MannKind Corporation: Take a Deep Breath, This Time Afrezza Will Work

Elie  Ofek; Amanda  Dai

Case | HBS Case Collection | August 2017 (Revised July 2018)

MannKind Corporation: Take a Deep Breath, This Time Afrezza Will Work

by Elie Ofek and Amanda Dai

Abstract

In June 2014, MannKind Corporation announced that after years of development and billions of dollars in expenses, the FDA had finally approved its drug, Afrezza. MannKind would thus be the only company with an inhalable insulin on the market. As an alternative to injectable rapid-acting (or mealtime) insulin, Afrezza boasted a potential market of at least 4 million diabetic patients. Shortly thereafter, Sanofi, a company with vast experience in the diabetic space, became MannKind’s marketing partner and helped launch Afrezza in February, 2015. Although the drug had a black box warning and required doctors to perform a lung test on patients, expectations were high, with some analysts predicting peak sales of up to $4 billion a year. However, those lofty hopes were quickly dashed when Afrezza generated lackluster first-year sales, driving Sanofi to terminate its short-lived contract with MannKind in January 2016. MannKind's management attributed the launch’s failure to a poor marketing approach, convinced that Sanofi, despite its strong global presence and experience, did not effectively address critical barriers to adoption. The company now planned to overhaul Afrezza’s entire marketing strategy. This included rethinking which patients and physicians to target, how to position the drug to engender interest and adoption, how to lower end consumer price, through which media to convey Afrezza's benefits, and how to streamline the process of performing the lung test and getting the drug into the hands of patients. But would all these changes and initiatives, no matter how well executed, be enough to turn sales around? Would Afrezza ever realize the potential that Alfred Mann, the late founder and former CEO, saw in the novel treatment?

Keywords: Health Care and Treatment; Product Launch; Product Positioning; Marketing Strategy; Adoption; Pharmaceutical Industry;

Language: English

Format: Print

28 pages

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Citation:

Ofek, Elie, and Amanda Dai. "MannKind Corporation: Take a Deep Breath, This Time Afrezza Will Work." Harvard Business School Case 518-031, August 2017. (Revised July 2018.)

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Case | HBS Case Collection | December 2016 (Revised December 2018)

From Start-Up to Grown-Up Nation: The Future of the Israeli Innovation Ecosystem

Elie Ofek and Margot Eiran

In June 2016, Benjamin (Bibi) Netanyahu, Prime Minister of Israel, wrestled with how to sustain Israel’s strong innovation track record and the country’s reputation as the “startup nation.” Despite the economic miracle the country had wrought since its founding, he knew he could not be complacent. On the one hand, in 2015 Israeli start-ups raised record-breaking amounts of venture capital, and exits for the year totaled over $8 Billion. On the other hand, government expenditure on R&D had decreased and Israel’s position in the Global Innovation Index had fallen. Several other indicators, such as achievement tests among elementary school students in math and science, painted a grim picture. Furthermore, in spite of the wealth created by many high-tech Israeli firms, socioeconomic gaps in the country had widened. A two-tier economy had formed. The long-term sustainability of the “innovation economy” was in doubt, as the sector faced increased competition from foreign innovation hubs, was being reshaped by the growth of Multinational Corporations (MNCs) locating R&D centers in Israel, and had to contend with a vexing shortage of human capital and low labor force participation among some groups. Netanyahu had to assess whether it was time to sound the alarm, and whether drastic and immediate measures were needed to right the innovation economy ship. Bibi mulled over which policies or interventions would best curb the erosion of Israel’s competitive position as an innovation powerhouse and how best to promote social equality. He pondered whether public policy could make a difference or whether the market and societal currents, responsible for these trends, were too strong for him and his government to try to contend with. Several prominent figures, including the Governor of the Central Bank of Israel, Knesset members, Israel’s Chief Scientist, prominent business leaders, academics, and journalists weigh in on the formation of the Israeli entrepreneurial and innovation ecosystem, the challenges it faces going forward, and what approaches might help it continue to thrive.

Keywords: Israel; Israeli Start-up Nation; Innovation economy; Entrepreneurial mindset; scaling-up; Unicorns; Innovation clusters; High-tech; innovation management; Multinational Corporation R＆D Centers; Social equality; Two-tier economy; Liberalizing an economy; foreign investment; Military service; Quality of human capital; Socioeconomic gaps; labor force participation; Government initiatives; Innovation and Management; Entrepreneurship; Venture Capital; Business Startups; Government and Politics; Economy; Equality and Inequality; Education; Resource Allocation; Globalization; Israel;