Where’s Giant Leap for MannKind?

In midsummer, I wrote that MannKind Corp.’s best hope for success was nigh. The Valencia company was then about to start directly marketing its only product, an inhalable insulin that allows diabetics to avoid injections. I opined that perhaps the company’s own sales team could do better than the disappointing results turned in by the company’s old marketing partner, Sanofi, which gave up on the product. I was hopeful for MannKind. The product, called Afrezza, represents an advance for diabetics. What’s more, a successful MannKind could quickly become one of the biggest public companies in the Valley area. And I always admired the company’s founder, the late serial entrepreneur Al Mann, who poured a fortune and his last years into the company. I crossed my fingers for MannKind’s new sales team. Alas, any candid end-of-year assessment of MannKind’s sales results cannot be rosy. Since MannKind’s sales team started selling in mid-year, total prescriptions for Afrezza have been mostly below 300 a week, only a little better than Sanofi’s results. They’ve been trending up slightly, which is good, but the upturn is not nearly sharp enough. Worse, refills for the product have been mostly below 150 a week and trending down slightly. That’s alarming because it implies roughly half the patients who try Afrezza quickly drop it. A company executive a couple of weeks ago said that the product’s price appears to be a factor and so does its efficacy. Both are problems, but efficacy probably is a bigger one. After all, any medicine that isn’t as effective as its rivals faces steep odds. Sanofi recently agreed to pay MannKind millions of dollars in a settlement for its breached marketing deal. Also, it agreed to buy $10.2 million worth of Afrezza on Dec. 2. That certainly gives needed cash to the company. But since MannKind, by one estimate, burns through $10 million a month, the Sanofi payout merely buys MannKind a handful of months. Meanwhile, the company’s stock listing may become imperiled and, well, MannKind will need much more than crossed fingers in 2017. • • • In the past, whenever I came across an article in which someone boosted the notion of secession, it elicited a chuckle from me. Boy, that’s out there, I thought. But now, I’m not sure a majority of Californians would vote to stay in a country led by Donald Trump. In fact, a nascent petition drive seeks to put the secession question before the state’s voters. And look at the mayors of sanctuary cities who vowed to remain so, even if they must defy federal orders. Revolt is in the air. Consider the rancor in Sacramento last week when state lawmakers opened their session. According to an article in the Los Angeles Times, Assembly Speaker Anthony Rendon of Paramount called Trump’s appointments “white nationalists and anti-Semites” and went on to say that “Californians do not need healing. We need to fight.” Remember, Rendon is not some masked polemicist pulled off the street. He is the speaker of the state assembly, an adult in a leadership position. Yet there was no indication in the article that any Democrats tried to walk him back; indeed, some reports said he got a standing ovation. That means at some level, he was speaking for the state, a state that increasingly seems to be itching to defy the incoming president and disobey federal law if it comes to that. We could debate whether Californians’ tone and temperament are all that much different from the secession talk that we heard from livid Republicans, especially in Texas, during the eight years of the Obama administration. But that’s not the point. The point is this: lately it’s become starkly clear that left and right have grown way, way apart. More than I realized. We no longer respectfully debate – the other side will never be convinced. The rage is so intense that we now either clam up about politics – like at your Thanksgiving dinner – or we shout, calling each other vile names. As marriage counselors say, when contemptuous words are spewed openly and without remorse or apology, it signals a cavernous problem with the relationship. And that’s where we are. A cavernous problem with the relationship. The left wants a progressive march toward European-style social democracy that emphasizes justice and equality. The right yearns for a return to the exceptional country that grew strong on its experiment of liberty mixed with capitalism. These two paths are divergent; as each side marches farther down their trail, left and right get further apart. Maybe that’s why we’re shouting so much; we feel as if the other side has wandered pretty far away. And yes, I know. It’s phenomenally difficult for secession to succeed. But you know how these things work. If eventually the country arrives at a point where there’s general agreement on all sides and in the middle that a divorce is best, then divorce it will be. Don’t get me wrong. I don’t want the country to split up. I believe that someday left and right will find some common footing again. OK, so maybe I’m a naïve idealist. All I’m saying is that the whole idea of secession, which not long ago seemed kind of loony, now feels almost mainstream. The needle that measures the likelihood of a serious secession movement has moved past “forget about it,” past “very unlikely” and now hovers over “somewhat unlikely.” But it keeps moving up. I don’t know about you. But now, when I read about the notion of secession, I no longer chuckle. Charles Crumpley is editor and publisher of the Business Journal. He can be reached at [email protected].