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# MannKind CEO Says Afrezza's Adult Business 'Underperformed' As Pediatric Launch Drives Growth
- URL: https://www.bullished.co/mannkind-ceo-says-afrezzas-adult-business-underperformed-as-pediatric-launch-drives-growth-4fea9a81/
- Published: 2026-11-06T07:59:52.000Z
- Updated: 2026-11-06T07:59:52.000Z
- Description: Afrezza revenue rose about 5% in the third quarter, while adult share of voice fell about 65%, the CEO told analysts.
- Author: Matteo Parrino
- Tags: Earnings, MNKD, Industry: Healthcare

MannKind CEO Michael Castagna said on the company's third-quarter earnings call Thursday that Afrezza's adult business fell short this year, even as a pediatric launch returned the inhaled insulin to growth, with [$19.3 million](https://finance.yahoo.com/markets/stocks/articles/compared-estimates-mannkind-mnkd-q3-223002005.html?.tsrc=rss&ref=bullished.co) in quarterly net revenue.

## Three reasons adults slipped

MannKind, a biopharmaceutical company that sells Afrezza, Furoscix and V-Go and earns royalties on United Therapeutics' Tyvaso DPI, saw Afrezza revenue rise about 5% from a year earlier. Total prescriptions grew 17% from the second quarter, Castagna said.

He wanted to be "candid about our adult business, which is underperformed this year," and gave three causes. Turnover in the field team slowed activity with some key prescribers, and several new insulin pumps in type 2 diabetes created more competition for the same patients.

The third was promotion: Afrezza responds to it, Castagna said, and adult share of voice fell about 65% as resources shifted to the pediatric launch and to nephrology to support Furoscix.

Asked by a Leerink Partners analyst when pediatrics could offset an adult pullback, Castagna said part of the decline was driven by two top prescribers amid the field turnover. "That is all stabilized," he said, and he expects adult growth and a turn "going into next year."

## Pediatrics now one in four

Pediatric patients account for about one in four effective prescriptions, Castagna said. Four months in, Afrezza's share of pediatric mealtime-insulin prescriptions is more than double its adult share.

More than 2,000 pediatric patients have been treated since launch, across roughly 600 prescribers, and all 60 priority pediatric institutions have prescribed it. Average monthly new-to-brand prescriptions are up nearly 80% from the second quarter.

Chief Financial Officer Chris Prentiss said prescription growth is running ahead of revenue because of a pediatric access program that runs through the end of 2026\. More than half of pediatric prescriptions are already reimbursed by insurance.

## The $35 program ends

Castagna said the $35 cash-pay program will end this year and will not continue into 2027, which will offset some pediatric gains. He said roughly half of pediatric prescribers came from non-targeted outreach such as social media and conferences.

For adults, he said the company may shrink Furoscix sales territories, now covering both nephrology and cardiology, freeing Afrezza capacity to double down on adults while keeping pediatric pressure.

Prentiss said MannKind expects a return to profitability in the fourth quarter on both a standard-accounting and adjusted basis, and for 2027 as a whole.

Learn

- [How To Read An Earnings Call Transcript: Start With Guidance, Then Find What's Missing →](https://www.bullished.co/learn/how-to-read-an-earnings-call/)  
How to read an earnings call transcript: check guidance first, look for dropped metrics, compare growth with last quarter, and watch hedged wording.

### Sources

- [Compared to Estimates, MannKind (MNKD) Q3 Earnings: A Look at Key Metrics](https://finance.yahoo.com/markets/stocks/articles/compared-estimates-mannkind-mnkd-q3-223002005.html?.tsrc=rss&ref=bullished.co) — Yahoo Finance
- [MannKind (MNKD) Reports Q3 Loss, Misses Revenue Estimates](https://finance.yahoo.com/healthcare/articles/mannkind-mnkd-reports-q3-loss-214512323.html?.tsrc=rss&ref=bullished.co) — Yahoo Finance
- [MannKind: Q3 Earnings Snapshot](https://finance.yahoo.com/markets/stocks/articles/mannkind-q3-earnings-snapshot-212627888.html?ref=bullished.co) — Associated Press
- [MannKind: Q3 Earnings Snapshot – WTOP News](https://wtop.com/national/2026/11/mannkind-q3-earnings-snapshot/?ref=bullished.co) — wtop.com
- [MannKind: Q3 Earnings Snapshot | king5.com](https://www.king5.com/article/syndication/associatedpress/mannkind-q3-earnings-snapshot/616-a23b1eb9-cebf-49b5-ba51-e52c3e6a0e71?ref=bullished.co) — Associated Press