You have to admire the passion

You have to admire the passion

Diabetic investor has rarely, if ever, seen such passion as we have with the continuing debate over Afrezza. Yes it seems a day doesn’t go by when someone offers an impassioned defense of this drug. Having covered this space for nearly 20 years Diabetic Investor has been racking our memory, what’s left of it anyway, for another drug or device which generated this much passion. About the closet thing we came up with was the search for the Holy Grail of diabetes devices a true non-invasive glucose monitor or perhaps the quest to develop a true closed loop insulin delivery system.

In many respects the passion generated for these way cool yet to be commercialized devices is similar to the passion generated for Afrezza. Like Afrezza supporters of these way cool yet to be commercialized devices focus not on the business of diabetes but the management of diabetes. While Diabetic Investor is all for improvements in drugs and devices we cannot escape the realities of the business of diabetes. A business which is not driven by way cool technology but the harsh realities that someone has to pay for all this way cool technology or drugs.

Another similarity is how supporters of these new drugs or devices put so much emphasis on small sample sizes. Had Twitter or blogs been in vogue 10 years ago we’re sure the quest to develop a non-invasive glucose monitor would have been garnered the attention a closed loop insulin delivery system and Afrezza has garnered today. Sure it’s great to know that a handful of patients are using Afrezza effectively and it’s even better these patients are managing their diabetes more effectively.

The problem with these small sample sizes is twofold. First people who read patient blogs believe that one person’s experience is representative of the entire diabetes population. Second people who don’t have diabetes seem to believe that these patients are typical patients or put another way that every person with diabetes is actively engaged with their diabetes management. While this would be great sadly this is not the case.

We just love it when Afrezza supporters state that every insulin patient should be using the drug. How they seem to believe that these insulin using patients cannot achieve good control without using Afrezza. The reality is this is not even close to the truth.

Like the supporters of way cool yet to be commercialized devices they consistently ignore things like formulary placement, patient co-payments, whether a drug is profitable and who companies partner with. For Afrezza this is particularly important as MannKind (NASDAQ:MNKD) partner is Sanofi (NYSE:SNY) a company who has a less than impressive history in diabetes for any product not named Lantus. The Afrezza supporters believe that since Sanofi is multi-billion dollar international conglomerate they must be well run, something that is also nowhere close to reality. This would be like saying that just because Chicago is a big city its public school system is well run, something else that’s not close to reality.

Still Diabetic Investor admires the passion these people have. One thing that everyone agrees on no matter how they feel about Afrezza or way cool yet to be commercialized devices is the need for better drugs and devices. How diabetes management even with all the advancements made over the years is still a 24x7x365 job with no days off. That achieving good control is hard work. That we still have a long way to go before managing diabetes is an afterthought for patients, where diabetes management fits into a patient’s life and doesn’t run their lives.

Later this week at the ADA conference we’ll hear lots of pontificating by experts. There will be lots of talk about new drugs new devices and how diabetes management is getting easier. Studies will be presented and these experts will debate various data points. Yet expect for a few outliers these experts lack passion, to these experts diabetes is research project. The same can be said about the companies that are exhibiting at the conference, for many diabetes is just about money. Now there is nothing wrong with any of this as they say it is what it is.

Still Diabetic Investor can’t help but think how things in diabetes would be different if these experts and companies had the passion seen with Afrezza supporters. How different it would be if they understood the way to riches or accolades is by putting the needs of the patient above all else.