No we aren’t making this up

No we aren’t making this up

One of the consistent themes promoted by Afrezza supporters is the street has it all wrong, that they don’t understand what an outstanding product this is and the impact it has on patients. They consistently state that things like formulary coverage, the need for additional tests or the fact that many physicians are uncomfortable putting a growth hormone into the lungs, just don’t matter. Additionally they ignore the fact that Sanofi (NYSE:SNY) diabetes is a mess and other than Lantus every product they have touched in diabetes has been a disaster. Yet on top of all this they believe the direct to consumer marketing campaign, twitter and blogs will drive Afrezza sales.

Simply put they ignore the business aspects of Afrezza confusing positive reviews by a handful of patients with Afrezza being commercially successful.

Yesterday Robert Sacher, who according to his profile is a “Private investment analyst and writer with an interest in companies with emerging technologies oriented towards improving healthcare, alternative investments, emerging markets, and technology.” Penned a piece for Seeking Alpha entitled; “MannKind’s Afrezza: Another Look At The Early Adopters”. Here is some of what Bob, who is long MannKind (NASDAQ:MNKD) had to say;

“MannKind Corporation (NASDAQ:MNKD), CFO, Matt Pfeffer, announced at this week’s JMP Securities Life Sciences Conference that patients clearly prefer Afrezza over insulin injection. He also stated,

“We are getting a lot of attention in the media and in places like I frankly have never been before like on Twitter…I want to follow what’s happening out there…I encourage you to go take a look because there’s a lot of buzz out there, especially in the Type One community which is very active. You’ll see they are posting regularly about the product and their experiences with it and I have yet to find one that was not positive. So, it’s pretty exciting, it’s very active and the buzz is increasing and is increasingly positive.”

The company posted a slide as part of Pfeffer’s conference showing that over 1,800 tweets about Afrezza have been made in the last thirty days.”

This is a true statement as Diabetic Investor is part of the ongoing Twitter debate. A debate which is very amusing as Afrezza supporters just love finding new and creative ways to call Diabetic Investor the world’s biggest idiot. Listen we have always known that we’re not the sharpest knife in the drawer but unlike these Afrezza zealots we have yet to see Twitter turn a niche product into a blockbuster.

Bob then goes onto state that feedback from Afrezza users has been overwhelmingly positive citing many of the bloggers who are using Afrezza. This is also a true statement but ignores one huge problem, these early adaptors like most early adaptors are not representative of the overly diabetes population. If MannKind supporters like Bob knew anything at all about managing diabetes they would stop quoting the bloggers. As we have stated consistently there is no doubt that Afrezza works, that there is a place for it in the treatment paradigm however unlike the Afrezza zealots we do not believe every insulin using patient needs Afrezza.  That the majority of patients with diabetes are not as actively engaged in their diabetes management as these bloggers are.

Yet Bob goes on writing;

“Interestingly, the Canadian Diabetes Association posted a link to a recent article, published at The National Post, entitled, Inhaled Insulin Will Eventually Mean No More Shots For Diabetics. The link, on the CDA Facebook page, also posed a question for diabetics to answer: Would you consider an insulin inhaler if it meant ditchin a needle?

At the time of this writing, there were 62 responses to the question. Of the 62 replies, there were 29 in favor of inhaled insulin and 10 not in favor. The other responses did not express a clear opinion for or against the inhaled insulin.

Possibly even more interesting is the fact that at the time of this writing, 155 people had shared the CDA link. Of those 155, there were an additional 27 people who “liked” the article, implying that they too were in support of inhaled insulin as an alternative to needle based injected insulin.

“Being a diabetic for almost 45 years, I would ditch my needles in a heartbeat”, wrote Karen Fulawka Reimer. And, Donna Bell wrote,

“Been taking insulin for over 38 years. Would love to inhale instead of stab.”

Now we hate to burst Bob’s Afrezza bubble but insulin using patients stating they would prefer inhaling insulin to injecting is about as shocking as people in Chicago stating they prefer summer weather to another polar vortex.  Had Bob done even the slightest research he would have found these exact same comments made when Exubera hit the market and well we all know how that product turned out. Again as we have stated from day one IF the only advantage Afrezza has over injectable insulin is the fact that it’s inhaled then the product is in big trouble, which it is.

Bob concludes by stating;

“In conclusion, it looks like Afrezza is working very well for early adopters who have been using it for up to these past five months. However, it does not work well for everyone and it definitely requires getting to know how it works in order to make maximum use of its effectiveness. Taking this into consideration and considering that there is likely to be a large uptake in new users after the start of DTC, there is the likelihood that a considerably larger number of people will soon be using Afrezza.

The new users will also be reporting back as to how Afrezza is working for them, and if their reports are as successful as those of the initial early adopters, investors may soon see hundreds of reports, if not thousands, coming from new Afrezza users. However, investors should also know that it will take months to begin to see these reports as it takes several weeks to obtain an appointment with many endocrinologists and it will take three months before A1C results can be quantified.

In the meantime, we may likely see MannKind’s stock price continue to be traded in a sideways pattern until the new Afrezza users who respond to Sanofi’s DTC start to be counted and take market share away from the needle based injection insulin producing companies. But, if the next group of new users begin to overwhelmingly embrace Afrezza, it could be possible that the long awaited breakout to the upside in MannKind’s share price, in the double digit range, could actually become a permanent reality sometime by the end of this year or in 2016.”

Reading through this conclusion Diabetic Investor came to our conclusion that Bob should consider switching professions and seriously consider becoming a corporate communications professional. These people are experienced at writing double speak which makes absolutely no sense whatsoever.  Yep nothing like hedging every possible statement so that should it turn out that Diabetic Investor is right and Afrezza is nothing more than a niche product, Bod can say “Hey it’s not like I didn’t warn you.”

This is another consistent with Afrezza supporters as they will scream long and loud should Afrezza by some miracle become a commercial success. Yet they become eerily silent when things don’t go as they project.

Honestly Diabetic Investor has no plans to gloat when Sanofi walks away from Afrezza or it becomes obvious to management that Afrezza will never be anything more than a niche product. Frankly our wine drinking friends in France have suffered enough and while we’ll miss this gift that keeps on giving, even Sanofi deserves a break. When the end does come we will however send our good buddy Serge and our new best friend Olivier some great wine to help drown their sorrows. It’s the least we can do for all the great copy they have given us.