matt saids it is the first phase insulin response you get with afrezza, that you do not get with fast acting analogs, that is responsible for Afrezza’s amazing effect.
The insulin sends a signal to the liver to stop making glucose. that is the first phase response.
this video shows it
http://www.mannkindcorp.com/Collateral/Flash/English-US/Animations/timing_animation.html


#89

I use IV shots…:scream:


#90

Honestly, I wish a few of you Afrezza users who don’t want to see this drug leave the market would write a letter to Dr.OZ and tell your story. You put Afrezza on that show with him walking through how it works with a few testimonials and it would truly breath life into it. I don’t know if any of you ever watched his show, but my wife records it daily and watches it when she gets home. He’s the Oprah of Health and Lifestyle daytime TV. She told me that she’s tried to get products at the store after seeing it on his show, and they are sold out. I know this is much different, but I know he has talked about certain drugs many times. He’s all about healthy and lifestyle benefits which I think Afrezza is all about. He also does an awesome job on telling people how things work in your body. It’s just a suggestion to those who’d like to see Afrezza stay on the Market. Here’s the link.
http://www.doctoroz.com/contact


#91

We know ALL about Dr. Oz :worried:


#92

I’ll shoot an email to Dr. Oz on Monday. Can’t hurt.


#93

Keep me in the loop on how that goes, it’s not exactly a charge I’m interested in leading but if they wanted people to share how much it’s improved their lives-- I’d have a lot to say


#94

Will do. I’m not qualified to say much, but if there’s any interest, I’ll definitely let this board know. It is certainly a good case study on many levels, and perhaps it will pique some interest.


#95

I have written a first draft of a letter to Dr. Oz, as suggested above. I don’t know any other way to let you folks read it than to just copy it here in it’s entirety. As a rather new Afrezza patient, I am asking help from those who might know the story and the drug better than I. I welcome suggestions.

Here goes:

I am writing to suggest that your show might be interested in producing a segment on the new inhaled insulin drug Afrezza and some of the controversy surrounding it. It is a story that encompasses not only a revolutionary new treatment for Type 1 and Type 2 diabetics but also the tribulations in getting a drug to market and ensuring its success despite its proven efficacy for many, many patients.

Afrezza is an inhaled insulin powder developed by a company named MannKind and its founder, Al Mann. As far as I know, it is the second inhaled insulin powder to make it to the market in the US. The first, Exubera, was introduced about 10 years ago and was a quick failure, not least of which because the inhaling apparatus was about the size of a can of tennis balls. Afrezza’s delivery system is totally different – a discreet, whistle-like device in which small cartridges of medication are inserted. It’s about the size of a man’s thumb.

The unique thing about Afrezza is the way it works. The insulin enters the patient’s bloodstream much quicker than traditional, injected insulins, so it acts faster to reduce blood-glucose levels. It also leaves the body quicker, so that if a diabetic finds that he needs a subsequent dose of insulin to offset a high-carbohydrate meal, he can take that dose without having to worry so much about the insulin that is already working in his body and risk the possibility of a dangerous low-blood-glucose episode.

Another advantage of Afrezza is that, when taken along with meals, it somehow tends to prevent blood sugar from rising in the first place, apparently by blocking the release of insulin by the liver. What many patients find is that this combination of effects means that they do not have to be nearly as exacting with their meal-related dosages (called boluses) when using Afrezza, and their blood-glucose levels remain very stable without having to exactly count carbohydrate, protein and fat levels of each meal in order to calculate exactly how much of a bolus they need for a particular meal. As one might imagine, this is a tremendously freeing advantage. These patients also report that they are achieving some of the best blood-glucose levels of their lives with fewer highs and lows along the way when using Afrezza.

Though only about a year on the market, Afrezza has gained some very vocal fans among its users. They are not only achieving their healthiest A1C levels ever, they are doing so without having to give nearly as much thought to what they are eating and how to dose themselves. For some, it has been truly revolutionary.

Now, for the bad news. MannKind has been in a partnership with a major drug company, Sanofi, to promote and supply Afrezza to physicians. The launch of this medication has not gone well, and Sanofi announced recently, they will pull out of this partnership within six months. Afrezza, quite simply, has had difficulty gaining acceptance, despite some distinct advantages over traditional insulins.

For one thing, Afrezza is primarily for mealtime boluses. A different type of insulin is still needed by patients to provide blood-glucose control between meals, called “basal” insulin. In addition, Afrezza works so differently from traditional insulins that medical providers must be educated and familiarize themselves with the product in order to prescribe it properly and train patients in its use. Afrezza is also not for everyone. There are very clear restrictions to its use with patients who suffer from certain lung disorders.

For the right patients with proper training, however, Afrezza has been truly revolutionary in its ability to control blood sugars with minimal hassle to the patient. Many describe their experience as being almost like they no longer had diabetes at all – not a cure, but almost as good in terms of making the disease easier to deal with.

I believe the Afrezza story would be one of great interest, not only in terms of how it works differently – and better in many ways – than traditional insulin, but also as a case study on the many barriers of bringing a promising new medication to market. Should you decide to pursue it, I could assist in finding a number of users who would be more than willing to tell of their successes with it and their fears that future availability is uncertain at best. I, and many Afrezza users, hope that you will find merit in pursuing this multi-faceted story.


#96

My drug coverage, United Health Care for Medicare-ites, said it would cover Afrezza! In Florida.
So, getting older is not at all bad, if we can get what we want.


#97

Looks good Jim, I think you mis spoke about the liver releasing ‘insulin’ instead of glucose. If it were my letter id probably just leave that whole bit out about how it may or not have anything to do with that process, because frankly I don’t know if it’s accurate…

Other than her I think you covered quite a lot of territory in a reasonably short statement, which is good.


#98

Nice catch, Sam. I wasn’t sure how certain that effect is. I’ll rework it.


#99

I’m not sure is exubera was a powder or a vapor… I just mean the part about the liver I’m not sure about, I’ve only seen wild speculation on that front…

I’ve absolutely found that precise carb counting isn’t necessary… I have my own theories on the mechanism but nothing exactly scientific…


#100

Well stated, Jim2


#101

That’s my thinking, it can’t hurt. Would be something if they did have it on the show.


#102

The more actual users submit something, the higher the possibility that someone might pay attention. I think the more you personalize it the better.