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  "documentTitle": "Soleno Therapeutics (SLNO)",
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  "notes": "The slide uses direct quotes from an endocrinologist to undermine the product's differentiation and pricing justification.",
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      "text": "Endocrinologists already asking if they just use generic diazoxide – unconvincing answer; unknown mechanism of action",
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      "text": "Endocrinologists already asking if they just use generic diazoxide – unconvincing answer; unknown mechanism of action \"For our group because half of us trained at CHOP, we use a lot of diazoxide, and I even asked that question like, can you just use your garden variety diazoxide. And then, they explain it's extended-release. And okay, but you can give it a couple of times a day.. And, obviously, we still don't know exactly why it works...everybody in endocrine is really familiar with diazoxide for hyperinsulinism. So, trying to understand the difference of mechanism with the long-acting and the salt formulation were some of our questions\" - Pediatric endocrinologist at a Delaware academic center with eight endocrinologists and ~50 PWS patients",
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      "text": "\"Ethics of is this worth $1 million a year\"; endo's at recent annual meeting already asking why they can't use regular diazoxide Q: \"Right, but obviously the centers with the most PWS patients, centers like yours, CHOP, the sophisticated ones, those endocrinologists are all going to have tremendous experience with diazoxide suspension anyway. In those sophisticated centers, do you think they'd be more comfortable just using that off-label?\" A: \"I think so. If they couldn't get approval for Vykat — but we do talk about the ethics of is this worth $1 million a year? And you have this conversation with the same thing with Crenessity. The conversation I had at the Pediatric Endocrine Society conference, what we all said was, can we just prescribe regular diazoxide?\" - Pediatric endocrinologist at a Delaware academic center with eight endocrinologists and ~50 PWS patients",
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      "text": "For our group because half of us trained at CHOP, we use a lot of diazoxide, and I even asked that question like, can you just use your garden variety diazoxide. And then, they explain it's extended-release. And okay, but you can give it a couple of times a day.. And, obviously, we still don't know exactly why it works...everybody in endocrine is really familiar with diazoxide for hyperinsulinism. So, trying to understand the difference of mechanism with the long-acting and the salt formulation were some of our questions — Pediatric endocrinologist at a Delaware academic center with eight endocrinologists and ~50 PWS patients",
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      "text": "Source: Scorpion Capital consultation calls with experts",
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      "text": "Endocrinologist #4 stated that Vykat’s rep failed to explain why physicians couldn’t use generic diazoxide suspension instead, which is already used extensively for infant hyperinsulinism; that he and his colleagues are struggling to understand how Vykat’s formulation is any different; that a group at the recent annual Pediatric Endocrine Society meeting asked the same question; and that they’d be comfortable using it off-label in its place, due to the “ethics” of a $1MM drug and especially if insurers deny the drug: “half of us trained at CHOP, we use a lot of diazoxide, and I even asked that question like, can you just use your garden variety diazoxide...they explain it's extended-release...okay, but you can give it a couple of times a day... everybody in endocrine is really familiar with diazoxide for hyperinsulinism...so, trying to understand the difference”; “we do talk about the ethics of is this worth $1 million a year...the conversation I had at the Pediatric Endocrine Society conference, what we all said was, can we just prescribe regular diazoxide?”",
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