ADA Day Three
As has become the custom here at the ADA, Monday is investment day when the analysts swoop down from New York to see what’s new in the world of diabetes. Here’s a taste of what DI experienced:
1. While there wasn’t a great deal of news in the insulin pump world, DI has learned that Smiths Medical is set to upgrade their Cozmo system. Scheduled to be released in the fall, Cozmo users will be required to go online, pass a test and then send their pump to the company which will be replaced with a brand new pump. According to the company the hardware itself will not be updated, instead the upgrade is software related.
DI wonders how users will react to this type of upgrade and whether or not it will prompt Cozmo users to examine alternatives. With the OmniPod now available and the Paradigm® REAL-Time approved the hassle of passing a test and then waiting for a replacement pump could backfire on Smiths. Although the company would not provide any details on the upgrade and wasn’t even sure if it would be ready by the fall, DI doubts any software improvements will match the advanced technology of the OmniPod or Paradigm® REAL-Time. DI sees this as the beginning of the end for the Cozmo.
2. With all the interest in continuous glucose monitoring (CGM) for people with diabetes, there is an even greater opportunity in the hospital market, in particular in the Intensive Care Unit (ICU). This has prompted several CGM upstarts to revise their efforts from concentrating on diabetes and move towards developing a system for hospitals. An environment with more favorable reimbursement prospects. The majority of these companies are concentrating on adapting their existing systems for a hospital ICU unit.
One company has developed an innovative concept that uses existing and accepted technology but with a twist. Since the publication of the Portland Protocol, hospitals across the country are adapting this or similar protocols. As part of this protocol ICU nurses collect hourly glucose readings, while the meters are slightly different than what’s available to the consumer, the procedure remains the same. That is, each hour the nurse uses a finger stick to gather the blood and results are recorded on a meter. Glucon has developed an interim device to CGM, which automates the glucose monitoring. Instead of the nurse collecting glucose readings each hour the patient is hooked up to an automated blood glucose meter that is hooked up one of the patients IV tubes.
While this is not a continuous monitor, it does save the hospital and nurses valuable time. DI will have much more on this device in Part Two of Devices and Delivery Systems Report.
3. Speaking of CGM, the debate has changed from will the technology work to just how often it will be used. DI has spoken with several early adopters who no longer use their CGM on a regular basis. In essence after 30 to 45 days of continuous use patients have enough information about their glucose trends and have made the necessary adjustments, if any, to their therapy regimen. After this period, the go back to their conventional finger stick meter using the CGM occasionally. DI will have a more detailed revenue model for CGM in our ADA issue which will be published later this month.
4. Looking over these past three days DI was actually a little disappointed in the conference. As expected Exubera garnered much attention, yet it is questionable whether all this attention will turn into commercial success. Based on our physician interviews, while excited by the prospect of no injections, Exubera really isn’t the answer, the basic feeling among physicians was, great concept but too many unanswered questions.
5. While both Merck (NYSE:MRK) and Novartis (NYSE:NVS) will have more information on their respective DPP-4’s, neither looks to be a major commercial success.
6. Amylin (NASDAQ:AMLN) remains the darling of the diabetes world and for good reason. Besides Byetta and the long-acting version of Byetta, the company has an impressive pipeline in obesity and has built an equally impressive group of researchers. With a firm tailwind at their backs Amylin is the most valuable property in the diabetes space.
DI will have a more detailed assessment of the ADA in out recap issue which will be published later this month. In addition Part Two of Devices and Delivery Report will contain even more detailed information on this exciting market.