From SA comments:
"'With its substantially more expensive cost, it will have a tough road to being a sole solution for most diabetics.'???
That road is made even tougher by evidence that using afrezza is apparently not desirable -- consider :
1) MNKD was only able to recruit 26 people into the afrezza arm of the STAT study while the lispro arm had 34 -- that indicates that of the 60 diabetics they recruited for the study, four of them simply refused to enter the afrezza arm -- Mannkind offered NO explanation
2) of the 26 in the afrezza arm, 2 DROPPED OUT -- Mannkind offered no explanation but you can be reasonably certain that they simply didn't like using the drug -- NO other explanation from MNKD
3) of the 24 left, 7 were non-compliant; so almost ONE THIRD either couldn't or wouldn't use it in the manner needed to achieve the ALLEGED improved "time in range" -- again NO explanation from MNKD as to WHY they were non-compliant
4) there were also 2 that DIDN'T have any CGM data -- no explanation as to why from Mannkind, but I SUSPECT that simply didn't CARE to mess with the device
So OVERALL, 4 + 2 + 7 +2 = 15 which means that HALF of the patients effectively FAILED the study.
And bear in mind that this was only a FOUR WEEK study. IMAGINE the failure rate at four MONTHS or MORE.
Then consider that there are ONLY about 1.25 milion type 1 diabetics in the US. If HALF of them are going to REFUSE to use afrezza and/or a CGM to achieve the ALLEGED benefits of "time in range, then MNKD is left with a measly 600,000 potential customers.
THEN factor in that NO insurer that I know of will pay for use of TWO prandial insulins, so Mannkind is getting its potential customer base SQUEEZED from BOTH the USER side and the INSURER side.
Finally, toss in the hassle of spirometry, calculating equivalent doses, lack of long term safety data, etc, helping prevent ENDOS from ever considering using the drug, and it SHOULD be pretty that afrezza is a NO WIN situation."
