A Disturbing Trend
From time to time Diabetic Investor reviews
the FDA’s Maude database to see if any trends are developing in the insulin
pump world. Given the increasingly competitive nature of this market Diabetic
Investor has become concerned that insulin pump patients aren’t receiving the proper
amount of training on how to effectively use their pump. Based on various field
reports insulin pump sales reps are spending less and less time training
patients. While we understand their primary objective is to sell more systems,
patient training is also part of their job description.
Looking over the most recent batch of
adverse event reports from the major insulin pump companies our fears have been
confirmed as there are numerous reports of insulin pump patients experiencing
hyperglycemia (this is the exact opposite of hypoglycemia when the patients experiences
low blood sugars). While it would be an overstatement to say that all of these
events were a direct result of poor training or pump malfunctions, this trend
This trend should send a signal to all
investors who believe that the many companies seeking to enter this already
over-crowded market can be commercially successful just by building a system.
It is not an overstatement to say that building the system is the easiest step;
the real test comes in selling and supporting the system. This is also the most
expensive part of the process.
Recently Diabetic Investor has examined
several of these new companies and has found their systems to be interesting,
yet when asked how they plan to handle the complex process of selling and
supporting these systems their answers are weak at best. Most seem to believe
that can save money by automating the training process and by making their
systems “smarter”. Just as glucose monitoring companies have become overly
dependent on new technology, insulin pump companies have taken this addiction
to new technology to even greater heights.
The fact is no matter how “smart” the systems
pretend to be, there are humans who use them. Humans who need to understand the
many nuances to insulin pump therapy. While insulin pump companies will argue
this point, insulin pump therapy from the perspective of outcomes isn’t that
much different than a patient well trained on multiple daily injection therapy.
The reality is insulin pump therapy is
more of a lifestyle choice.
This is why training is critical to a pump
patient. Unlike an MDI patient who does not have to worry about their insulin
delivery system malfunctioning or inclusions from an improperly inserted
cannula, pump patients have a host of concerns. Just ask any pump patient, not
using an OmniPod, how many times their tubing has become entangled or how often
they’ve accidently pulled off their infusion set. This does not mean OmniPod
patients are exempt from issues as Diabetic Investor has experienced first-
hand pod failures.
Insulin pump therapy can be an excellent
therapy option when the patient is properly trained. Too often these patients
are not receiving the proper training which leads to serious adverse events and
greater overall healthcare costs. In the convoluted world of insulin pumps
where pump companies are constantly looking for ways to lower costs, one just
might think these geniuses would figure out that they just might be able to
lower their support cost with better training. That better training just might
stop those constantly complaining patients from calling their customer support lines.
To Diabetic Investor this is the biggest
problem of all, in that, the people running these companies are either
engineers or bean counters who don’t the slightest clue what’s it’s actually like
to be an insulin pump patient. The open disdain these people have for their
customer base is astonishing. They sit around complain about those pesky
patients who they believe have nothing better to do than to complain about their
This disdain can also be seen in some of
the new products that are being developed. Rather than acknowledge that a
system is designed so it can sold at profit, they continue to spew the
corporate BS that their design is actually better for the patient. Diabetic
Investor has no problem whatsoever with these companies making a profit, after
all this is America and we’re not a socialist country, at least not yet. But to
claim that’s it better for the patient to have to perform multiple steps before
they can even use these systems is the height of hubris.
Is it any wonder that this disdain has
filtered down to the sales teams who are constantly being hit with higher sales
quotas. As Diabetic Investor has pointed out before one of the most difficult
jobs in diabetes is being an insulin pump sales rep. Besides putting in an 80
work week, it’s not uncommon for these reps to work weekends and receive phone
calls in the middle of the night from those pesky constantly complaining
Back in the day there were some truly great
people running these companies, people who understood just how complex insulin
pump therapy can be. They understood that it was the patient who came first.
They did not ignore the bottom line, rather they understood that you can treat
the patient with respect and still make a nice profit. Sadly those days are a
thing of the past and the attitude appears to be; damn the patient let’s make
Let’s hope that besides developing newer,
better systems that these newcomers also bring with them a better attitude.
Perhaps that would make the established wake up and realize that how you treat
the patient actually matters and can have a positive effect on the bottom line