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I'm a value investor focused on buying companies trading below the intrinsic value. I've a back ground in engineering & finance. I'm also a Chartered Financial Analyst. I did my MBA from Emory University's Goizueta School of Business
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  • 20 Reasons Why Mannkind's Afrezza Is Superior To Novolog/Humalog 5 comments
    Jan 7, 2014 11:11 AM | about stocks: LLY, NVO, MNKD

    Mannkind's (NASDAQ:MNKD) lead drug Afrezza is nearing the PDUFA date of 15-Apr-2014. Afrezza is an inhaled insulin for use during meal times. Mannkind has submitted the NDA for the 3rd time. Here are the 20 reasons why Afrezza is superior to its nearest competitors Novolog/Humalog. Novolog is marketed by Novo Nordisk (NYSE:NVO) and Humalog by Eli Lily (NYSE:LLY).

    1. Afrezza is ultra-rapid acting insulin with a pharmacokinetic profile that mimics endogenous secretion of insulin. In plain English, Afrezza works like body's natural secretion of insulin by pancreas during meal time. Novolog/Humalog are called rapid acting analogues and don't even come close. The reason for the ultra-rapid acting is due to the fact that Afrezza has monomeric insulin.

    2. Afrezza is delivered by a sleek device that is discreet, portable and easy to use. Novolog & Humalog are delivered by injections. The inhaler is disposable.

    3. Afrezza has lower post-prandial glucose excursions. Hence it results in lower long term diabetic complications.

    4. Afrezza requires little or no titration compared to Novolog/Humalog. There are no correctional dosages needed. The accurate carb counting would be a thing of the past.

    5. Afrezza requires less blood glucose (NYSE:BG) level testing. This is one of the major pain points of diabetics. A typical diabetic needs one or more correctional insulin shots after a heavy meal and 3-4 times BG testing.

    6. Afrezza reduces the stress on pancreas as it takes the load off the pancreas. The hyperglycemia is less pronounced for Afrezza users. (see pg. 7). Brief glucose excursions outside the normal physiological range are especially damaging to β-cells. Afrezza helps the pancreas live longer.

    7. Afrezza patients will show better compliance. This reduces the long term diabetic costs. Recent survey indicates that 1/3rd of patients fail to take insulin as prescribed.

    8. The physicians can initiate insulin therapy earlier with Afrezza.

    9. No injection site complications like lipodystrophy, pain, redness, irritation and no need to keep track of injection sites for rotation.

    10. No post meal snacking and weight gain with Afrezza. The post meal snacking is a feature of Novolog/Humalog that causes hypos due to long tail.

    11. Afrezza shows much lower incidences of hypoglycemia. According to this article, One in 20 people (an estimated 2-4 percent and 6 percent in patients younger than 40 years old) will perish from severe hypoglycemia.

    12. Afrezza offers lower costs in the long run if we consider the reduced BG tests, no correctional dosages, better compliance and reduced long term complications due to lack of hyperglycemia.

    13. The Griffin research mentioned earlier says that prophylactic use of Afrezza prevents type 2 diabetes. It is a hard sell to use deploy prophylactic use of Novolog/Humalog

    14. Survey of patients who participated in Afrezza trials reported higher satisfaction rates

    15. Anecdotal evidence from trial patients who used Afrezza reported better HbA1C. In some recent trials, Mannkind was able to show superiority in A1C. You can read more about the background on A1C in this article as well.

    16. Due to superior kinetics, Afrezza shuts off the hepatic secretion of glucose. The body needs less insulin during meal time.

    17. Patients need less training, Afrezza is easier to learn and use

    18. Obese patients will show better glucose clearance with Afrezza. Children who take meal time insulin will be less traumatized. The FDA has approved pediatric trials for Afrezza.

    19. Afrezza is a God sent for needle phobic patients.

    20. Afrezza is easier to use for visually impaired patients and for patients with various disabilities.

    Afrezza, if approved will give the current rapid acting analogues a run for its money. Al Mann, the CEO of Mannkind corp says that Afrezza will be the greatest medical product in history. The potential market size is just enormous. According to the recent Canaccord presentation, the potential patient population in U.S. alone includes

    · 3.2 million on prandial insulin

    · 1.9 million on basal insulin as the only insulin

    · 12.6 million on oral agents alone

    Disclosure: I am long MNKD, . I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.

    Disclosure: The author is long MNKD.

    Themes: long-ideas Stocks: LLY, NVO, MNKD
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Comments (5)
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  • pacard
    , contributor
    Comments (91) | Send Message
    Great job. An excellent summary. I'm also a mnkd investor. Not sure if you're aware but I wanted to invite you over to Mannkind Central (mannkind.freeforums.n... They have an excellent community and what they claim is the largest membership forum dedicated to MNKD.


    There's always room for more good contributors. Hope you stop by. I'm sure the moderators would be happy to promote your blog as well.


    Here's to a profitable '14.


    7 Jan 2014, 02:03 PM Reply Like
  • sharptail
    , contributor
    Comments (2) | Send Message
    I was a patient in a Technosphere Insulin (original name for Afreeza) trial (Type 1) for 2 years beginning in 2008. During that time I had by far the best control of my blood sugars levels before and after that. I work much harder now with an insulin pump and still cannot match that level of control. Needless to say I have been waiting for a long time for this medication to be approved and available.
    8 Jan 2014, 06:13 PM Reply Like
  • US Investor
    , contributor
    Comments (123) | Send Message
    Author’s reply » Hi Pat


    I know you from the diabetes forum, IN fact I had put your experience in my blog years back



    Thank you for your comment and hope FDA approves Afrezza this time
    8 Jan 2014, 09:25 PM Reply Like
  • sharptail
    , contributor
    Comments (2) | Send Message
    I was a patient in a Technosphere Insulin (original name for Afreeza) trial for 2 years beginning in 2008. During that time I had the best control over my blood sugar levels in 30 years of Type 1 diabetes. Now with an the best therapy available, an insulin pump, I work a lot harder, but cannot match that level of control. Needless to say I have been waiting a long time for this medication to be approved and available.
    8 Jan 2014, 06:13 PM Reply Like
  • Snowboard 2k01
    , contributor
    Comments (124) | Send Message
    20 Feb 2014, 02:29 PM Reply Like
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