Tim - when Sanofi had the marketing rights their target market was the T2s. They never took the product out of a controlled launch but the few advertisements they had where all about it being inhaled. Several months into the launch they decided to “go in a different direction”. By the end of 2016 they ended the marketing agreement and later in 2016 announced a joined partnership with Google/Verily called Ondou.
Why they ended the agreement is up for speculation. One is that if afrezza was actively marketed and became the front line treatment for T2s then not only would the other orals no longer be needed but it would kill the T2 Lantus/Toujeo market. Sanofi had just bet the farm on Toujeo and if the T2 would never progress they would never need the basal. Especially since they principle issue with T2s is not during fasting but the meal time sugar spikes. afrezza could have spelled doom for much of the T2 basal sales which is huge.
Ondou is suppose to announce their product offering soon, as they are suppose to launch in 2018 so the speculation should soon be over. Dr. Steve Edelman who is a big afrezza fan was reported as being the architect of the Ondouo protocol. So, we will see what happens.
When Mannkind got the rights back they decided the “low hanging fruit” market was the T1s since the early adopters and the most vocal had been the T1s who are claiming on social media it had changed their lives. Those T1s were more about the tight BG control they were getting and Mannkind followed this lead so their focus has been more on how it mimics the healthy pancreas and how fast its in and out not on the shots.
As they redirect with corporate wellness programs and the bigger T2 market the “No Shots” will become a big thing for marketing along with no carb counting. Of course near non-diabetic time in range BG is the key. In the short term after getting the marketing back, for little Mannkind it was more about making sure afrezza really was as good as Al Mann said it was so they could get the financial support to pay the electric bill. I think what every one who has been following is now seeing is afrezza is better than almost everyone thought, except Al Mann. Where a lot of new T1s are starting to use it is for corrections. Thats how Gary Scheiner started along with many others.