MannKind refocuses on endocrinologists to give Afrezza launch a jolt

Last week, MannKind officially regained the marketing rights for its inhaled insulin drug Afrezza from Sanofi. But MannKind had already begun its next marketing moves to revive the moribund drug, tapping a new commercial exec and a new ad agency, and devising a new roll call for doc-detailing.

In mid-March, MannKind hired Michael Castagna as chief commercial officer to oversee Afrezza, which had languished after its Sanofi-led launch. Castagna, who holds a pharmacy degree as well as an MBA from the Wharton School of Business, came from Amgen, where he oversaw its biosimilar efforts. Before that he worked at Bristol Myers-Squibb and Sandoz where he shepherded several drug launches.

Castagna, now a month into the job, has hired the advertising agency precisioneffect--which recently changed its name from LehmanMillet--and begun mapping out the new marketing direction for Afrezza.

First up are endocrinologists. While Castagna said he wouldn't critique Sanofi's strategy, he noted that its main target audience was primary care physicians treating Type 2 diabetics. MannKind's plan instead is to go directly to the 5,000 endocrinologists in the U.S. who care for both Type 1 and Type 2 diabetes patients.

Many endocrinologists weren't specifically detailed on Afrezza, he said, so getting doctors up to speed on usage is important before launching any broader DTC campaign. But consumer ads are coming, likely within the next 12 months, he said.

When asked what a DTC campaign might look like, Castagna said planning has just begun. However, he did say, "This is about freedom for patients and them controlling their life as opposed to diabetes controlling their life. It's about bringing about that insight."

"I don't think telling people who are on insulin, 'Hey, try this' is going to work," Castagna went on to say. "I know people would say it's a no-brainer--it's inhaled versus an injection--but you've got to have that emotional connection that people are dealing with this disease every single day."

MannKind will maintain a consumer website in the meantime, he said, and may do some targeted direct-to-patient communications in larger markets that already have a core group of doctors and patients who understand the product.

Diabetes educators will play a role as well. Usually nurses, they will be employed by MannKind, Castagna said, and work similarly to medical science liaisons. Insurance companies are also important, he said, noting that MannKind is already working to remove managed care barriers and he is pleased with the progress.

"The reason I took the job is that I've been in this industry 20 years and I've had lots of specialty brands, but I've never had a brand that had patient advocates like this one who aren't paid and have no real ties to the company, but they just love this product and are authentic advocates on how it's radically shifted their life in a positive way," he said.

- read MannKind news about marketing rights
- see news release on the Castagna hire