You know the old saying: "If at first you don't succeed, try, try again."

That's exactly what MannKind (MNKD -4.76%) is doing. The biotech's CEO Matthew Pfeiffer talked about a new plan for the company in 2017 at the J. P. Morgan Healthcare Conference last week. What is this new plan -- and will it work?

Image source: Getty Images.

Plan C

MannKind's first approach for gaining commercial success for inhaled insulin drug Afrezza was to partner with a large pharmaceutical company. When French drugmaker Sanofi (SNY -2.69%) signed a deal to market Afrezza, it seemed like MannKind's plan just might succeed. 

However, those hopes were dashed early last year when Sanofi pulled the plug on the deal following disappointing sales for Afrezza. MannKind was forced to go to a "plan B" -- marketing Afrezza on its own. The company regained marketing rights to the drug in April 2016.

With this backup plan, MannKind used an outside contract sales force. There can be problems associated with relying on an external sales team, and MannKind seems to have experienced some of them. As a result, Matthew Pfeiffer said at the J. P. Morgan conference that MannKind will more than double its in-house sales team and discontinue using contractors.

MannKind now appears to be turning to "plan C." Not only is the company changing its strategy by beefing up its internal sales team, MannKind also intends to begin direct-to-consumer marketing for Afrezza, including airing a television commercial that's currently in production and potentially sponsoring a reality TV series.

In addition, Pfeiffer said that the company is working hard to sign contracts with managed care organizations. He mentioned that MannKind already has gained formulary access for Afrezza with Aetna (NYSE: AET) and Express Scripts (NASDAQ: ESRX).

He also stated that MannKind is looking to expand internationally. Regulatory filings are planned for several countries, including Australia, Brazil, Canada, and Mexico.

Evaluating the plan

Let's evaluate MannKind's new plan item by item. First, pulling sales in-house appears to be a good move. If Afrezza has any chance of commercial success, MannKind needs to be able to effectively control its message and direct sales efforts.

What about the cost of adding sales staff? Pfeiffer indicated that the additional expense won't make as big of an impact as you might think. MannKind won't have to pay for the contract sales team and is using stock options as financial incentives to attract sales professionals.

Direct-to-consumer marketing has worked well for other companies. It's possible that MannKind will see good results. Afrezza is the kind of product for which, at least in theory, you'd think raising patient awareness could pay off. Pfeiffer said that the company is going to try direct-to-consumer marketing on a more limited basis first to see how it works out. That makes sense.

Reaching out to managed care payers seems to be a no-brainer. Sanofi wasn't successful at signing any managed care deals, but MannKind appears to be making good progress on this front. Pfeiffer said that the company isn't having to give huge discounts to gain access to formularies with the pricing environment changing.

Diabetes isn't on the rise just in the U.S., so obtaining regulatory approval in other countries should be a positive step for MannKind. Pfeiffer admitted that the company got off to a slower start on this front, adding that some entities were waiting to see if MannKind survived.

Will it work?

MannKind appears to be making several good steps with its latest plan. However, whether or not the plan will actually work remains to be seen. I will hand this to Matthew Pfeiffer and his team, though: They're doing some things that Sanofi should have done and in ways that are relatively cost-effective. 

Probably the biggest concern for MannKind is having the time for its plan to pay off. The company reported $35.5 million in cash and cash equivalents at the end of the third quarter of 2016. Its cash position is bigger now with the $30.6 million received from Sanofi recently. MannKind also can borrow another $30.1 million from The Mann Group and can sell $50 million of its stock through an existing arrangement.

It's too early to know if MannKind's plan will work or not. But the company is certainly trying, trying again.