When a company reports a big loss that's worse than what analysts expected, you expect the stock to go down. That's exactly what happened with MannKind Corporation (NASDAQ:MNKD) After the market closed on Tuesday, the biotech reported a third-quarter loss of $32.9 million, or $0.31 per share -- well below analysts' estimates. And MannKind stock opened on Wednesday 10% below its previous close. That's not surprising.

This loss and the market reaction don't mean much at all for what the future might hold for MannKind. There were several things in the company's third-quarter update that will likely impact what happens next, though. Here are five things that you don't want to overlook -- one of them that indicates things will get worse for MannKind, and four that could mean things will get better.

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Things will get worse

1. Upcoming stockholder vote

MannKind CEO Michael Castagna said in the company's third-quarter conference call that there will be a special meeting of stockholders on Dec. 13, 2017. In this meeting, stockholders will vote on increasing authorized shares by 140 million.

With MannKind only having cash and cash equivalents of $20.1 million at the end of the third quarter, expect stockholders to approve the issuance of more shares. While the move would help ensure that MannKind stays afloat, it also would mean more dilution of existing shares is on the way. We're not talking about just a little dilution, either: MannKind currently has under 106 million shares outstanding.

Things will get better

2. Improved bottom line in the fourth quarter

Sometimes math can be pretty simple. MannKind provided guidance in August that projected net revenue for the second half of 2017 would be between $6 million and $10 million. In its third-quarter update, the company said that it now expects to hit the low end of that range. MannKind reported net revenue of $2 million in the third quarter, so that implies the company will make around $4 million in the fourth quarter. 

MannKind also now projects to increase its cash burn in the fourth quarter to between $30 million and $32 million. Subtract the high end of that range from the revenue projection, and it translates to MannKind posting a net loss of around $28 million in the fourth quarter. That's still not a good thing, but it would be an improvement from the company's second and third quarters.

3. Label update

The U.S. Food and Drug Administration (FDA) gave MannKind most of what it wanted in early October with significant label revisions for the company's inhaled insulin product Afrezza. Michael Castagna called the label change "a pivotal moment in the history of the company." 

MannKind's third-quarter results didn't reflect this label change. You probably won't see a huge impact in the fourth quarter, either, since the company first had to train its sales team on the new label before they began talking up the changes with physicians. However, the impact of the Afrezza label change in 2018 for MannKind could be significant.

Patrick McCauley, MannKind's chief commercial officer, stated in the quarterly conference call that the sales team has already received early feedback from healthcare providers that was "very encouraging." He mentioned that sales reps are being able to schedule more appointments with healthcare providers who are now "willing to listen" to their message about Afrezza. McCauley said that MannKind's top sales priority is emphasizing the label changes.   

4. TV commercials

Marketing studies conducted by MannKind have shown that 98% of diabetic patients aren't aware of Afrezza. Once they're made aware of the availability of the inhaled insulin, though, they tend to be very interested. MannKind dipped its toes into the water of promoting Afrezza on television with its sponsorship of the cable TV show Reversed earlier this year. Now, though, the company is expanding its TV campaign.

McCauley said that MannKind will air TV commercials for Afrezza in nine targeted markets. The commercials will air on news programs such as 60 Minutes, talk shows like Ellen and Dr. Phil, sports events including NASCAR races and NFL games, as well as entertainment programs on cable networks A&E, Travel Channel, and TNT. 

Although MannKind will spend millions on this campaign, it could pay off. Afrezza is the type of product that should benefit from direct-to-consumer marketing. Castagna said that investing in TV advertising has been a matter of "when, not if." 

5. Managed care contracts

Castagna said that MannKind's top priority with managed care companies is removing the requirements for prior authorizations of Afrezza. The good news is that Castagna mentioned that the FDA label change for the product has spurred some managed care organizations to reevaluate their earlier policy decisions for Afrezza.

He stated that MannKind feels good about its discussions with multiple payers on relaxing hurdles for patient access to Afrezza. Castagna doesn't expect the product to become the preferred brand for most payers, but the company is "happy being covered," adding that "it's only going to get better."

Overall outlook

So are things getting better or worse for MannKind overall? I think you have to differentiate between the stock and the business and between the short term and the long term. 

In the short term, the stock price will suffer with a significant amount of dilution. However, the stock offering behind that dilution will allow MannKind's business to march forward. MannKind still has an uphill battle, for sure, but the company appears to be in better shape now to convince payers, physicians, and patients about the benefits of Afrezza than it's been in the past. However, it remains to be seen if better will be good enough.

Keith Speights has no position in any of the stocks mentioned. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.