When one door closes…

MannKind and Sanofi announced the end of their Afrezza partnership. What happened?

News came last week that MannKind and Sanofi are ending their Afrezza partnership.

Afrezza, in case you don’t know, is a fast-acting insulin that is inhaled. Look ma, no needles! Instead of a needle poke you take several deep breaths. That has a certain appeal among the people getting poked.

There was some fanfare when Afrezza was approved by the FDA, and it even generated some Internet buzz. So what happened?

Sales were disappointing.

Afrezza had become the poster child for the complexities of introducing a new treatment to the market. It was proven effective. It received FDA approval. Doctors and patients were educated about its benefits and limitations; Afrezza can’t be used by people with asthma or lung ailments. But was Afrezza being stocked by pharmacies? And, more importantly, was it added to any of the payer formularies? Meaning, would any health insurance companies pay for it?

Success in pharma requires every step in the process of introducing a new treatment be successful. Afrezza was oh so close.

Meanwhile, every person using insulin continues to to poke themselves…daily…several times.


Update: On January 21, 2016 MannKind announced it has entered into a collaboration and license agreement with a newly formed entity, Receptor Life Sciences, Inc.

Reversing Type 2 diabetes

While some people with Type 2 have been able to delay adding medication through lifestyle change, to tell the story in a way that says that will work for everyone is dangerous.

Recently, a journalist contacted me looking for a person who had “reversed their diabetes” through diet and lifestyle changes. The journalist was writing a story for a national magazine.

While I think I understand the premise of this story…

It’s a story of hope…

I find it to be a false hope and a dangerous narrative.

Diabetes is a complex, chronic, degenerative disease.

While some people with Type 2 have been able to delay adding medication through lifestyle change, to tell the story in a way that says that will work for everyone is dangerous.

It leaves people living with Type 2 vulnerable to the blame & shame culture that says “if only you would exercise, stop eating sugar, and/or loose weight your disease will go away.” This is simply not true.

This also leads people living with Type 2 to feel like a failure when they get to the point that they do need to take medication. The idea that you should be able to “reverse” diabetes leads people to delay starting medication when they need it. Ultimately, this can lead to the complications (caused by poorly controlled diabetes) that people hope to avoid by making lifestyle choices.

My own story is that my A1C was over 13 when I was diagnosed. Today it’s substantially lower than that. I’ve made lifestyle changes and I take medication. I use all the tools available to me to manage my blood glucose.

Anything less would be foolhardy.

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The Cost of Testing

cc jessicafm

The New York Times ran an article last week on the high cost of diabetes—not for society, but for the individual.

Protecting Yourself From the Cost of Type 2 Diabetes [ http://www.nytimes.com/2010/11/13/health/13patient.html ]
By WALECIA KONRAD
Published: November 12, 2010
Diabetes patients spend $6,000 on average a year on care, one reason only 25 percent of diabetics get the treatment they need.

Oh wow. A useful article about the financial burden of diabetes. Then I read further…
The article asks what steps can patients take to reduce the cost of diabetes? Continue reading “The Cost of Testing”

What’s My Window of Opportunity?

Some of my medications have to be taken before meals. The directions on the label are very specific, take “30 minutes before meal.” This drove me nuts.

But one simple question to my doctor put an end to this madness.

cc Mr T in DC

Some of my medications have to be taken before meals. The directions on the label are very specific, take “30 minutes before meal.” This drove me nuts.

In trying to take my medicine properly I’d delay eating. Or I’d gamble on how long before dinner was going to hit the table.

Eating out was a particular nightmare. There’s no predicting how long it will take to get seated. And after that who knows how fast or slow service will be? When I asked the server for something to eat with my pill, inevitably I would get the (white) bread basket. A single roll could be half the carbs allotted to the meal! Continue reading “What’s My Window of Opportunity?”