MannKind (NASDAQ:MNKD) has finally gotten its hands on an FDA approval for its inhalable insulin for diabetes patients. The years-in-the-making approval marked an important (and necessary) milestone for MannKind, but its approval presents a host of new challenges for the company.

The biggest of those challenges is unquestionably money. MannKind simply doesn't have enough of it. The company's $35 million stockpile won't be enough to orchestrate the significant land grab necessary to amass critical market share.

That means MannKind is probably going to be looking for a partner or a suitor.

One company that might be wise to consider acquiring MannKind is AstraZeneca (NYSE:AZN), which is fresh on the heels of deflecting attempts by Pfizer to buy it.


Source: AstraZeneca

Hitting aggressive targets
AstraZeneca faces its own challenges, including demonstrating to investors that its board was correct to argue against Pfizer's $118 billion bid.

The c-suite's argument for remaining stand-alone stems from enthusiasm -- for right or wrong -- surrounding its new operational focus.

The company argues that its sales will return to their 2013 levels by 2017 and that sales could essentially double by 2023 on the back of new products for big patient populations including diabetes.

In December, AstraZeneca demonstrated its willingness to pay out cash to shore up its diabetes product line up when it spent more than $4 billion to buy out partner Bristol-Myers Squibb from their diabetes joint venture.

That deal gave AstraZeneca a $1 billion collection of diabetes drugs, including GLP-1 inhibitors Byetta and Bydureon, which compete against Novo Nordisk's blockbuster Victoza.

In addition to those diabetes drugs, AstraZeneca also won approval for SGLT-2 inhibiting drug Farxiga in January.

Despite the potential from those drugs, AstraZeneca's diabetes pipeline is a bit thin in terms of new molecular entities. Instead, most of its diabetes trials center on potential label expansions or combination drugs, such as SaxaDapa, which combines its Onglyza with Farxiga.

That suggests that the company may be willing to add another drug, such as Afrezza.


Source: MannKind

Opportunity with risk
Of course, rolling out Afrezza may not be all roses and daisies. The company didn't win FDA approval until its third attempt, and its FDA-approved label is far from a slam dunk for doctors considering prescribing it.

Afrezza also isn't the first inhalable insulin to ever reach the market. Pfizer launched and soon shuttered Exubera almost a decade ago. Granted, Exubera was not the same drug as Afrezza and Afrezza's dosing is far simpler, but it still raises doubt over Afrezza's commercial success in the back of investors' minds, and conceivably those of potential acquirers, too.

If Afrezza's launch falls on deaf ears, an acquirer like AstraZeneca would be faced with a stiff write-off. After all, MannKind's $4 billion market cap suggests the drug would need to do at least $500 million in annual sales just to get to a price to sales level that matches up with other industry acquisitions, such as Shire's purchase of ViroPharma or Actavis' purchase of Forest Labs.

Fool-worthy final thoughts
The big question facing investors is what kind of a deal MannKind is hoping for. If it's hoping to remain a standalone company, it will probably have to give up a big chunk of its sales, perhaps as much as half, to link up with a partner like AstraZeneca. If that happens, justifying MannKind's current market cap gets tougher.

If a company like AstraZeneca does come to the table with an acquisition, I'd be surprised if it's willing to pay much in the way of a premium. If not, negotiations could stall until early sales data comes in. Another option, however, might be for AstraZeneca to ink a deal that contains an option to buy MannKind later. Regardless, there's no indication AstraZeneca has any plans to link up with MannKind, so investors will have to wait and see.

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Todd Campbell has no position in any stocks mentioned. Todd owns E.B. Capital Markets, LLC. E.B. Capital's clients may or may not have positions in the companies mentioned. Todd owns Gundalow Advisors, LLC. Gundalow's clients do not have positions in the companies mentioned. The Motley Fool has no position in any of the stocks mentioned. Try any of our Foolish newsletter services free for 30 days. We Fools don't all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.

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