Editor's note: Updated to correct a mischaracterization of MannKind's assistance to doctors who want to conduct lung testing on prospective Afrezza patients.The company helps physicians identify spirometers suitable for the testing. It does not purchase the machines for doctors, nor is it involved in such transactions in any way.
When Sanofi ($SNY) dumped the inhaled insulin Afrezza back on its developer MannKind ($MNKD) earlier this year, the smaller company hailed it as an opportunity. Afrezza was just one product in the BIg Pharma’s diabetes family. It would never have Sanofi’s undivided attention.
Back home at MannKind, it would be an only child.
Plenty of skeptics scoffed. If a Big Pharma powerhouse couldn’t succeed with Afrezza, why would MannKind? But since then, the Valencia, CA-based drugmaker has been toiling to prove them wrong, with a sales-and-marketing strategy on a shoestring budget--at least compared with the typical Big Pharma launch.
For the most bang for its buck, MannKind is focusing on specialists, and targeting patients already using insulin. It’s using digital promotions, rather than blanketing the airwaves with TV ads. And it’s hoping social media--including committed Twitter advocates--will help build awareness.
Investors have pressed MannKind for more direct-to-consumer efforts. Commercial chief Michael Castagna said during the company’s Q2 earnings call that the company isn’t ignoring that feedback. The company will have its first print ad in journals mid-September, and a newly revamped website after that.
But, he said, MannKind’s specialty-oriented strategy, rather than Sanofi’s primary-care push, means mass-market DTC would just be wasted.
“[I]t is important to understand the difference” between a mass ad campaign that would reach a broad group of people, including those “who may not be a target audience,” Castagna said, “versus a direct-to-patient effort” focused on patients in the niche MannKind is targeting, a group that amounts to about 6.5 million people.
The company is also zeroing in on some known obstacles. Faced with prior authorization requirements from payers, it set up a patient reimbursement hub, MannKind Cares, administered at doctors’ offices, Castagna said during the earnings call.
After pharmacists struggled to figure out how to combine various packaging quantities to help new Afrezza patients titrate their initial dosing, MannKind is launching a voucher patients can use for a prepackaged titration pack.
With Afrezza lacking preferred formulary status, the company is using a co-pay card--limiting out-of-pocket costs to $15 per month--to help ease patients onto Afrezza therapy. MannKind is looking to social media to help spread the word about the card.
To help ease the way for pre-prescription lung testing advised by the FDA, the company also helps physicians identify spirometers suitable for the screenings.
Meanwhile, MannKind has built its commercial infrastructure from scratch, CEO Matthew Pfeffer said during the company’s Q2 earnings call, hiring commercial management, marketing staff, nurse educators, medical science liaisons and so on. MannKind has also recruited in-house drug reps and supplemented with contract salespeople, Pfeffer told FiercePharma in an email.
MannKind has been touting its focus on specialists, rather than primary-care doctors as Sanofi did. Another big difference: The company isn’t focusing on Afrezza as an inhaled alternative to injectable insulins. It’s touting the product’s fast-acting nature--and its fast-dissipating effects.
So far, the company has attracted 300 new subscribers, and just a week into its new sampling program, 300 orders had been placed. It’s looking for results from a speaker program that launched this month. And it’s making the rounds of local and regional physician conferences to talk up the med.
All this nitty-gritty is no doubt intended to reassure investors that MannKind is on the job and that script numbers will start rising, after a big drop after Sanofi backed out of the marketing deal. MannKind believes. And Castagna believes doctors do, too. “I want samples and copays in my office,” he quoted physicians as saying. “[O]nce I have them, I'll start to prescribe Afrezza again.” The company certainly hopes so.
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