Some Quick Observations

Some Quick Observations

Over the weekend we commented on the poorly designed Afrezza web site, a site which seems to be designed to discourage used of Afrezza rather than encourage it. Yet over the weekend we thought we may have been too harsh on our wine drinking friends as they do have more than fair share of problems besides Afrezza. After all the drug was just launched and perhaps they will redesign the site as the launch progresses. So over the weekend we decided to check out web sites for two other new drugs which recently hit the market and both long-acting GLP-1’s, Tanzeum™ from GlaxoSmithKline (NYSE:GSK) and Trulicity™ from Lilly (NYSE:LLY).

This past Saturday we noted that on the Afrezza site (www.afrezza.com) the box warned that came with the drugs approval was featured not once but actually twice on home page. Not knowing the rules we thought perhaps this was an FDA requirement, that they basically told Sanofi (NYSE:SNY) the boxed warning must be prominently featured. However when checked the sites for Tanzeum (http://www.tanzeumrems.com/) and Trulicity (www.trulicity.com) both drugs which also carry a boxed warning we got a vastly different picture. Yes patients can easily find the warning but the warning does not dominate the page as it does on the Afrezza site.

Next we also thought it might just be a good idea if the folks at Sanofi would have a video which showed a patient using Afrezza. Remember this is inhaled insulin, no more painful injections. All we hear about is how much this device is than the Exubera bong, how much easier it is to use. One just might think the best way to illustrate all this would be a video. Yet there is video to be found, which is dramatic departure from the very well done video on the Trulicity site and also well done video on the Bydureon (www.bydureon.com), the drug Trulicity and Tanzeum competes with.

To be fair the Tanzeum site isn’t all that great either and really adds little value.

One more thing before we leave the subject of video’s based on the Trulicity and Bydureon video’s, AstraZeneca (NYSE:AZN) is in trouble. Long ago before the Bydureon pen became available we reasoned sales of the drug would drag given the dosing dynamics. We further reasoned sales would improve once the pen became available as it makes dosing so much easier for the patient. While the Bydureon pen is a major improvement over the previous delivery system, the Trulicity pen is far more patient friendly and uses a smaller needle. Looked at side by side it’s doubtful a majority of patients would select Bydureon over Trulicity.

This is another reason isn’t all that impressed with Astra as quite frankly they blew it with Bydureon. They likely realize this which is why they are being aggressive with payors as they are desperately fighting off Lilly’s equally aggressive approach with Trulicity. We’ll learn more about this fight Friday when Astra reports fourth quarter and full year results.

Speaking of being aggressive and getting back to Afrezza, we noted that Sanofi is already using co-pay cards and free offers for the drug. Something we thought a little unusual as unlike Trulicity, which has a similar offer, Afrezza really doesn’t have any direct competitors as it’s the only inhaled insulin commercially available. Yet as we noted Sanofi was basically forced into this margin eating strategy given the drug has been regulated to the formulary graveyard with a trier 3 position.

The harsh reality is the team assigned to Afrezza knows this is an uphill battle, but thanks to the now ex-CEO, they forced to make the best of a very bad situation. Try as they might they cannot get away from one indisputable fact; you can put lipstick on a pig but at the end of the day it’s still a pig.

For their part the Afrezza sales team, the team that has been publicly humiliated by the acting CEO and foot in mouth specialist Serge Weinberg, is already complaining about the lack of a bonus plan, how management knows nothing and how hard it’s going to be to sell this drug with a trier 3 position. Yes there are some who are trying to drink the kool-aid offered by management, that inhaled is better than injections, but even these folks aren’t overly optimistic. While sales people always love to complain we’ll give them this much if the Afrezza web site is an example of how this drug is going to be marketed than it’s time to make sure resumes are up to date.

Now just in case anyone thinks we’re making too much of this site and its very poor design, remember this is 2015. This is not 1985. When people hear about a new drug either from their physician, Certified Diabetes Educator, friend whoever the first thing they do is go to the web for more information. And as Momma Kliff used to say; You don’t get a second chance to make a first impression. The bottom line is web sites matter and matter more so for drugs like Afrezza which are supposed to be unique. Patients know that drugs sites are nothing more than glorified advertisements, still they like to see how a drug they may be using is delivered. Something that is critical for an injectable or in Afrezza’s case inhalable.

Think from the perspective of a Type 2 patient who’s being advised to switch therapy regimens. They can add this new inhaled insulin or this once-weekly injection, and just for grins and giggles let’s take formulary position out the equation. The patient will naturally go the web for more information. Go visit both sites and then ask based on their respective sites which drug makes the better impression. Granted we have over simplified this however it would be foolish to ignore this aspect of the equation.

More importantly to Diabetic Investor the Afrezza site is just another example of how Sanofi just doesn’t get it, that they just don’t understand how things work today and sadly really don’t care much about the patient. Honestly they should thank their lucky stars that they had Lantus and given how they have done in diabetes other than Lantus, it seems like a miracle they didn’t screw up Lantus too.

Please Serge this Friday please explain to everyone again why Afrezza is going to be a blockbuster, why Afrezza is the greatest thing to happen to diabetes since the discovery of insulin. Tell us how Sanofi is going to make money here when you’re giving the product away, capping what a patient pays (which just eats into your already thin margins) after the freebie, for a drug which is expensive to make and has a trier 3 formulary position. Explain why the Afrezza team felt it necessary to broadcast the fact that Afrezza carries a box warning, not just once but twice on the drugs home page.  Please do this with a straight face and we’ll do our best not to laugh as your nose starts growing.

