'Reversed' is not your usual reality TV show.

Shot in Montego Bay, Jamaica, the show boasts opportunities for type 2 diabetic participants to restore their health. It follows them over eight days where they will learn to exercise, eat right and bare their struggles in cathartic therapy sessions.

Their host, Charles Mattocks, is a smooth-talking entrepreneur, who has used his family fame (his uncle was Bob Marley) and his own medical history (diet and exercise to manage diabetes instead of insulin) to portray himself as a guru to diabetics everywhere.

But 'Reversed' seems unlikely to take off, with no competition at all and the only goal, to turn the participants' health around with education on reading nutritional labels to recognising a safe range for blood sugar levels.

The show that airs next month, is obviously a way for Mattocks to advocate his methods of self-help and a season-long advertisement for a luxury getaway at the sparkling resort. But it is also a marketing gambit by a pharma company that may face bankruptcy.

"A huge waste of money" investors say

Drug manufacturer MannKind has been cashing out millions of dollars each month. It only has one product, Afrezza, ̶ an inhalable form of insulin ̶ which is only used by 3,000 patients ̶ and recently announced that it would be bankrupt before the end of this year.

“We don’t have a ton of cash. As a small company who’s building, you gotta think differently and you gotta be more creative,” said Michael Castagna, who was promoted last week to CEO of MannKind.

He says that the expenditure is less than the annual cost of keeping a typical employee on staff to sponsor the TV show. Plus, it allows MannKind to target a very specific audience: people with diabetes who are likely to be in the market for insulin.

One would expect Afrezza to be used by the participants, but none of them are, and it is unclear if the inhaler will be mentioned in the show itself. Rather, MannKind only gets 60-second ads during commercial breaks throughout the 10-episode debut season. Many analysts think it is a bad choice.

"It's a huge waste of money," said David Kliff, who has type 1 diabetes and publishes the newsletter Diabetic Investor. "I don't get it. It dumbfounds me."

The downfall of MannKind

"Reversed" cast members sign a "contract" promising to stick to healthy habits for managing their diabetes. Photo credit: Alissa Ambrose/Stat News

But MannKind is desperate.

Three years ago it got approval to market Afrezza to both type 1 and type 2 diabetics, even pharma giant Sanofi signed on to market the product and analysts said it had blockbuster potential.

However, there was no market traction. Many insurers refused to cover it, and those that did, made it more expensive or put restrictions in place on when it could be prescribed.

Doctors were not confident of the product as it did not prove to be better than conventional injectable fast-acting insulin. Many patients did not know of its existence either.

It only went downhill for MannKind. Early 2016, MannKind saw another devastating blow: Sanofi bailed on the marketing deal, leaving MannKind struggling to distribute the product on its own, with the company's stock in steady free fall.

So it is not surprising when Castagna agreed to sponsor a new show that focused on diabetes.

"It's definitely a PR problem that they have," said Amy Tenderich, a patient advocate who said she sees the MannKind sponsorship as a "creative way" to reach out to potential customers.

Flip or flop: Will the "creative way" work?

Indeed a "creative way", as the norm in the pharmaceutical trade includes promotion of their products through patient groups, students and internet chatrooms often for drugs to get around the ban on limited advertising to doctors only.

Even when advertising to doctors, they often offer incentives to prescribe and promote drugs including kickbacks, gifts, free samples and consulting agreements.

Some companies pay specialised medical communication agencies to recruit and train leading doctors, specialists and academics as "key opinion leaders" to promote drugs to other doctors through presentations, research papers, discussions and debates.

While some were enthusiastic and looking forward to see how MannKind would fare with this deal, others are skeptical.

Too little, too late, a commenter on an online investor complained. Others question whether MannKind was targeting a large enough audience as the channel it airs on, Discovery Life only average 88,000 viewers per night during prime time.

Castagna remains confident, saying that the sponsorship also had "nothing to do with whether or not we survive, or do well, or fail", but he's confident they'll make it. MIMS

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