The Wall Street Journal has a good post-mortem of Sanofi’s inhaled insulin experience with Mannkind. I was puzzled by that deal when it was announced, because I’d had a long history of being puzzled by Mannkind and their product (not to mention by their investors, who are a breed apart). Well, they were, anyway – I wonder how many of them are still hanging in there, taking the stage yet again in a long-running production of The Righteous Shareholders Confront the Evil Short Bashers.
Despite the industrywide retreat from inhaled insulin, former Sanofi CEO Christopher Viehbacher believed the advantages of inhaled insulin—speedier delivery to the bloodstream and a reduced dependence on needles—meant it was still worth a bet. In 2014, he agreed to pay MannKind up to $925 million, mostly in milestone payments, for the rights to market the recently approved Afrezza. By ending the agreement when it did, Sanofi capped its 2015 losses at roughly €200 million, according to the company.
A pittance, I’m sure. As the article goes on to say, one big problem was that no data were ever produced to indicate that Afrezza was any better than injectable insulin, which left the pitch at “avoid the needle”. And that really doesn’t seem to be enough, especially with hard-to-shake worries about lung effects in the long term. The pricing (and the insurance status, Tier III) of the product didn’t help, either. That seems to be what the company is holding out hope for. Mannkind says that they have enough cash to make it into the second half of the year (November? July?), and are hoping to make a new deal with someone who would like to see the product achieve minimal market penetration at an even lower price point. Well, no, that’s not what they’re saying, but that’s what’s most likely to happen, assuming that they can find anyone willing to try it.