Over the weekend we commented on the poorly designed Afrezza web site, a site which seems to be designed to discourage used of Afrezza rather than encourage it. Yet over the weekend we thought we may have been too harsh on our wine drinking friends as they do have more than fair share of problems besides Afrezza. After all the drug was just launched and perhaps they will redesign the site as the launch progresses. So over the weekend we decided to check out web sites for two other new drugs which recently hit the market and both long-acting GLP-1’s, Tanzeum™ from GlaxoSmithKline (NYSE:GSK) and Trulicity™ from Lilly (NYSE:LLY).

This past Saturday we noted that on the Afrezza site (www.afrezza.com) the box warned that came with the drugs approval was featured not once but actually twice on home page. Not knowing the rules we thought perhaps this was an FDA requirement, that they basically told Sanofi (NYSE:SNY) the boxed warning must be prominently featured. However when checked the sites for Tanzeum (http://www.tanzeumrems.com/) and Trulicity (www.trulicity.com) both drugs which also carry a boxed warning we got a vastly different picture. Yes patients can easily find the warning but the warning does not dominate the page as it does on the Afrezza site.

Next we also thought it might just be a good idea if the folks at Sanofi would have a video which showed a patient using Afrezza. Remember this is inhaled insulin, no more painful injections. All we hear about is how much this device is than the Exubera bong, how much easier it is to use. One just might think the best way to illustrate all this would be a video. Yet there is video to be found, which is dramatic departure from the very well done video on the Trulicity site and also well done video on the Bydureon (www.bydureon.com), the drug Trulicity and Tanzeum competes with.

To be fair the Tanzeum site isn’t all that great either and really adds little value.

One more thing before we leave the subject of video’s based on the Trulicity and Bydureon video’s, AstraZeneca (NYSE:AZN) is in trouble. Long ago before the Bydureon pen became available we reasoned sales of the drug would drag given the dosing dynamics. We further reasoned sales would improve once the pen became available as it makes dosing so much easier for the patient. While the Bydureon pen is a major improvement over the previous delivery system, the Trulicity pen is far more patient friendly and uses a smaller needle. Looked at side by side it’s doubtful a majority of patients would select Bydureon over Trulicity.

This is another reason isn’t all that impressed with Astra as quite frankly they blew it with Bydureon. They likely realize this which is why they are being aggressive with payors as they are desperately fighting off Lilly’s equally aggressive approach with Trulicity. We’ll learn more about this fight Friday when Astra reports fourth quarter and full year results.

Speaking of being aggressive and getting back to Afrezza, we noted that Sanofi is already using co-pay cards and free offers for the drug. Something we thought a little unusual as unlike Trulicity, which has a similar offer, Afrezza really doesn’t have any direct competitors as it’s the only inhaled insulin commercially available. Yet as we noted Sanofi was basically forced into this margin eating strategy given the drug has been regulated to the formulary graveyard with a trier 3 position.

The harsh reality is the team assigned to Afrezza knows this is an uphill battle, but thanks to the now ex-CEO, they forced to make the best of a very bad situation. Try as they might they cannot get away from one indisputable fact; you can put lipstick on a pig but at the end of the day it’s still a pig.

For their part the Afrezza sales team, the team that has been publicly humiliated by the acting CEO and foot in mouth specialist Serge Weinberg, is already complaining about the lack of a bonus plan, how management knows nothing and how hard it’s going to be to sell this drug with a trier 3 position. Yes there are some who are trying to drink the kool-aid offered by management, that inhaled is better than injections, but even these folks aren’t overly optimistic. While sales people always love to complain we’ll give them this much if the Afrezza web site is an example of how this drug is going to be marketed than it’s time to make sure resumes are up to date.

Now just in case anyone thinks we’re making too much of this site and its very poor design, remember this is 2015. This is not 1985. When people hear about a new drug either from their physician, Certified Diabetes Educator, friend whoever the first thing they do is go to the web for more information. And as Momma Kliff used to say; You don’t get a second chance to make a first impression. The bottom line is web sites matter and matter more so for drugs like Afrezza which are supposed to be unique. Patients know that drugs sites are nothing more than glorified advertisements, still they like to see how a drug they may be using is delivered. Something that is critical for an injectable or in Afrezza’s case inhalable.

Think from the perspective of a Type 2 patient who’s being advised to switch therapy regimens. They can add this new inhaled insulin or this once-weekly injection, and just for grins and giggles let’s take formulary position out the equation. The patient will naturally go the web for more information. Go visit both sites and then ask based on their respective sites which drug makes the better impression. Granted we have over simplified this however it would be foolish to ignore this aspect of the equation.

More importantly to Diabetic Investor the Afrezza site is just another example of how Sanofi just doesn’t get it, that they just don’t understand how things work today and sadly really don’t care much about the patient. Honestly they should thank their lucky stars that they had Lantus and given how they have done in diabetes other than Lantus, it seems like a miracle they didn’t screw up Lantus too.

Please Serge this Friday please explain to everyone again why Afrezza is going to be a blockbuster, why Afrezza is the greatest thing to happen to diabetes since the discovery of insulin. Tell us how Sanofi is going to make money here when you’re giving the product away, capping what a patient pays (which just eats into your already thin margins) after the freebie, for a drug which is expensive to make and has a trier 3 formulary position. Explain why the Afrezza team felt it necessary to broadcast the fact that Afrezza carries a box warning, not just once but twice on the drugs home page.  Please do this with a straight face and we’ll do our best not to laugh as your nose starts growing.